Start Center - Strategic Analysis, Research & Training Center

Innovations in Paper Health Registers

Innovations in Paper Health Registers

Across all health sectors, improving data systems can result in better health outcomes - but in many settings, the data systems in use are far from perfect. Low-resource settings and non-electronic systems face particular challenges. Health registers are a vital information tool in these contexts because they include individual-level information and are also the basis of administrative reporting from the health facility up to the national level.  The Bill & Melinda Gates Foundation engaged the University of Washington START Program to identify strategies that might improve paper health register systems so they can better support patient care and optimal reporting, with a focus on settings where electronic systems are not yet feasible.

The START team developed case studies of innovative paper health registers, including Ethiopia’s Family Folder, Ghana’s Simplified Registers, South Africa’s 3-Tiered Antiretroviral Treatment Monitoring Strategy, and Uganda’s Tuberculosis and Leprosy Program Register. Through these case studies, START made recommendations for strengthening paper health register systems that demonstrate innovation in register design, human resource models, policymaking, and implementation strategies. Our commentary on these finding and links to the case studies have been published in the Journal of Global Health.


6 / 6 / 2014


Bill & Melinda Gates Foundation

Final Report

Ghana Case Study
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Ethiopia Case Study
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South Africa Case Study
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Uruguay Case Study
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Uganda Case Study
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Strategies from Case Studies Summary
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21 / 3 / 2016
Strengthening paper health register systems: Strategies from case studies in Ethiopia, Ghana, South Africa and Uganda
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