Diversity of Health Information Systems in Developing Countries

The need for harmonization in planning and implementation

31 July 2013

Phnom Penh, Cambodia Following on from the webinar “ICT to support Social Health Protection” organized by GIZ Bangladesh and the Joint Learning Network in October 2012, CIM expert Michael Stahl proposes in this article that harmonizing health information systems should be a priority for technical assistance for social health protection.

Many de­vel­op­ing coun­tries in Asia, such as Vietnam, Laos, Indonesia and the Philippines, have already introduced social health insurance schemes to different extents, but are now dealing with highly fragmented IT applications among health care implementers. The same issues are found in several African coun­tries.

Other de­vel­op­ing coun­tries have yet to implement health insurance programmes, or are in the final planning stages, and their governments would like to avoid making the same mistakes as neighboring coun­tries. Cambodia, Bangladesh and Nepal are good examples of countries, which are beginning technical implementation of social health insurance systems.

In addition, planning and experimentation of these systems are happening in isolation within each coun­try, when viable solutions may already have been developed in other coun­tries. Apart from many practical concerns in achieving health care goals in de­vel­op­ing coun­tries, one of the main issues is the use of information technology (IT) in health services, and the lack of harmonized approaches in planning, de­vel­op­ing and implementing IT solutions for social health protection implementation.

This paper focuses on the operational side of social health protection implementation in de­vel­op­ing coun­tries, explaining how harmonization of social health insurance schemes benefits all stakeholders, and describing how monitoring and evaluation activities can be unsuccessful or lead to wrong results. The relationship between improperly working operational aspects of data management, and the difficulties that arise from this situ­a­tion, are also examined. Lastly, the reasons for high fragmentation rates among social service implementers are discussed.

Please find the GIZ discussion paper here