(via periodic health facility surveys or routine health statistics). Information sources for these important measures remain undeveloped. Research is needed to determine a simple methodology that district health managers can apply to understand the annual reach and coverage of their services. Innovative combinations of epidemiological and demographic information would help provide annual estimates at the district level.

Health status in low-income countries is changing more rapidly now than at in any prior time in human history. To track and, eventually, to steer these population health dynamics and to understand what such transitions imply for health systems and policies will require radical changes in and a strengthening of national health-information systems so as to provide essential information. In their summary of the issues, Byass, de Savigny, and Lopez (2011) suggested that strengthening the information systems will require concerted investments on three fronts:

1.  Interim investments in sentinel or sample registration systems that provide timely and high-quality longitudinal data on deaths and causes of deaths, combined with a concurrent development of effective civil registration systems for vital statistics;

2.  Periodic national cross-sectional omnibus sample surveys of the top 10 major risk factors for the major causes of death; and

3.  Annual sub-national sample surveys or routine statistics on effective coverage of the essential health interventions relevant to these causes of death.

The workshop highlighted the need for countries in sub-Saharan Africa and their international funding partners to prioritize these three dimensions of their national strategies for strengthening health systems.

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