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Transcript of eJharkhand 2014 - e-Governance Implementations – Opportunities and Challenges - Dr Manish Ranjan,...
From e-Governance to m-Governance
Scripting new dimensions
Saturday, April 8, 2023 1
Dr. Manish Ranjan, IASMission Director,National Health Mission, Ranchi Jharkhand
• The need for effective and holistic governance is very well reflected in UN Secretary General’s words
– "...as we all know, infrastructure is not just a matter of roads, schools and power grids. It is equally a question of strengthening democratic governance and the rule of law. Without accountability, not only of the government to its people but of the people to each other, there is no hope for a viable democratic State. "
– Ban Ki Moon
The Information Technology revolution provides us a wonderful opportunity to optimize and improve
governance across all sectors:The key implementation measure being e-Governance
e-Governance
These technologies can serve a variety of different ends: better delivery of government services
to citizens improved interactions with business and
industry citizen empowerment through access to
information efficient government management
Performance of the governance via electronic medium in order to
facilitate an efficient, speedy and transparent process of disseminating information and provide efficient and
effective service delivery to the citizens.
e-Governance aims at making the interaction between government and citizens (G2C), government and business enterprises (G2B), and inter-agency relationships (G2G) more friendly, convenient, transparent, and inexpensive
e-Governance initiatives in health sector in Jharkhand
– Health Management Information System (HMIS)
– Mother and Child Tracking System
– Direct Bank Transfer – Case Based Web Based ICT
application for TB (Niskhay)– National Anti Malaria
Management Information System (NAMMIS)
– Integrated Disease Surveillance Program web portal
– Mamta Vahan MIS– National Cold Chain
Management Information System
– JRHMS website– Human Resources for Health– MTC MIS– WIFS MIS– Vehicle tracking system– Chikitsya Salah: 104– E-Blood Bank– Biometrics Application– Video conferencing through
skype– Online reporting for PCPNDT
act
Health Management Information System• Facility wise data uploaded from Health facilities (District to Health Sub
Center level)• Jharkhand one of the few States having facility wise data entry • 4545 out of 4582 health units entering data every month• 270 indicators being monitored on a monthly basis
Saturday, April 8, 2023 7
Bokaro
Palamu Chatra Hazaribagh
KodarmaGiridih
Deoghar
GoddaSahibganj
Pakur
GarhwaDhanbad
Khunti
RanchiLohardaga
Gumla
Pashchimi SinghbhumPurbi SinghbhumSimdega
Saraikela
Latehar
Jamtara
Ramgarh
Dumka
Bokaro
Palamu Chatra Hazaribagh
KodarmaGiridih
Deoghar
GoddaSahibganj
Pakur
GarhwaDhanbad
Khunti
RanchiLohardaga
Gumla
Pashchimi SinghbhumPurbi SinghbhumSimdega
Saraikela
Latehar
Jamtara
Ramgarh
Dumka
Bokaro
Palamu Chatra Hazaribagh
KodarmaGiridih
Deoghar
Godda
Sahibganj
Pakur
GarhwaDhanbad
Khunti
RanchiLohardaga
Gumla
Pashchimi SinghbhumPurbi SinghbhumSimdega
Saraikela
Latehar
Jamtara
Ramgarh
Dumka
Q2 (Jul – Sep 2013)Q2 (Jul – Sep 2013)Q1 (Apr – Jun 2013)Q1 (Apr – Jun 2013)
Q3 (Oct – Dec 2013)Q3 (Oct – Dec 2013)
Good performing
Promising
Low
Very low
Using HMIS for performance monitoring: HMIS Dashboards Indicators: 2013-14
16 indicator based dashboard based on life
cycle approach
Dumka - Block wise HMIS based DashboardQuarter 1, 2 & 3 (2013-14)
Good Performing Promising Low performing Very low performing
Q3, Q2 & Q1- Average Index values - Component wise
SN BlocksOverall Index 1. Reproductive age
group 2. Pregnancy Care 3. Child Birth 4. Postnatal mother and new born Care
Q3 Q2 Q1 Q3 Q2 Q1 Q3 Q2 Q1 Q3 Q2 Q1 Q3 Q2 Q1
1 DHQ 0.5086 0.4617 0.4912 1.0000 0.6220 0.5587 0.4595 0.4581 0.5976 0.3831 0.4117 0.3992 0.3382 0.3992 0.3995
2 Gopikandar 0.4759 0.5911 0.5111 0.4572 0.6139 0.3333 0.3526 0.4332 0.3294 0.1013 0.3343 0.4113 0.8354 0.8896 0.8593
3 Dumka Sadar 0.4390 0.4602 0.4794 0.1031 0.0502 0.0294 0.4452 0.5505 0.4961 0.6667 0.6667 0.6812 0.4977 0.4919 0.6115
4 Masalia 0.4213 0.4402 0.4174 0.2752 0.2785 0.3333 0.4977 0.3375 0.2825 0.0614 0.0764 0.1173 0.6486 0.8581 0.7827
5 Kathikund 0.3951 0.5492 0.5660 0.1515 0.4756 0.3333 0.3099 0.4560 0.4486 0.0914 0.3520 0.5086 0.8088 0.8048 0.8575
6 Jarmundi 0.3617 0.4327 0.4337 0.1200 0.3333 0.3333 0.2463 0.2617 0.2420 0.1004 0.1884 0.1742 0.7790 0.8099 0.8415
7 Raneshwar 0.3408 0.4374 0.3940 0.1397 0.4071 0.4392 0.2835 0.3495 0.2876 0.2778 0.2489 0.2950 0.5567 0.6566 0.5327
8 Shikaripada 0.3283 0.5138 0.4697 0.0136 0.2888 0.2667 0.4035 0.6197 0.5256 0.1759 0.2992 0.2432 0.5335 0.6717 0.6716
9 Ramgadh 0.3167 0.4069 0.4618 0.0306 0.4294 0.3333 0.2867 0.3093 0.3391 0.1125 0.0911 0.1870 0.6408 0.6804 0.8265
10 Saraiyahat 0.3132 0.4108 0.4031 0.0000 0.1602 0.1228 0.3246 0.4748 0.4595 0.0867 0.1682 0.1161 0.6258 0.6427 0.6873
11 Jama 0.2684 0.3688 0.3877 0.0020 0.3115 0.2798 0.2724 0.3094 0.3396 0.0472 0.1057 0.0990 0.5571 0.6205 0.6737
Mother and Child Tracking System• Flagship program for enlisting and tracking of beneficiaries for effective
service utilization• Generation of automated work plans for facilitating delivery of services• Beneficiaries enlisted in 2013-14:
– Mother 347,643– Children 262,649
• Beneficiaries enlisted since inception in January 2011:– Mother 1,414,553– Children 1,474,098
Saturday, April 8, 2023 10
Automated Work plan generated through MCTS
Nikshay: Case Based Web Based ICT application for TB• A case based-web based recording & reporting system in RNTCP• Designed and developed by NIC (HQ)• Enables healthcare service delivery, ensuring voluntary participation
of various stakeholders and integrating public and private sectors
Objectives:Promoting real time TB surveillanceMinimizing patient default rateEffective program managementLinking TB database with UID
Achievements64,425 notified TB patients (up to 20.02.2014) in Nikshay222 Private health facilities have been registered & 908 TB patients notified by them
http://nikshay.gov.in/user/login.aspx
Generation & utilization of information
PHIs including DMCs
Monthly PHI Report (Paper Based)
Tuberculosis Unit
TB Register
District TB Centre
State TB CellCentral TB Division Database
Quarterly FeedbackQuarterly and Annual Performance Reports
Laboratory Register at DMC
Treatment Card for each patient at PHIs
C&DST Laboratory DOTS Plus site
DOT Provider
National Anti Malaria Management Information System (NAMMIS)
ComponentsHome
MIS Data Entry
MIS Output
MIS Administration
Change Password
My Profile
Log Out
NAMMIS Collaborative Tools
The State of Jharkhand has consistently been appreciated at the National level for effective and holistic use of this application
The State of Jharkhand has consistently been appreciated at the National level for effective and holistic use of this application
Integrated Disease Surveillance Programme (IDSP)
• Objective: Strengthening of Disease Surveillance System for epidemic prone diseases to detect and respond to outbreaks
• Use of Information Technology for collection, compilation, analysis & dissemination of data
• Network– Data Centers – Training Centers – Video Conferencing System• Software / IDSP Portal (www.idsp.nic.in)• 24 X 7 Call Center (1075 / 1800-11-4377)
Data Flow
All the districts in the State provide weekly reports
Impact of IDSP portal• Progressive increase in case reporting (Acute Diarrhea Diseases, Food
Poisoning, Chicken Pox, Measles ,Malaria, Dengue, AES, Chikungunya, JE, Jaundice etc. over the years
Strategic Management Information System (SIMS) under NACP
Primary reporting unit levels(with in a district)
DAPCU(District Level)
SACS(State Level)
NACO(National Level)
Direction of data flowEach level, sends data to next
level after validation
Monitoring and Feedback
Report generation and use of data
Report generation and use of data
Report generation and use of data
Monitoring and Feedback
Monitoring and Feedback
Reporting units in SIMSReporting Unit
LevelReporting Unit Type
State State AIDS Control Society (SACS)
District District AIDS Prevention Control Unit (DAPCU)
Units within districts
ICTC, Blood Bank, ART, CCC, STI clinic, Link worker, Laboratory
Report verification in SIMSNegative reports can be verified in SIMSAfter verifying becomes
CLHA MISAs part of the pediatric
program the Pediatric Anti Retroviral Treatment (ART)
record online software filled up for each child
coming to the ART center
CLHA: Children Living With HIV / AIDS, CCC: Community Care Centers, STI: Sexually Transmitted Infections
The Mamta Vahan Initiative: Innovating with local entrepreneurs
Saturday, April 8, 2023 22
The Innovation: Free referral transport for pregnant women and new borns
Launched on 4th July 2011 in Ranchi, entire state covered by October 2011
Advocacy and commitment observed at the highest level with the then State Cabinet
Ministers and Member of Parliaments launching the service across various districts
Management Information System (MIS) interplay in the Initiative
Saturday, April 8, 2023 23
Home Page of the Application
Call Details Entry FormatFacility Detail Entry Form
Feedback Detail Entry From
Vehicle and Owner Details Entry Form
What has the initiative achieved???
Saturday, April 8, 2023 24
3, 60,637 pregnant women rendered
services from July 2011 till June 2013
Progressive increase in the Institutional Delivery
Rates in the State: from 40% in 2011-12 to 46% in
2013-14
In 2012-13 referrals by Mamta Vahan accounted for
43% of institutional deliveries in Government facilities in the State (Total institutional deliveries: 325712,
Referrals: 139601)
56% of the services utilized by marginalized
population groups in 2012-13 (SC- 11900, ST –
29013,OBC -37011)
Performance Analysis of Mamta Vahan MISUse of Computer Application makes self
monitoring and analysis possible
Saturday, April 8, 2023 25Data analyzed for financial years 2010-11, 2011-12 and 2012-13
Average calls attended per
day: 457
Average cases transported per
day: 391
% calls received versus attended
(home to facility): 96%
Average time taken to reach the facility: 50
minutes
Average cost per run: Rs 460
% calls received versus attended
(facility to home): 98%
National Cold chain MISObjective - To capture real time data for efficient cold chain management Objective - To capture real time data for efficient cold chain management
Components of NCCMIS
Details of cold chain pointsHR StatusEquipment and spares status and transactionsUnder repair and condemnation detailsAvailability of cold chain space
NCCMIS AchievementsBaseline details of the cold chain data uploaded on the portalRegular monitoring of the data and updation by the state cold chain teamTracking of under repair equipments and follow up with the districts for fixing the problemNew supplies to districts are crossed checked with the inventory captured in NCCMIS
Jharkhand Rural Health Mission Society website• Inaugurated in 2011 the website provides a comprehensive
overview of all activities and interventions ongoing in the State (http://210.212.20.93:8082/jrhms/)
Saturday, April 8, 2023 28
Human Resource Information System (HRIS) in Jharkhand• Ministry of Health and Family Welfare, Govt of Jharkhand
initiated efforts to establish a web-based HR Management Information System in July 2010
• IntraHealth International through USAID Vistaar Project supported the effort
• Used an open source application, iHRIS Manage• Major Activities
– System requirement study– Customisation of software– Development of data collection form– Orientation of staff for data collection and entry– Standardisation of job titles – Actual data collection, entry, verification and validation for Ranchi
district (all cadres) and Medical Officers for entire State– Generation of HRIS reports
HRIS Strengthening Approach
1629
HRIS: Key Results Online Health Workforce directory for State- 4,437 Online Doctors directory for all districts -1,628 Online Health Workforce directory for Ranchi - 1,947 Basic HRIS reports designed and available for use Customized reports are being used for decision making process Doctors deployed in
Dept. of Home (Jail), Social Welfare, Labour, Employment & Training included in iHRIS
State Level MToT completed in August 2013 iHRIS Manage Administrator Technical Training completed in Nov
2013 at New Delhi for 5 Person from DoHFW District level training for block levels users Completed for 23
districts in Dec 13
A web based MIS has been developed for all 70 MTCs in the State URL is http://mtc.dreamworksinfotech.com/ The MIS application has been operational since April 2013
Web based MIS for Malnutrition Treatment Centers (MTCs)
Saturday, April 8, 2023 33
Impact of MTC MIS
Improved cure rates
Weekly Iron and Folic Acid Supplementation (WIFS) MIS • Need for WIFS MIS
– Un-availability of proper MIS for Adolescent Health Programme in Jharkhand.
– To establish of MIS with available resources and manpower
– To streamline the reporting channel block level to state level.
– Reduce Working hour and Manpower for WIFS MIS
Impact of pilot intervention in Khunti district:
Reporting ensured from all blocks
Consistent coverage
Vehicle Tracking System
Real Time tracking of Mobile Medical Units (http://rosmertaengg.com/vts/)
60 of the 100 operational MMUs have been equipped with this system
Has resulted in improved accountability and service delivery
Biometrics application
Ensures accountability
Improved efficiency
Adherence to timeliness
Increased work output
Widening the horizon
e-Governance e-Governance
Immediate need to further increase the scope of e-Governance initiatives
The answer
m-Governance
m-Governance The extension of e-
Governance to mobile platforms
Strategic use of government services and applications which are only possible using cellular/mobile
telephones Laptop computers personal digital
assistants (PDAs) wireless internet infrastructure
m-Governance v/s e-Governance M-Governance compliments e-Governance: expands reach Available anywhere and anytime Addresses the mobility of Government itself.
Mobile Users (Wireless) in India as on June 2013
(millions)
Internet and Broadband users as on June 2013 (millions)
Total subscribers: 903.09 Internet subscribers: 21.89
Urban : 545.48, Rural: 357.61 Broadband subscribers: 15.20
Available data from TRAI is testimonial to this:
In addition 176.50 million subscribers accessed internet by mobile devices between April to June 2013
m-Health
Wide use of m-health applications across the globe:247 million people have downloaded a health app40000 medical apps are now available for tablets and smartphones59% of patients in emerging markets use at least one m-Health application or service compared with 35% in the developing world
m-Health initiatives in JharkhandRealizing the need Government of Jharkhand has initiated various m-Health initiatives
Mobile banking:The next era of financial inclusion
Banking–Barely 300m bank accounts in a country of 1.2bn people, Unique bank account holders even lesser
–Only 35% of the adult population has a bank account–Serviced by 106 K bank branches, 150K ATM network one of the lowest ATM per inhabitant ratio –69% population is rural, with ~639K villages–Only 5% villages have bank branches, 73% of farmer households have no access to formal sources of credit
Robust Mobile Money ecosystem is key to Financial Inclusion
India : StatisticsMobility
–~903 Mn+ Telecom connections (Expected to touch1.1 Bn by 2015)–Tele-density stands at 73.1%–Rural tele-density at 41.7%
43
ServicesPayments
• Money Transfer • To registered M-Pesa
account• To any bank account• To any mobile in India
• Cash withdrawal• Person to Merchant
• Airtime recharge• Utility /DTH payments• Merchant Payments
Deposits • Interest bearing Savings Bank
Account
ServicesPayments
• Money Transfer • To registered M-Pesa
account• To any bank account• To any mobile in India
• Cash withdrawal• Person to Merchant
• Airtime recharge• Utility /DTH payments• Merchant Payments
Deposits • Interest bearing Savings Bank
Account
m-pesa
44
Why M-Pesa for JSY Disbursals? M-Pesa offers last mile delivery of
Banking & financial services Leverage on the existing Telecom
infrastructure Rapid scaling up of Agent points Efficiency & transparency in payment
disbursals Online monitoring & reporting Ease of use
Works on USSD on any feature phone
Available in vernacular language
M-Pesa offers last mile delivery of Banking & financial services
Leverage on the existing Telecom infrastructure
Rapid scaling up of Agent points Efficiency & transparency in payment
disbursals Online monitoring & reporting Ease of use
Works on USSD on any feature phone
Available in vernacular language
• Being piloted in Namkum block in Ranchi district
• Disbursement of funds to beneficiaries initiated
CommCare: Mobile Solution for Frontline Workers
Manage Apps and UsersRemotely manage your CommCare application and mobile workforce from our web-based application.
Monitor & Support Workforce“Active Data Management” utilizes the data you collect to focus on the continuous performance improvement of your workforce.
Web
Manage DataUse CommCare Mobile for complex data collection, submitted to the web in real-time
Manage ClientsUse “case management” to track client data
Engage with MultimediaUse images, audio, and video to educate and engage frontline workers and their clients.
Mob
ile
CommCare: Jharkhand RoadmapBeing piloted in Chandil block in Seraikella-Kharsawan
•Objective: To create a field-tested Standardized Open-Source Mobile App for Sahiyas that:
• helps in tracking pregnant women & children, home visit scheduling
• is easy to use for low-literate users• includes multimedia content such as images, audio, & video
for BCC• contains key data points as required by MCTS• works in online & offline mode (for areas with no
connectivity)• tracks immunizations• is replicable and scalable• sophisticated supportive supervision mechanisms
• Engaging women for improving demand for services
• Create a m-channel linking women to quality services by– Using the technology to inform women and
communities about entitlements, and schemes like JSY, JSSK
– Promote Birth Planning and service uptake– Feed back patient experiences to private and
public providers and facilities for continuous quality improvement
Linking Women to Services: Quality of Maternal Care (MoM-QC)
The Proposed Model
Women & communities call a toll-free number to give feedback., leave or seek information
The submitted information validated
Validated data published online
Validated data also published for access on same toll-free number
People can call into the toll-free number to listen to published reports
Engaging Women & Community through voice based social media, Mobile Vaani
Information on Entitlements, BPCR and QoC disseminated via the social media network
Improvement in QoC
Bring reports to the attention of health providers and facilities
Registered
health facility
Process overview
Step 1: Receive weeklyRequest SMS
Step 2: Health workercounts and notes
Step 3: Send response SMS on time: Receive incentive
Step 5:Reports via internet, smart phone e-mail
Step 6: Taking appropriateaction
The system accept SMS messages from any mobile network
SMS for Life in Jharkhand• Problems existent in logistics
management– Stock outs in peripheral health structures– Health logistics– Lack of accurate surveillance data
→ SMS for Life to quantify the problem → SMS for Life to improve surveillance &
HMIS → Need for evidence based planning and
action as India is working towards increasing universal coverage and health spending
e-Governance initiatives: providing a comprehensive approach
Works on the face of quality in the health system
Exploits modern ICTs Electronic HIS
Uses pay-for performance
Enhance transparency & accountability
Potential to improve access to services
Addresses extrinsic & intrinsic motivation
Potential to revolutionize service delivery mechanisms
Way forward
It’s only the tip which has been explored
e-Governance is rising
The potential is unparalleled and the need of the hour is to harness the resources effectively and optimally