Interview with Dr. Ramesh Krishnamurthy, new Chief of HMN’s Information Systems and Framework team
On 1 March 2010, Dr. Ramesh Krishnamurthy joined the HMN Secretariat in Geneva to lead the Information Systems and Framework team. Previously Scientist and Senior Informatics Advisor at the Centers for Disease Control and Prevention (CDC) in Atlanta, USA, he brings many years of experience in health and informatics. The HMN communications team interviewed Dr. Krishnamurthy to find out more about his aspirations for the Network and national HIS strengthening efforts.
Interviewer: Dr. Krishnamurthy, welcome to HMN. You have joined HMN at a critical moment, with the Network about to embark on a new strategy for the next five years. Why did you join HMN and what do you bring personally to the Network?
While working at CDC, I travelled to many countries to provide technical support on surveillance informatics. People I met in ministries of health spoke of their need for interoperable systems and standards to enable them to exchange data between various sub-national offices and health facilities. These were not the usual IT specialists but epidemiologists and upper level administrators. Often, when I asked what drove them to focus on interoperability and standards, they referred to the HMN Framework document.
These conversations brought into focus HMN's potential as an agent of change. I think the single most important achievement of HMN is that it has brought the world’s attention to the issues surrounding national health information systems and the need to strengthen them using a framework-based approach.
When I was offered the position as Chief for the Information Systems and Framework team, I felt both elated and humbled. I realized the extraordinary opportunity for me to contribute at a global level towards reliable, sustainable, country- owned, and country-led development of national health information systems.
The founding principles of WHO are central to HMN's mandate, making this partnership strong and steadfast in its goals. So, I feel that it was a fitting opportunity for me to give back to society and be at the forefront of change and leadership for HIS strengthening.
Interviewer: HMN is only as strong as the partners that make up the Network. From your background at CDC and elsewhere, what does HMN need to do to fully engage Network partners and achieve its ambitious goals for national HIS strengthening?
First we need an inclusive and transparent process to identify who the Network partners are and how they can best collaborate to build an effective partnership.
Second, we need to continue to build awareness and use of the HMN Framework. The Framework provides a set of principles and ideas which can serve as a common platform for different Network partner roles and actions.
Third, we need to take the HMN Framework to a level where tools are fully developed in collaboration with partners so that the Framework can be properly implemented at the country level.
In order to do the all of this we need to have a good understanding of the various issues influencing the current state of national HIS development. This will help determine how and where partners can be most effective and have greatest impact.
One important issue relates to governance. Countries are increasingly recognizing the need for reliable data and information to fulfill, for example, the recent International Health Regulation mandates, to assess progress towards the Millennium Development Goal targets, and other national and global goals. Countries also recognize the need for a systems-wide approach to development as well as the need for greater coordination among donors and other partners. Lastly, countries understand the need for sustained investment in HIS, both national and international.
Another issue is capacity. Information communication technologies (ICT) for HIS are not as widely used as paper-based systems. There are not enough trained HIS personnel in countries which restricts both data collection and use at national and sub-national levels. Country HIS assessments have shown that data is not extensively used for public health action at the local level, due in some instances to the poor quality of the data. In addition, the burden of reporting of data on countries is immense.
Interviewer: What do you see are HMN's key achievements since 2005 and what would you like the Network to achieve over the next 5 years?
One of HMN’s major achievements has been to draw attention to the need for stronger national health information systems and to offer a roadmap for countries to help them address this need.
As the only global partnership focused on bringing together a network of partners to strengthen national level health information systems, HMN has helped more than 80 countries to make progress using the HMN Framework and tools. More than sixty countries have conducted HIS assessments and 24 countries have developed fully-costed strategic plans for implementation.
This is no small feat for an organization that did not even exist five years ago.
The next five years will be challenging in a positive way, with the Network focusing on effective partnerships to accomplish a core set of priorities.
We need to encourage coordination of efforts to standardize electronic data collection, appropriate use of ICTs and help countries to harmonize indicators, for example through a centralized indicator registry. We need to support human resource capacity-building and encourage sustained national financing of HIS.
Interviewer: What would be your one wish to improve HIS?
As a pragmatic and practical person, it is difficult for me to share just one wish to improve HIS. At the end of the day, every human life matters and saving lives and improving health outcomes of the citizens of the world means that we need to assist countries develop health information systems that can measure various aspects of expected health outcomes. I believe a framework approach to HIS strengthening is crucial in changing the way information is collected, analyzed and used. When the groundwork is properly laid out and defined, we are one step closer to achieving better health. This is hard to accomplish but HMN has started a framework approach and my wish is to help HMN in the worldwide adoption and implementation of this framework to strengthen national health information systems.