Transcript
8/3/2019 Introduction to HMIS
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SHSRC CONSULTANTS WORKSHOPNHSRC NEW DELHI
17 AUGUST 2010
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Introduction to HMIS
NRHM & required monitoring
HMIS reform & its implementation
Current status
Challenges
Other e health initiatives
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Health Management Information
Systems
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Management
Process
Ungathered Gathered
Information Information
Unallocated Effectively & efficiently
Resources allocated resources &
Monitor Progress
GatheringInformation
Decision making(about effective
& efficientallocation ofresources)
Decisionimplementing/resourceallocation
Achievementof desired AIM
Decision
1. Screen all PW for anaemia.2. Provide IFA to everyonewith focus on treating severeanaemia cases3. Make sure anaemic &complicated cases arereferred on time & treated.
1. Blood testing facility in allhealth centres.
2. IFA to be available fordistribution.3. Ensure Blood storage
facility in CHC/FRUs4. ANM & Doctors are
trained on dealing withobstetric complications &severe anaemia cases.
5. Provide referral transport
to send complicatedcases to higher centre forcare.
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Basic building blocks of
HMIS
Data- are raw material in the form of numbers,characters, images that give information afterbeing analyzed.
Information: is a meaningful collection of dataorganized with reference to a context.
Knowledge: when information is analyzed,
communicated and acted upon, it becomesknowledge.
Data Information Knowledge
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Translation of data
-
information
-
knowledge
DATA
In the box number ofwomen registered forANC is given
& called DATAELEMENT, Valuesgiven on the right sideare the DATA.
Data Element- Record of
an event or activity
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Information
Information meansputting data intocontext. E.g., In thisbox data are beingput into the context
of Maternal HealthIndicators bymonths. Data term,pregnant womenregistered for ANC isconverted into
information bycalculating anindicator% ofpregnant womenregistered for ANC infirst trimester.
Maternal HealthIndicators Apr-07 May-07 Jun-07
% First trimester ANCregistration(Early ANCRegistration
Rate) 55.6 57.0 55.9% pregnant women
given TT 81.8 90.5 86.4% pregnant women
consuming IFA-100 Tabs 59.4 68.8 62.3
% pregnant womenwith severeAnaemia
% Pregnant womenconsuming IFA-200 Tabs (DoubleDose) 23.9 24.3 26.6
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Knowledge
Knowledge, once information is analysed and acted upon, the consequences ofthese actions can be further evaluated and used to revise need for moreinformation as well as action.
ANC registration ofone PHC is 14%;
What are the differentreason or measure to
be taken to ensurethat its ANC
registration can beimproved?
2 PHCs had over 90% ANCregistration rate. Is it right, are we
registering all ANC cases?% of ANC registration
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NRHM-Key intervention & requiredmonitoring
Architectural correction of Basic health care delivery system
Reducing regional imbalance in health infrastructure ex. BIMARU STATES.
FRUs/24x7 PHC/ IPHS standards
Decentralization & local management of programmes & health facilities.
Integration of organizational structures, programs-RCH/VBDCP/Blindness/Leprosy/
Effective management of Human Resources
Pooling of resources.
Increasing community participation & ownership.
Integration of determinants of health such as- sanitation, hygiene, nutritionand drinking water with health.
ASHA
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Comprehensive HMIS forNRHM
Strengthen capacities for data collection,assessment and review for evidence-basedplanning, monitoring and supervision.
Challenge: Routine reporting system inefficientfor effective management of health services.
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HMIS Reform under NRHM
Focus to shift from FORMATS and DATA ELEMENTS toINDICATORS and their use for action
Each data element collected should contribute to at leastONE indicator, preferably MORE.
HMIS should be local action-led, not data-reporting-driven
Reduce duplication of reporting e.g. Form 6, RIMS
Eliminate design ambiguity- ANM to report services sheprovided NOT institutional services.
Disaggregated data to be best captured by surveys. e.g.SC/ST & M/F data.
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HMIS Reform under NRHM.
Creation of data sets for district level &below.1. Sub Centre monthly data set
2. PHC monthly data set
3. CHC monthly data set4. District monthly stock data set
5. District Quarterly data set
6. District quarterly FMR
7. District Annual data set
Proposed use of Free & Open Sourcesoftware for optimum utilization of availableresources (75% for capacity building, 25%for Software etc.)
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Stages of HMIS implementation underNRHM
Stage 1-Establishment of overall system across states incountry.
Reporting Formats
HMIS resource material
Infrastructure (Computer, People) Information Flow
Training
Review & addressing challenges
Stage 2-Improvement in the data quality & information use Process of data verification, confirmation etc.
Developing culture of information use at all levels
Stage 3-Ensuring sustainability, developing advance skill &review of overall implementation
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Subcentre Data Set
PHC Data set
Block
CHC Data Set
District Head
Quarter (DPMU)
STATE HEAD
QUARTER
National Level
District / Civil
Hospital Data
set
HMIS- Information Flow & reporting forms
DHIS -2
Web Portal
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Data entry status
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Districts BlocksDistrict level
facilities
STATES
E
xisting
Districtsreportingat
districtlevel
istrictreportingthrough
blocks
Districts
notreporting
Existingblocks
locksreportingatblock
level
locksreportingthrough
lowe
rfacilities
not
reporting
E
xisting
re
porting
Tamil Nadu 32 31 0 1 0 0 0 0 0 0
HP 12 0 12 0 73 73 0 0 19 17
MP 50 0 50 0 330 328 0 2 68 56
Nagaland 11 11 0 0 Starting Facility wise data entry from this month
Orissa 30 0 30 0 327 322 0 5 93 91
Chandigarh 1 0 1 0 4 0 4 0 3 3
Maharashtra 35 20 15 0 37 15 22 0 0 0
Karnataka 29 0 29 0 178 0 178 0 0 0
J&K 22 0 22 0 111 0 110 1 18 15
Uttarakhand 13 0 13 0 103 103 0 0 34 32
Facility wise below block data entry
Block wise data entry
District wise data entry
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Districts BlocksDistrict level
facilities
STATES
Ex
isting
Districts
reportingat
distr
ictlevel
istrictrep
ortingthrough
b
locks
Districtsnotreporting
Existingblocks
locksreportingatblock
level
locksreportingthrough
lowerfacilities
notr
eporting
Ex
isting
rep
orting
Assam 27 27 0 0 0 0 0 0 0 0
BIHAR 38 1 37 0 489 462 0 27 71 48
Kerala 14 0 14 0 207 0 201 6 93 93
Meghalaya 7 7 0 0 0 0 0 0 0 0
West bengal 19 3 16 0 343 289 0 54 126 108
Punjab 20 0 20 0 117 0 117 0 97 97
Manipur 9 0 9 0 41 0 41 0 9 8
Gujarat 26 0 26 0 181 0 181 0 46 46
Mizoram 8 0 8 0 82 0 81 1 22 9
Sikkim 4 0 0 4 0 0 0 0 0 0
Total 407 100 302 5 2623 1592 935 96 699 623
Facility wise below block data entry
Block wise data entry
District wise data entry
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Uttarakhand
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Data Entry Status (in %) by states in DHISapplicationNo. Level of data entry Apr_09 May_09 Jun_09 Jul_09 Aug_09 Oct_09 Nov_09 Dec_09
16 Punjab Block/PHC/SC/DH 85 90 85 86 89 89 88 85
1 Tamil Nadu District level only 1 19 82 78 46 77 72 37
2 HP District/Block 55 56 64 62 56 62 60 60
18 Mizoram District/PHC/CHC/SC 6 53 48 31 50 54 59 52
13 Kerala District/Block/PHC/CHC 22 29 31 28 28 54 56 59
3 MP District/Block/SDH 48 47 48 50 48 59 55 50
17 Manipur PHC/CHC/SC 41 53 51 44 61 62 55 45
4 Nagaland District level only 46 43 48 42 38 46 46 34
12 BIHAR District/Block PHC/SDH 18 17 18 19 20 37 36 40
5 ORISSA District/Block/SDH 36 41 40 40 33 31 35 30
6 Chandigarh District/SHC/PHC/SC/SDH 12 22 34 24 20 53 34 46
15 West bengal District/Block 37 31 23 22 17 35 34 29
9 J&K District/Block/PHC/SDH 48 46 42 37 36 27 33 318 Karnataka District/Block/PHC/CHC 27 27 27 28 19 30 30 29
10 Uttarakhand Only Block PHC/CHC/SDH 25 24 22 22 18 27 24 23
7 Maharashtra District/rural/Corporation 29 27 30 31 30 25 21 19
11 Assam District 18 19 18 14 0 0 0 0
14 Meghalaya District 71 69 69 55 14 0 0 0
19 Tripura 0 0 0 0 0 0 0 020 Sikkim 0 0 0 0 0 0 0 0
Oct-09 1-Jan-10
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Challenges
Data reporting- From all lower facilities & from far flung areas.
Data Quality Ambiguity about data elements & reporting formats in field staff.
Duplication
Completeness
Integration- of other vertical program information systems into routine
reporting. Use of Information at all levels-
for monitoring & evaluation, for planning, for management ofhealth programs & facilities.
Data do not speak for themselves-Einstein
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Other Innovations
Mobile Based Data Transmission & Reporting
Hospital Information System
Human Resources Management Information
System
NBITS
E- Mamta
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THANK YOU
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