The PRISM framework identifies strengths and weaknesses in RHIS performance and bridges the gaps, leading to improved health system performance. Routine health information systems (RHIS) attempt to produce timely and quality information about what is happening in health sector organizations. Ideally, this information is used to guide day-to-day operations, track performance, learn from past results, and improve accountability
Health systems strengthening has become a top priority of many global and national health agendas as a way to improve health outcomes. With the global health context becoming increasingly complex, national health systems are beginning to move away from a focus on disease-specific health responses to comprehensive strengthening of health systems. This paper will discuss the unique role of health data in strengthening the other five building blocks of health systems; define specific interventions to strengthen the use of data in decision making; and provide a framework for developing, monitoring, and evaluating interventions to improve the use of and demand for data.
PRISM Framework and its tools applications have expanded since 2004. Now it has been applied in Pakistan, Uganda, South Africa, Mexico, Paraguay, Honduras, Haiti, China and Cote d’Ivore for assessment and evaluation. It has been applied in diverse countries of Africa, Asia, Latin America and Caribbean continents. While these applications showed the strengths and appropriateness of PRISM Framework and its tools in identifying strengths and weaknesses of the routine information systems, they brought some challenges to attention. First, to make a distinction between RHIS performance indicators – accuracy, timeliness and completeness, from their counterpart processes. Second, to keep minimum variables in various tools for triangulation of information to avoid respondent’s burden of filling the details. Third, better measurement of use of information. Thus, there was a need to revise the PRISM tools. Uganda PRISM evaluation in 2007 for testing its reliability and validity also helped to make the revisions.
The PRISM framework and its tools have been used in more than ten countries in different parts of the world, from Asia to Africa, and from the Caribbean to Latin America. The user guide meets an urgent need, which has been identified in the field, for capacity building in routine health information sys‐ tems (RHIS) to help professionals use RHIS more effectively.
In recent times of resource constraints, good governance, transparency and accountability have become the mantra of development, and consequently more attention is given to strengthening evidence-based decision-making and information systems. Also, the emphasis on tracking Millennium Development Goals (van Etten et al. 2005) and the practice of performance-based release of funding requested by international funding agencies, such as the Global Alliance on Vaccines and Immunization (GAVI) and the Global Fund to Fight AIDS, TB, and Malaria (GFTAM), require increasing amounts of quality information. This trend is reinforced in the health sector by emerging infectious diseases and environmental disasters, which need timely information for action.
The Health Metrics Network (HMN) was launched in 2005 to help countries and other partners improve global health by strengthening the systems that generate health-related information for evidence-based decision-making. It is therefore intended that by 2011, this Framework and Standards for Country Health Information Systems (the “HMN Framework”) will be the universally accepted standard for guiding the collection, reporting and use of health information by all developing countries and global agencies.