03381nas a2200349   4500000000100000008004100001260001300042653001100055653002800066653003200094653001100126653002400137653001200161653003500173653004200208653003100250653001300281100001600294700001600310700001600326700001800342700001400360700001600374700001900390245013400409856005100543300001100594490000700605050003200612520237300644022001403017       2008                            d  c2008 Jun10aBrazil10aCross-Sectional Studies10aEvaluation Studies as Topic10aHumans10aInformation Systems10aleprosy10aManagement Information Systems10aMedical Records Systems, Computerized10aPreventive Health Services10aSoftware1 aGalvão PRS1 aFerreira AT1 aMaciel MDGG1 aDe Almeida RP1 aHinders D1 aSchreuder P1 aKerr-Pontes LR00aAn evaluation of the Sinan health information system as used by the Hansen's disease control programme, Pernambuco State, Brazil.  uhttps://leprosyreview.org/article/79/2/17-1182  a171-820 v79  aInfolep Library - available3 a<p><b>BACKGROUND: </b>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).</p><p><b>METHODS: </b>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.</p><p><b>RESULTS: </b>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.</p><p><b>CONCLUSIONS: </b>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.</p>  a0305-7518