Quelle stratégie pour le renforcement des Systèmes d

Quelle stratégie pour le renforcement des Systèmes d

Quelle stratégie pour le
renforcement des Systèmes
d’Information Sanitaire
Grégoire Lurton
Solthis
Juin 2012
Grégoire Lurton
1 /23
Sommaire
1 De quoi parle-t-on ?
Besoins de données
Architecture
2 La collecte de données
Outils Informatiques
Outils papier
3 Quelle stratégie de renforcement
Grégoire Lurton
2 /23
Système d’Information Sanitaire
-
Inspiré de Mokdad et Lozano (2010)
Grégoire Lurton
3 /23
Système d’Information Sanitaire
-
Inspiré de Mokdad et Lozano (2010)
Grégoire Lurton
3 /23
Système d’Information Sanitaire
-
Inspiré de Mokdad et Lozano (2010)
Grégoire Lurton
3 /23
Besoins de données
Abou Zahr et al. (2007) From Data to policy, Lancet.
Grégoire Lurton
Besoins de données
4 /23
Architecture du SIS
HMN (2008) Framework and Standards for Country Health Information Systems.
Grégoire Lurton
Architecture
5 /23
Architecture
simplifiée
$
'
Définitions
'
$
&
'?
Sources de données
- Analyse des données
&
&
Grégoire Lurton
%
%
'
$
-
Stockage et
diffusion
des données
%
&
Architecture
$
%
6 /23
Sources de données
1
Données administratives
I
I
Grégoire Lurton
Recensement
État civil
Architecture
7 /23
Sources de données
1
Données administratives
I
I
2
Enquêtes
I
I
Grégoire Lurton
Recensement
État civil
EDS
Études épidémiologiques
Architecture
7 /23
Sources de données
1
Données administratives
I
I
2
Enquêtes
I
I
3
Grégoire Lurton
Recensement
État civil
EDS
Études épidémiologiques
Systèmes d’Information de Routine
Architecture
7 /23
Sommaire
1 De quoi parle-t-on ?
Besoins de données
Architecture
2 La collecte de données
Outils Informatiques
Outils papier
3 Quelle stratégie de renforcement
Grégoire Lurton
8 /23
Données aiguës et chroniques
Données aiguës
-
Quantité de données fixe
Charge de travail constante
-
Grégoire Lurton
9 /23
Données aiguës et chroniques
Données aiguës
-
Quantité de données fixe
Charge de travail constante
-
Données chroniques
-
Quantité de données variable
Charge de travail croissante
-
Grégoire Lurton
9 /23
Ce qu’on veut
I
Un système de collecte de données chronique
I
Permet le suivi des patients
I
Permet le suivi des files actives
I
Pas de surcharge de travail au niveau des sites
I
Utilisable dans différents contextes
Grégoire Lurton
10 /23
Papier contre informatique
Système papier
Forces
I
Faiblesses
I
Grégoire Lurton
Possible
partout
I Robuste
Collecte et
analyse des
données au
niveau des
sites
I Charge de
travail
11 /23
Papier contre informatique
Système papier
Forces
Faiblesses
Grégoire Lurton
Possible
partout
I Robuste
I
Collecte et
analyse des
données au
niveau des
sites
I Charge de
travail
I
Système informatisé
Forces
Faiblesses
I
Informatisé...
Besoin d’infrastructures
I Besoin de
ressources
humaines
I Fragile
I
11 /23
Biais des données informatisées
-
Grégoire Lurton
12 /23
Biais des données informatisées
-
6
Perdu de vue
Grégoire Lurton
12 /23
Biais des données papier
-
Grégoire Lurton
13 /23
Biais des données papier
-
6
Pas perdu de vue
Grégoire Lurton
13 /23
Système informatisé - Exemple du Niger
'
Dossier Patient
&
Grégoire Lurton
$
'
-
$
Doublon
%
&
'
-
%
Outils Informatiques
$
Saisie
&
%
14 /23
La question de la saisie
Number of Forms
15000
10000
5000
0
0
60
120
300
600
Time to enter one Form (seconds)
Grégoire Lurton
Outils Informatiques
15 /23
La question de la saisie
Agadez
600
CHA
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120
60
Time to enter one Form (seconds)
0
Dosso
Galmi
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2005 2006 2007 2008 2009 2010 2011 2012 2005 2006 2007 2008 2009 2010 2011 2012 2005 2006 2007 2008 2009 2010 2011 2012 2005 2006 2007 2008 2009 2010 2011 2012
Date
Grégoire Lurton
Outils Informatiques
15 /23
La question de la saisie
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Maradi
Poudrière
Tahoua
Zinder
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1000
800
600
400
200
0
1000
nbresuivi
800
600
400
200
0
1000
800
600
400
200
0
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2006
2008
2010
2012
2006
2008
2010
2012
2006
2008
2010
2012
2006
2008
2010
2012
periode
Grégoire Lurton
Outils Informatiques
16 /23
Résultats des données
Grégoire Lurton
Outils Informatiques
16 /23
Système papier - Exemple de la Guinée
Grégoire Lurton
Outils papier
17 /23
Nouveau Système
I
Dossier patient réservé pour le suivi médical
I
Informatisation progressive là ou c’est possible
I
Mise à jour annuelle de la file active
I
Facile à analyser
Grégoire Lurton
Outils papier
18 /23
Données Guinée
Grégoire Lurton
Outils papier
19 /23
Sommaire
1 De quoi parle-t-on ?
Besoins de données
Architecture
2 La collecte de données
Outils Informatiques
Outils papier
3 Quelle stratégie de renforcement
Grégoire Lurton
20 /23
Évaluation des données
Grégoire Lurton
21 /23
Évaluation des données
Grégoire Lurton
21 /23
Les liens entre S&E et renforcement des
SIS
I
Grégoire Lurton
Quelles incitations adressées aux programmes ?
22 /23
Les liens entre S&E et renforcement des
SIS
I
Quelles incitations adressées aux programmes ?
I
Grégoire Lurton
Afficher des bons résultats
22 /23
Les liens entre S&E et renforcement des
SIS
I
Quelles incitations adressées aux programmes ?
I
I
Grégoire Lurton
Afficher des bons résultats
Améliorer la qualité des données
22 /23
Les liens entre S&E et renforcement des
SIS
I
Quelles incitations adressées aux programmes ?
I
I
I
Grégoire Lurton
Afficher des bons résultats
Améliorer la qualité des données
Quelles cibles fixer ?
22 /23
Les liens entre S&E et renforcement des
SIS
I
Quelles incitations adressées aux programmes ?
I
I
Afficher des bons résultats
Améliorer la qualité des données
I
Quelles cibles fixer ?
I
Proposer de nouveaux outils d’analyse ?
Grégoire Lurton
22 /23
Proposer de nouveaux outils d’analyse des
données
Grégoire Lurton
23 /23
Proposer de nouveaux outils d’analyse des
données
Grégoire Lurton
23 /23