Essential evidence for guiding health system priorities and policies: anticipating epidemiological transition in Africa.
BACKGROUND
Despite indications that infection-related mortality in sub-Saharan Africa may be decreasing and the burden of non-communicable diseases increasing, the overwhelming reality is that health information systems across most of sub-Saharan Africa remain too weak to track epidemiological transition in a meaningful and effective way.


METHODS
We propose a minimum dataset as the basis of a functional health information system in countries where health information is lacking. This would involve continuous monitoring of cause-specific mortality through routine civil registration, regular documentation of exposure to leading risk factors, and monitoring effective coverage of key preventive and curative interventions in the health sector. Consideration must be given as to how these minimum data requirements can be effectively integrated within national health information systems, what methods and tools are needed, and ensuring that ethical and political issues are addressed. A more strategic approach to health information systems in sub-Saharan African countries, along these lines, is essential if epidemiological changes are to be tracked effectively for the benefit of local health planners and policy makers.


CONCLUSIONS
African countries have a unique opportunity to capitalize on modern information and communications technology in order to achieve this. Methodological standards need to be established and political momentum fostered so that the African continent's health status can be reliably tracked. This will greatly strengthen the evidence base for health policies and facilitate the effective delivery of services.
Umeå Centre for Global Health Research, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden; MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; peter.byass@epiph.umu.se.
Peter
P
Byass
Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
Don
D
de Savigny
Melbourne School of Population and Global Health, University of Melbourne, Carlton, Australia.
Alan D
AD
Lopez
D000349:Africa / Q000453:epidemiology; D000367:Age Factors; D002423:Cause of Death; D002648:Child; D046688:Child Mortality; D004992:Ethics, Medical; D005260:Female; D063005:Health Information Systems; D006291:Health Policy; D006292:Health Priorities; D019456:Health Transition; D006801:Humans; D008297:Male; D009026:Mortality; D011050:Policy Making; D011057:Politics; D012042:Registries; D012307:Risk Factors; D012737:Sex Factors
epidemiological transition; health information; health policy; health services; sub-Saharan Africa