Strengthening health information systems: Policies, gaps, and a framework for reform

This paper integrates three studies that collectively assess the current state of the health information system (HIS) in the Philippines and identify strategic directions for its strengthening. In the first paper, we examine the critical role of the HIS across the health system, emphasizing the challenges and opportunities associated with digitalization. Using a mixed-methods approach, we evaluate the HIS through a process-people-product framework in the context of key health sector actors: regulators (government), purchasers (PhilHealth), providers (health workers and facilities), and consumers (patients and communities) - and analyze how these interactions influence data generation, use, and decision-making. In the second paper, we focus on the technical and technological design of the Department of Health's HIS. Drawing on an extensive review of existing literature and policies, we identify systemic barriers to interoperability and effective data management. Our analysis reveals deficiencies in data standardization, the limited adoption of interoperable platforms, and fragmented data management practices. We recommend the adoption of national data standards, migration towards a centralized data warehouse, and enhancement of data governance to improve accessibility, security, and utility. Building on these findings, our third paper proposes a monitoring and evaluation (M&E) framework to assess health system performance as a determinant of health. Drawing from international frameworks, we situate the Philippine health system within the context of ongoing universal health care reforms. The proposed framework highlights key performance dimensions, such as quality, efficiency, responsiveness, and equity, and underscores the need for a robust HIS to generate high quality data for continuous system monitoring and accountability.