LEPROSY
Leprosy Review
0305-7518
British Leprosy Relief Association
Colchester, UK
17-1182
0305-7518/08/064053+12
10.47276/lr.79.2.171
Original Papers
An evaluation of the Sinan health information system as used by the Hansen’s disease control programme, Pernambuco State, Brazil
GalvãoPaulo Roberto Silva
aFerreiraAndréa Torres
bMacielMaria Das Graças Galvão
ade AlmeidaRejane Pereira
bHindersDuane
cKerr-PontesLígia Regina S.
ea
Epidemiological Surveillance Department, State Health Secretariat, Pernambuco, Brazil
b
Hansen’s Disease Control Programme, SES, Pernambuco, Brazil
c
LEPRA Brazil Representative, Natal, Brazil
d
Netherlands Leprosy Relief Brazil, Rio de Janeiro, Brazil
e
Department of Community Health, Federal University of Ceará, Brazil
Correspondence to: Pieter AM Schreuder, NLR Brasil, Av. Marechal Câmara 350, Sala 1002, Centro, Rio de Janeiro, Brasil, CEP: 20.020-080 (Fax: +55 21 2532 7989; e-mail: pieter@hansen.org.br)
01062008
79
2
171
182
28032008
© Lepra
2008
Background
Since the introduction of the national notifiable diseases information system (SINAN) in Pernambuco State, Brazil, in 1994, many problems have been encountered. The aim of this study was to evaluate the SINAN software, quality of data input, the transfer of the computerised data from the municipality to state levels, human resources and other factors associated with the health information system infrastructure (HIS).
Methods
A cross-sectional study was carried out in Pernambuco state, North-eastern Brazil, in 2005. A sample of health regions and municipalities was chosen. SINAN forms from those municipalities were analysed and the flow of notifications followed from municipal level to the regional and finally to the state. Professionals from health units, district, municipal and regional Hansen’s Disease Control Programme (HDCP) and Epidemiological Surveillance System (ESS) coordinators, health secretaries and managers of the municipalities and health regions selected were interviewed.
Results
SINAN software is functioning up to expectation. However, at all levels of the health system, serious weaknesses not related to the SINAN software were found, varying from lack of human resources (limited number of staff and staff development), lack of infrastructure (office space, computers, supplies, etc.) to an absence of effective coordination, management and supervision of the HIS.
Conclusions
Lack of reliable, complete and timely information, and especially the lack of widespread analysis and use of available information in planning and management of health services were the main weaknesses found. Many areas need urgent attention: the quality of patient examination, recording and reporting, the timely processing of quality data, the coordination and management of disease control programmes, and the use of HIS reports by the health services and health managers. Regular feedback, supportive supervision visits and annual reviews are essential to monitor the system and make sure that essential information is decentralised and used by the primary health services and HDCP coordination. Assessing the quality of services from a client perspective would give additional information for the identification of strengths and weaknesses of the Hansen’s disease (leprosy) services.