Paving the path to national health observatories in the African Region

Health observatories contribute to improve the availability, quality and use of information and evidence for policy and decision-making by strengthening health information systems. Several countries in the African Region have in place or are at different stages of planning, developing or implementing their National Health Observatories (NHO).

Credit: WHO /Fid Thompson.

The NHO concept, as a space to gather, store, manage, analyse, and timely broadcast quality and reliable health information about a community or health services started flourishing in the 70s.

As information technology platforms designed to facilitate multistakeholder collaboration and partnership, NHOs can serve as one-stop-shop for the best available information and provide tools to strengthen the monitoring of health status and trends.

NHOs can also play a major role in stimulating national research capacity, and narrowing the gap between researchers and policy makers by promoting both an intense and smooth working collaboration.

NHO guidelines

With the African Health Observatory (AHO) support, several countries in the Region are developing their own national health observatories in order to reinforce their health information systems. Other countries intend to follow the same path.

AHO is developing guidelines to support countries in the NHO implementation process. The draft guidelines were presented at the AHO Expert Consultation held in Brazzaville, Congo, in April 2014.

The NHO organizational model may vary according to the country´s population density and geography, administrative divisions, the health system and health information system structure, and similar or related health services already in place (if any). 

It is also crucial to take into consideration the political, economic, health, cultural and social contexts, which often differ widely from country to country.

The structure of the NHO should remain flexible, with a minimum common ground to allow for data comparability within the Region and beyond.

Examples in the Region

Algeria  has had 5 regional health observatories since 1995. This regional structure was seen as the one that best fits the country’s geographic profile. The aim is to assure territorial and social balance, as well as a participative and proximity approach. The Algerian health observatories produce several tools, like health regional monographs, surveys, etc.

With the AHO support, Cabo Verde has been working on its pilot project for the last three years. The Cabo Verde NHO will work on the grounds of the islands health observatories and the national surveillance system. The required IT infrastructure and information workflow is working, therefore the team expects to launch it online soon.

The Cameroon has also been developing its NHO since 2010. Following the country’s health structure, the NHO has several functions, including health surveillance and alert, data collection, storage and analysis. It also contributes to the definition of health programmes monitoring and evaluation indicators.

The Congo has already its NHO prototype online. The project is making its first steps on the web, after the preliminary phase where the data managers along the national health information system were identified (in hospitals, health departments and districts), equipped with the necessary modem to be used for the data transfer, trained and linked in a network with specific roles and duties assigned.

Rwanda is also working on the construction of its NHO. The country’s NHO prototype will be based on the AHO layout with a light customization. The best way to link the NHO with the country’s health information system is now being considered.

Seychelles is in the process of planning a NHO. Due to the country’s social and geographic profile (no great disparity in health status within regions), the prospect is to have a single observatory that covers the entire country. The future NHO should be integrated under the current Ministry of Health (MoH) structure, preferably within the public health authority.

Sierra Leone is working towards the implementation of a NHO. The country decided to have a single NHO placed under the MoH umbrella. So far the project has enjoyed great political and partners support, which has enabled a multisectoral approach and reassemble all district and programme data to produce a national report.

Countries like Burkina Faso and Mauritania have already indicated their interest in developing a NHO.

Useful resources

African Health Observatory
Summary [In English] [In French]
Health observatories around the world
Presentation – part 1
Presentation – part 2
Global Health Observatory
Official website
European Observatory on Health Systems and Policies
Official website
Health Information and Intelligence Platform for the Western Pacific
Official website
Africa Health Workforce Observatory

Other resources

Strengthening the monitoring of progress on the health-related MDGs in the African Region, The African Health Monitor, issue 11
The African Health Observatory: Opportunity for strengthening health information systems through national health observatories (Document AFR/RC62/13)
Towards more effective National Health Information Systems in the WHO African Region