PRISM framework: a paradigm shift for designing, strengthening and evaluating routine health information systems

• Published in: Health policy and planning Vol. 24; no. 3; pp. 217 - 228
• Main Authors: Aqil, Anwer, Lippeveld, Theo, Hozumi, Dairiku
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01.05.2009; Oxford Publishing Limited (England)
• Subjects: Accountability; Advisors; Behavioural aspects; culture of information; Data collection; Decision making; Developing Countries; Disease; Evaluation; Health care industry; Health information; health management information system; Health policy; Health promotion; health system performance; Humans; Immunization; Information; Information dissemination; Information Management; Information systems; Information Systems - organization & administration; Information Systems - standards; Knowledge management; LDCs; Learning; learning organization; Management information systems; Original; Original articles; Quality Control; Routine health information system; Statistical analysis; Studies; Systems development; Total quality; Routine health information system; health management information system; culture of information; learning organization; knowledge management; health system performance
• ISSN: 0268-1080; 1460-2237
• DOI: 10.1093/heapol/czp010

The utility and effectiveness of routine health information systems (RHIS) in improving health system performance in developing countries has been questioned. This paper argues that the health system needs internal mechanisms to develop performance targets, track progress, and create and manage knowledge for continuous improvement. Based on documented RHIS weaknesses, we have developed the Performance of Routine Information System Management (PRISM) framework, an innovative approach to design, strengthen and evaluate RHIS. The PRISM framework offers a paradigm shift by putting emphasis on RHIS performance and incorporating the organizational, technical and behavioural determinants of performance. By describing causal pathways of these determinants, the PRISM framework encourages and guides the development of interventions for strengthening or reforming RHIS. Furthermore, it conceptualizes and proposes a methodology for measuring the impact of RHIS on health system performance. Ultimately, the PRISM framework, in spite of its challenges and competing paradigms, proposes a new agenda for building and sustaining information systems, for the promotion of an information culture, and for encouraging accountability in health systems.