Health Metrics Network (HMN)

HMN provides technical and financial support to countries to strengthen their health information systems (HIS). (A country-level HIS comprises the multiple sub-systems and data sources that together contribute to generating health information, including vital registration, censuses and surveys, disease surveillance and response, service statistics and health management information, financial data, and resource tracking.) However, HMN is not primarily a fund; its role is to draw on the strategy of partnership to provide technical inputs and catalytic financial support in an effort to enable countries and partners to convene stakeholders, develop plans, mobilise resources, and ensure assessment and monitoring of progress. Communication comes into play both in the way that HMN shares information about health information - e.g., by using information and communication technology (ICT) - and, on another level, in the range of activities and projects that HMN supports.

Available in 6 languages, the Health Metrics Network website is the first stop for sharing information about HIS issues and challenges - for partners, potential recipients of HMN support, and the general public. HMN newsletters, monthly updates, videos, brochures, and press releases detail the rationale behind HMN, and the framework and strategy that underpins this initiative. For example, organisers explain on this website that HMN places a key focus on research, since they have detected a lack of information on the relative strengths, usefulness, feasibility, and cost effectiveness of different data collection approaches (resulting, they say, in "a plethora of separate and often overlapping systems. Too often, inappropriate use is made of particular data collection methods, for example, the use of household [surveys] to produce information on adult mortality").

Developed in response to these observations, the HMN framework [PDF] is a process of collaboratively defining the systems needed at country and global levels - along with the standards, capacities and processes for generating, analysing, disseminating, and using health information. That is, participation is a key strategy, in that HMN works to link the normative framework for measurement in health with participatory assessment, planning, and implementation processes that are objective, transparent, and inclusive. This exercise is designed to focus the inputs of all stakeholders around a country-owned plan for health information development. Along these lines, HMN support to countries is predicated on the principles of country leadership and the linking of HIS development with broader efforts to enhance national statistical capacities according to mutually agreed-upon standards.

A central means of fostering this participation in building a strong HIS is the hosting, on the part of HMN, of in-person events. For instance, in April 2007, an HMN Technical Officer travelled to Damascus, Syria to consult with Health Ministry officials Damascus in an effort to: assist in coordinating HIS stakeholders and to strengthen collaborative mechanisms; develop a legal framework for health information; and build capacity for data management, analysis, and use. HMN also designs workshops, such as a 4-day workshop in March 2007 in Vietnam attended by 6 Asian nations committed to revamping the way they compile health care information. This workshop focused on the HMN assessment and monitoring tool, which is designed to help countries compare their performance against objective standards for health information. The tool, which consists of a standardised questionnaire to be completed by country stakeholders, provides a baseline assessment, as well as a means of diagnosing critical gaps in health information results, processes, context, and resources.

For example, at a workshop in Copenhagen, Denmark, HMN and the Armenian government signed a letter of agreement to assess and reform the HIS in that country - using both HMN's framework and assessment tool. Partnership is, again, a key theme here; the first step will involve convening high-level stakeholders from within the Armenian government, local non-governmental organisations (NGOs), and international bodies.

Health.

HMN is built on the premise that information is essential for public health action: it is, according to those who built the partnership, the foundation for policy making, planning, programming, and accountability. Organisers believe that "Health information is not simply an end in itself, but provides the foundation for better health. Thus, it matters not just to policy-makers and epidemiologists, but also to communities and health care providers. Unfortunately, sound information is rarely available in low-income developing countries due to under investment in health information systems (HIS) that are essential for data collection, analysis, dissemination and use. Today, countries face unprecedented demands for reliable and timely health data to support decision making, especially in the context of health sector reform. Sound data are needed to ensure accountability for resources and to meet global challenges such as the Millennium Development Goals (MDGs)."