Building Food Security & Nutrition in Guatemala Through the Power of Digital Analytics
Photo Caption: Staff from the Guatemala Health Area directorates meet on June 20, 2024. The purpose of the meeting was the first formal presentation of PROSAN dashboard by the Ministry of Health. Photo by Data.FI/Guatemala.
Authors: Zonia Aguilar and Otto Letona
Introduction
Guatemala’s Ministry of Public Health and Social Assistance (MSPAS) relies on a central information system called Health Information Management System (Sistema de Información Gerencial en Salud, or SIGSA) to capture data from all levels of healthcare service delivery. It is managed by the Information Technology Directorate (DTI), but in reality it functions more like a network of sub-systems, with 24 health specializations containing data on dozens of indicators.
The country itself is divided into 29 health areas. The central level and regional health areas routinely seek to generate information reports or pull analytics, but due to the volume of information, obsolete tech, and the user experience, obtaining a report can be highly challenging, often taking several hours, and occasionally requiring effort outside of working hours to avoid overloading the central servers.
The absences of an efficient reporting system and easily accessible information caused several organizations to face program implementation barriers, including Guatemala’s Food Security and Nutrition Program, known as PROSAN.
Organizationally located within MSPAS, PROSAN is a national technical-normative program whose main functions include monitoring the growth of children, counseling mothers, ensuring the population receive sufficient micronutrients, managing acute respiratory infections and diarrheal episodes, and diagnosing and treating acute malnutrition. This is a major national priority, as according to the latest national survey on maternal and child health, Guatemala has 46.5% of children with chronic malnutrition.[1]
At the end of 2023, PROSAN requested technical assistance from the Data.FI project to create a new health data repository that would collate and organize data according to set priorities. They also asked for a digital solution that could provide information in a timely and efficient manner for use in any department or level of service provision.
Defining Indicators to Inform System Development
Faced with this challenge, Data.FI began working with a technical working group (TWG) to facilitate the integration of different MSPAS departments, including the DTI, PROSAN, the Directorate for the Regulation of Care Programs, and the Directorate of Integrated Health Services Networks. The Tropical Agricultural Research and Higher Education Center (Centro Agronómico Tropical de Investigación y Enseñanza, or CATIE) Project,[1] which also supports the MSPAS, also joined the team.
Photo Caption: PROSAN and DTI staff prepare the official presentation of the dashboard during a June 17 meeting of the TWG.
Photo by Data.FI/Guatemala.
The TWG started by defining the prioritized health indicators that would structure the data on the new digital system. They utilized a methodology established by Data.FI to develop indicator reference sheets and then gradually assess the technical aspects, needs, and available data existent on the current information system. The selection of indicators took into consideration technical aspects, relevance and, above all, the existence and availability of data.
From the beginning, this work followed a three-phase approach, meant to gradually build the infrastructure and best practices within PROSAN: first, create a dashboard with six core indicators; second, add 10 indicators; and third, complete the remaining 30 indicators. The CATIE project was responsible for searching the information system for data for each indicator and organizing it in a repository, while Data.FI developed the data visualizations and dashboard technology based on agreed codes and prototypes. For its part, the DTI made final reviews, uploaded data, and was made responsible for periodic updates.
Photo Caption: Heath area staff during the June 20 presentation of the PROSAN dashboard by Ministry of Health officials. Photo by Data.FI/Guatemala.
This work required a high degree of coordination and multiple efforts to timely complete the tasks and planned times. The TWG faced challenges such as the multiple tasks of MSPAS officials who carry out their work with limited availability of personnel. And during the period in which the work was implemented, there was a change of government and public officials, which in part delayed the fluidity of decision-making. Currently, the DTI continues to work with a limited infrastructure (server hardware) that creates delays in data loading.
Phases 1 and 2 of this process have been completed, and the PROSAN dashboard is now operational within the servers and under the administration of MSPAS.
In June 2024, DTI and PROSAN presented the new Health Data System and the phase 1 and 2 dashboards to the MSPAS vice ministers who lead the different sub-departments. They showed how the new solution allowed for real-time monitoring of vital indicators, such as children < 5 years old with at least one growth monitoring check, women supplied with micronutrients at least once in pregnancy, children < 5 years old with acute malnutrition, and institutional births with low birth weight. The 15 total indicators of the dashboard can be disaggregated by health area, geographic area, time period, sex, age, and other socioeconomic or demographic data.
The dashboard was also launched and shared with local representatives of the 29 health area directorates, who now have access to a user-friendly and accessible tool. Indeed, the dashboard will give local health area authorities the opportunity to request and manage timely PROSAN data, opening the door for the continuous improvement of health services related to food security and strong nutrition.
Photo Caption: Screenshots of the PROSAN dashboard, showing different data visualization modes and categories of data collected.
Looking Forward
Given previous difficulties exporting and analyzing health data, this innovation represents a transformative moment for Guatemala’s health decision making.
The work behind the PROSAN dashboard exemplifies how the right combination of targeted technical support and locally coordinated effort capacitates countries to help themselves, putting health systems on a better path and allowing government bodies to more easily coordinate food security policies.
What’s more, the PROSAN dashboard is not only helping to solve a specific problem but is contributing to Guatemala’s ongoing digital health transformation. That’s because the solution addresses the country’s e-health building blocks, fostering a greater emphasis on data use across the enabling environment, and providing a digital tool that can be adapted and reconfigured in response to different needs.
In this way, the PROSAN dashboard has been immediately impactful. Through stronger health monitoring and sophisticated data use interventions health services can be improved and programs fine-tuned. This might seem only one step, but through these increased efficiencies Guatemalan lives are saved and a brighter future is within reach.
[1] The CATIE project has been financed by the European Union through the Scaling Up Nutrition funding stream.
[1] Ministerio de Salud Pública y Asistencia Social. (2015). VI Encuesta Nacional de Salud Materno Infantil. ENSMI 2014-2015. Guatemala City, Guatemala. Available online at: https://portal.siinsan.gob.gt/wp-content/uploads/2018/11/EnsmiIndicadoresBasicos_2014_2015.pdf
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