Inventory of PRISM Framework and Tools: Application of PRISM Tools and Interventions for Strengthening Routine Health Information System Performance

Download this publicationFacility-based routine health information systems (RHIS) support health services managers and providers in their daily decision making and enhance the efficiency and innovation in the delivery of quality health services. Unfortunately, as shown by various studies, RHIS in most developing countries produce low quality data and the use of information for planning and management of the health services is weak. In the past 10 years, the USAID-funded MEASURE Evaluation project has undertaken a major effort to strengthen RHIS in developing countries.

By the end of 2012, 23 countries throughout the world had applied the Performance of Routine Information System Management (PRISM) tools to assess the performance of their routine health information system (RHIS) at different levels and to guide the RHIS strengthening process. For the first time, a baseline for RHIS performance is now available in many countries: data quality ranged between 34% and 72%; and use of information between 30% and 53%.

This paper documents past and current use of PRISM tools and subsequent interventions to improve RHIS performance at all levels. It also explores opportunities to expand the use of the tools and to better adapt them to specific purposes and
country contexts. In addition, the paper describes the conceptual framework on the determinants of RHIS performances
and effectiveness of strategies to improve the system.

Some of the root causes for the low RHIS performance found in the inventory include the lack of standardization of the
data management processes as well as the absence of an information culture. The RHIS improvement interventions
resulting from these assessments ranged from national HIS reforms to capacity building in use of information. PRISM
assessments after intervention in China, Cote d’Ivoire, and Mexico have shown substantial improvements in RHIS

The examples shared in the paper highlight the RHIS permanence in various countries at different administrative levels,
efforts made to address identified gaps, and some observed progresses. Researchers are encouraged by preliminary
findings of PRISM assessments conducted after intervention show encouraging results, supporting the value of the use of
the PRISM tools. (JSI, 2013)

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