[afro-nets] Integrating Equity into Health Information Systems

[Claudio SChuftan <claudio@hcmc.netnam.vn>]

From: Ruggiero, Mrs. Ana Lucia (WDC)

Integrating Equity into Health Information Systems
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Health Metrics Network, World health Organization, May 2005

Available online at:
http://www.who.int/healthmetrics/library/issue_3_05apr.doc

"...Improving the ability of health information systems (HIS) to
support efforts to address health-equity challenges should be
viewed as a core objective. Inequities in health, its key deter-
minants (including access to health care) and in the conse-
quences of ill health occur among populations as a result of un-
fair discrimination based upon socioeconomic and other societal
factors. There is a growing recognition of ongoing and often in-
creasing health inequities both in developed and developing
countries. Despite this recognition, health information systems
continue to lag behind in terms of providing the information
needed to assess and address health inequities. Without empiri-
cal demonstrations of such inequities, as well as a country-
level capacity to use this information for effective planning,
movement towards equity is unlikely to occur.

The deficit in information on inequities both between and within
countries has been partly maintained by the historic structure
of the HIS in which data analysis by equity-related stratifiers
is usually not possible, and different data sources cannot be
linked. Global leadership has also been slow to address this
problem, though attention at the global level has increased in
recent years. The challenge now is to determine the information
needs for addressing health inequities; to shape health informa-
tion systems to meet those needs; to promote sensitization to
equity issues; and develop the skills required to use informa-
tion for effective planning and policy-making.

In addition to increasing the availability of various data
sources within countries, improvements need to be made in terms
of the equity-relevant information included in those sources. To
assess health equity adequately, equity indicators must be con-
structed. This requires having both a health measure (or measure
of determinant of health) as well as an equity stratifier (such
as a measure of socioeconomic position, sex, age, ethnic-
ity/race, and/or geographical position), and the ability to dis-
aggregate information according to these stratifiers.

This can be accomplished either by ensuring that appropriate eq-
uity stratifiers and health measures are available in each data
source, or by creating mechanisms to link records between data
sources. For example, effective linkages can be created by in-
cluding a unique identifier or geographical code in a variety of
data sources..."

Integrating Equity into Health Information Systems
TABLE OF CONTENTS
1. OVERVIEW
2. health equity indicators
§ 2.1: General considerations

§ 2.2: Criteria and rationale for selecting health-equity indi-
cators
§ 2.3: Measuring health status and determinants
§ 2.4: Measuring social position and stratification

3. Recommended measures of health status and health determinants
§ 3.1: Health status measures
§ 3.2: Measures of determinants of health
§ 3.3: Measures of health care
§ 3.4: Measure of social and economic consequences of ill health

4. Linking equity-relevant data between information sources
5. Assessment of what is needed and recommendations
6. Encouraging a culture of equity in health
7. References