Introduction to HMIS

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

Introduction to HMIS

Documents

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