Community diagnosis and health information systems in low- and middle-income countries

The inalienable human right to the ‘highest attainable standard of health’ has been a focus of the international public health community for more than 50 years. Yet, low- and middle-income countries (LMIC) still struggle with heavy burden of disease, inefficient health systems, and limited resources for improving the health of their citizens. Community diagnosis can inform public health planning and prioritization of resources for the purpose of addressing disparities in health outcomes. However, large amounts of good-quality data from multiple quantitative and qualitative, primary and secondary sources are ideally required in order to effectively assess current state and evaluate future performance against a broad range of important health metrics. Furthermore, information systems and health metrics should not be thought of as static and separate. Rather, they should ideally evolve together in a deliberate, iterative process over time from metrics selected based upon the information that is available (i.e. measure what is measurable) to information systems designed based upon the metrics that are important to measure (i.e. measure what should be measured). This chapter describes community diagnosis, information systems, and health metrics in the context of LMIC, highlighting these concepts and their challenges with examples of studies conducted in these settings.