I. Brief History of HMIS in Cambodia

The Ministry of Health formed the HMIS sub-committee with a remit to create a nationwide HIS in July 1992. HMIS was formally launched in 1993 and complete coverage across the country achieved in February, 1995. Since its inception, the HMIS has undergone a number of separate revisions (see Figure 1.1 for evolution of HMIS in Cambodia). In 1996, the system was revised to accommodate modifications resulting from the introduction of the Health Coverage Plan, which defined the services to be delivered by each health facility. In 1999, minor changes were made to the system to improve key indicator reporting. In 2003, additional indicators required for the monitoring and evaluation by health facilities and national programs were incorporated, and unused indicators were eliminated. In 2009, additional gender and vertical program data were included.  In mid-2010, the existing Access HMIS database was upgraded and migrated over to a web based (PHP/MySQL) database in order to reduce the administrative workload and reporting timeline while at the same time capturing accurate and timely data from all health facilities. The web based HIS application has seen many enhancements and was further developed alongside the feedback from the users resulting in the current HIS 3.0 version since 2015.

II. Strategic Direction HIS from Health Strategic Plan 3 (2016-2020)

The strategic direction sets a long-term broad policy direction for the entire range of health information systems (within both public and private sectors and dealing with health as well as health-related information). It articulates the strategic intent and constitutes the MoH blueprint for the health information systems development for years to come. The strategic direction is a guiding light for decision-makers, managers and health personnel to lead, manage and operate the health information systems, so that everyone in all health institutions at national and sub-national level moves in the same direction, while carrying out their respective activities that are steered towards a common vision. It also provides a framework within which the overall goal, strategic objectives and HIS strategies are formulated. Strategic statements include vision, mission, values and working principles (Figure 3.1). The HIS Master Plan, with clearly defined goal and objectives, along with clearly laid-out strategies, interventions and time bound targets, is developed as a means moving towards achieving the strategic intent of its development, in order to improve health outcome of the Cambodian population through better information, better decision making, better service delivery and better utilization of health services.

III. HIS 3.0 reporting requirements and functionalities

The HIS contains information on routine health service activities and health data from all levels of the national healthcare system. Its main objective is to provide the Ministry of Health and its constituent parts, including referral hospitals and health centers, with reliable and timely information on health indicators and health service activities. This information can then be used to improve program management, planning and resource allocation.
The HIS 3.0 requires all health facilities to capture monthly data into their respective reporting forms (HC1 for Health Centers and HO2 for Hospitals) through the web-based system. As of July 2017, all 117 referral and national hospitals and all 1,191 health centers are reporting into the HIS. There are also 1,661 licensed private or NGO health service providers (hospitals, polyclinics, clinics, maternity clinics and cabinets), registered in the system. More than one-third of these private or NGO facilities regularly report in the HIS. The two HIS reporting forms (HC1 and HO2) aggregate information from out-patient and inpatient services, in addition to information from national programs under the MOH. These including programs run by NMCHC, CENAT, CNM, NCHADS as well as the mental health, dental health and the blood bank programs. The system can generate a report with 56% of the core indicators that are defined in the MOH Health Strategic Plan 3 (2016 – 2020). Data quality is monitored in the system by several tools that allow HIS managers and users to view reports on data completeness, consistency, timeliness and reliability. Each month, all HIS 3.0 users are requested to enter aggregated data corresponding to the previous month. During the first 15 days of the month, users can capture and edit the previous month’s data. Following this period, the system automatically blocks further input and editing. Additional data editing requires permission from the DPHI system administrators in order to prevent data inconsistencies. The figure below illustrates the HIS 3.0 reporting flow throughout the country.