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Ties Boerma

Publications and source records attributed to Ties Boerma.

6 recordsLinked to original sources
PubMed2005

Cost and results of information systems for health and poverty indicators in the United Republic of Tanzania.

OBJECTIVE: To examine the costs of complementary information generation activities in a resource-constrained setting and compare the costs and outputs of information subsystems that generate the statistics on poverty, health and survival required for monitoring, evaluation and reporting on health programmes in the United Republic of Tanzania. METHODS: Nine systems used by four government agencies or ministries were assessed. Costs were calculated from budgets and expenditure data made available by information system managers. System coverage, quality assurance and information production were reviewed using questionnaires and interviews. Information production was characterized in terms of 38 key sociodemographic indicators required for national programme monitoring. FINDINGS: In 2002-03 approximately US$ 0.53 was spent per Tanzanian citizen on the nine information subsystems that generated information on 37 of the 38 selected indicators. The census and reporting system for routine health service statistics had the largest participating populations and highest total costs. Nationally representative household surveys and demographic surveillance systems (which are not based on nationally representative samples) produced more than half the indicators and used the most rigorous quality assurance. Five systems produced fewer than 13 indicators and had comparatively high costs per participant. CONCLUSION: Policy-makers and programme planners should be aware of the many trade-offs with respect to system costs, coverage, production, representativeness and quality control when making investment choices for monitoring and evaluation. In future, formal cost-effectiveness studies of complementary information systems would help guide investments in the monitoring, evaluation and planning needed to demonstrate the impact of poverty-reduction and health programmes.

Health Status Indicators↗
PubMed2005

Health information systems: the foundations of public health.

Public health decision-making is critically dependent on the timely availability of sound data. The role of health information systems is to generate, analyse and disseminate such data. In practice, health information systems rarely function systematically. The products of historical, social and economic forces, they are complex, fragmented and unresponsive to needs. International donors in health are largely responsible for the problem, having prioritized urgent needs for data over longer-term country capacity-building. The result is painfully apparent in the inability of most countries to generate the data needed to monitor progress towards the Millennium Development Goals. Solutions to the problem must be comprehensive; money alone is likely to be insufficient unless accompanied by sustained support to country systems development coupled with greater donor accountability and allocation of responsibilities. The Health Metrics Network, a global collaboration in the making, is intended to help bring such solutions to the countries most in need.

Decision Making↗
PubMed2003

HIV impact on mother and child mortality in rural Tanzania.

Child mortality in Tanzania rose from 137 per 1000 in 1992-1996 to 147 per 1000 in 1995-1999. Impact of HIV on child mortality is analyzed in a longitudinal community-based study in Kisesa ward, Mwanza region. HIV data on 4273 mothers from 3 rounds of serologic testing are linked to survival information for 6049 children born between 1994 and 2001, contributing 10,002 person-years of observation and 584 child deaths. Impacts of maternal survival and HIV status on child mortality are assessed using hazard analysis. Infant mortality for children of HIV-positive mothers was 158 per 1000 live births compared with 79 per 1000 for children of uninfected mothers; by age 5, child mortality risks were 270 per 1000 live births and 135 per 1000, respectively. Fifty-one deaths were observed among child-bearing women, 14 to HIV-positive mothers. Infant mortality among children whose mothers died was 489 per 1000 live births compared with 84 per 1000 for children of surviving mothers. Maternal death effects were statistically independent of HIV status. Allowing for age, sex, twinning, birth interval, maternal education, and residence, the child death hazard ratio for maternal HIV infection was 2.3 (1.7-3.3); hazard ratio associated with maternal death was 4.8 (2.7-8.4). The HIV-attributable fraction of infant mortality is 8.3% in a population in which prevalence among women giving birth is around 6.2%.

Adolescent↗