Hot off the press! Please read here an article published today about Developing and implementing national health
identifiers in resource limited countries: why,
what, who, when and how?
ABSTRACT
Many resource-limited countries are scaling up health services and health-information systems
(HISs). The HIV Cascade framework aims to link treatment services and programs to
improve outcomes and impact. It has been adapted to HIV prevention services, other
infectious and non-communicable diseases, and programs for specific populations. Where
successful, it links the use of health services by individuals across different disease categories,
time and space. This allows for the development of longitudinal health records for individuals
and de-identified individual level information is used to monitor and evaluate the use, cost,
outcome and impact of health services. Contemporary digital technology enables countries
to develop and implement integrated HIS to support person centred services, a major aim of
the Sustainable Development Goals. The key to link the diverse sources of information
together is a national health identifier (NHID). In a country with robust civil protections, this
should be given at birth, be unique to the individual, linked to vital registration services and
recorded every time that an individual uses health services anywhere in the country: it is
more than just a number as it is part of a wider system. Many countries would benefit from
practical guidance on developing and implementing NHIDs. Organizations such as ASTM and
ISO, describe the technical requirements for the NHID system, but few countries have
received little practical guidance. A WHO/UNAIDS stake-holders workshop was held in
Geneva, Switzerland in July 2016, to provide a ‘road map’ for countries and included
policy-makers, information and healthcare professionals, and members of civil society. As
part of any NHID system, countries need to strengthen and secure the protection of personal
health information. While often the technology is available, the solution is not just technical.
It requires political will and collaboration among all stakeholders to be successful.