Recognizing the degree to which health information enables national health systems to achieve the best possible health outcomes and return on investment;


Confronted by evidence that many national health information systems are poorly equipped to meet current information demands for policy decisions and are ill-prepared to meet future requirements, particularly in the context of emergencies, health crises and climate change;


Realizing that increased monitoring and evaluation investments by single-disease programmes in the context of rapid technological advances have the potential to dramatically improve health information systems if properly leveraged;


Noting the historical trends and factors contributing to the current gaps in health and population information and that equitable distribution of health outcomes is as important as achieving overall health goals;


Recognizing the requirement for national government stewardship of the health information system development and the responsibility of donors and international partners to support these systems;


Concerned that globally there are 40 million births (one third of the world’s annual total) and 40 million deaths (two-thirds of the world’s annual total) that are not legally recognized by civil registration systems – and that there has been no appreciable progress in many countries;


Welcoming the opportunity presented by new tools, technology and consensus in this area ,


Encouraging governments to include explicit strategies for national health information system development when preparing their national health strategies;

Agree to the following general principles:

1. Transparency and benefits
• guaranteeing transparency of all health data with due considerations for privacy and confidentiality
• ensuring that the benefits of data collection accrue to the people and communities who are the sources of that data

2. Good governance
• ensuring that information is collected from all public and private healthcare providers
• basing national health strategies on health information systems that monitor an agreed number of indicators used by all partners
• developing national performance monitoring tools to track progress towards health goals
• monitoring health equity by the application of socio-economic and living standards households surveys
• strengthening intersectoral collaboration and coordination to develop and govern national health information system policies

3. Investments and capacity building
• fostering a technologically competent health information workforce by appropriate training and recognition of necessary skills and tasks
• establishing national institutes, curricula and qualifications to train and certify professionals working in health informatics, data collection, analysis, dissemination and use
• mobilizing resources and investing at least 5% of health resources in national health information systems, with at least 2% allocated to building vital statistics systems – with the aim of achieving by 2020 – 90% completeness of birth and death registration and improved cause-of-death data
• investing in appropriate technology ¬¬– based on open standards – that permits rapid expansion to rural populations that empowers frontline employees with real time access to information and permits rapid action in public health emergencies
• scaling up investments in the information systems needed to track the emerging epidemiological transition

4. Harmonization and integration
• fostering integration of data produced by national statistical offices, ministries of health and other sectors
• facilitating intersectoral collaboration and data sharing through the use of open standards and common data models
• ensuring community participation and ownership through effective and timely feedback

5. Planning for the future
• promoting appropriate technological solutions compliant with open standards to leverage investments within and beyond countries
• negotiating for developing and emerging country access to products of - and collaboration with - standards development organizations
• assessing the probable impact of massive data flows on human resources and finance in terms of the capacity required to store, compute and analyse petabytes of data.

1 including the Health Metrics Framework endorsed by the World Health Assembly in 2007, the Bellagio eHealth Call to Action, the Paris Declaration, the Marrakech Action Plan on Statistics, the Call for Action on Health Data from Eight Global Health Agencies and the collective efforts to measure and achieve the Millennium Development Goals.