Principles of health information systems in developing countries.

The setting of this article is an all-embracing Health Information System (HIS)* of the type that exists mainly in developing and transition countries. It was inspired by work in Vietnam and other places. The article discusses the basic principles on which a well-functioning HIS needs to rest regardless of the technical means employed (paper, electronic devices). Eleven principles for designing or reforming a HIS are identified, including: explicit description of the underlying units (target population) and variables; no list of indicators to be fixed in advance; only one register per target population; technical coordination between registers and reports; correction algorithms; local use of data and indicators; autonomy of health institutions regarding the information that concerns them; and novel use of registers for various studies. Apart from their technical role, these principles give shape to the philosophy that underlies this article, and make clear that a HIS is not only a tool for collecting indicators; it is intimately tied to clinical and preventive practice, as well as to health management and health economy. In fact, it permeates the entire health system. It can potentially play a much more extended, varied, and useful role than simply that of providing health services to a community.