Computerized System In Computerized System In Himachal PradeshHimachal Pradesh
Computerized System In Computerized System In Himachal PradeshHimachal Pradesh
Health Management Information Health Management Information System (HMIS)System (HMIS)
Health Management Information Health Management Information System (HMIS)System (HMIS)
Health Management Information System in Himachal Pradesh
Presentation by Ms. Harinder HiraPrincipal Secretary-HealthGovt. of Himachal Pradesh
Before:
Data was available but not accessible
Summary of data was calculated by hand and therefore prone to errors
Long delay to produce reports
“Data Storage”
Need for the New HMISNeed for the New HMISNeed for the New HMISNeed for the New HMIS
• Reform health information systemReform health information system• Transition from reporting system to Transition from reporting system to
conscious use of informationconscious use of information• Managerial decision makingManagerial decision making• Accuracy of Data Accuracy of Data • Facility wise performanceFacility wise performance• New computerized HIMS is expected to New computerized HIMS is expected to
increase coverage & improve quality of increase coverage & improve quality of servicesservices
• Reform health information systemReform health information system• Transition from reporting system to Transition from reporting system to
conscious use of informationconscious use of information• Managerial decision makingManagerial decision making• Accuracy of Data Accuracy of Data • Facility wise performanceFacility wise performance• New computerized HIMS is expected to New computerized HIMS is expected to
increase coverage & improve quality of increase coverage & improve quality of servicesservices
Existing MIS FlowExisting MIS FlowExisting MIS FlowExisting MIS Flow
Health Workers atHealth Workers atSC LevelSC Level
Health Workers atHealth Workers atSC LevelSC Level
Form 6Form 6Form 6Form 6Other HealthOther Health
ProgramProgramFormsForms
Other HealthOther HealthProgramProgramFormsForms
Reports to PHCReports to PHCReports to PHCReports to PHC
Form 7Form 7Form 7Form 7
AAAA
Collects and fills dataCollects and fills data
AAAA
Reports to BlockReports to BlockReports to BlockReports to Block
Form 8Form 8Form 8Form 8
Reports to District H.Q.Reports to District H.Q.Reports to District H.Q.Reports to District H.Q.
Form 9Form 9Form 9Form 9
Reports to DirectorateReports to DirectorateReports to DirectorateReports to DirectorateMonthly Bulletin on Monthly Bulletin on Process of DifferentProcess of Different
DistrictsDistricts
Monthly Bulletin on Monthly Bulletin on Process of DifferentProcess of Different
DistrictsDistricts
Today:
Data is accessible at all levels
Reports are produced on time
Reports are used for monitoring and decision support
Current Status A computerised information system (HMIS) has been installed
in 10 districts out of 12 districts of Himachal Pradesh.
Monthly Reporting Forms 6, 7 and 8 are entered into the HMIS from all Blocks.
HMIS is on trial basis in remaining district of Sirmaur and Tribal District of Himachal Pradesh.
Data from SC, PHC, CHC and Hospitals is available for reporting, supervision, planning and analysis
Computerized HMISComputerized HMISComputerized HMISComputerized HMIS
Data Collection at Data Collection at Health Facilities Health Facilities Form 6, 7 and 8)Form 6, 7 and 8)
District Computer UnitDistrict Computer UnitBlock Computer UnitBlock Computer Unit
Decision Support Decision Support SystemSystem
State DirectorateState Directorate
Health Managers / Health Managers / Program OfficersProgram Officers
Through Through FloppyFloppy
Through FTP, using phone Through FTP, using phone lineslines
New Computerized HIMS FlowNew Computerized HIMS FlowNew Computerized HIMS FlowNew Computerized HIMS FlowSC, PHC, Block PHC,SC, PHC, Block PHC,CHC and Other HealthCHC and Other Health
FacilityFacility
SC, PHC, Block PHC,SC, PHC, Block PHC,CHC and Other HealthCHC and Other Health
FacilityFacility
Feedback on IndicatorsFeedback on IndicatorsFeedback on IndicatorsFeedback on IndicatorsForm 6Form 6Form 6Form 6
Collects and fills dataCollects and fills data
PHC fills additional dataPHC fills additional dataOn form 7On form 7
PHC fills additional dataPHC fills additional dataOn form 7On form 7
Reports to BlockReports to Block Computer UnitComputer Unit
Reports to BlockReports to Block Computer UnitComputer Unit
Hospitals fill additional dataHospitals fill additional dataOn form 8On form 8
Hospitals fill additional dataHospitals fill additional dataOn form 8On form 8
Reports to DistrictReports to District Computer UnitComputer Unit
Reports to DistrictReports to District Computer UnitComputer Unit
Reports to StateReports to State Computer UnitComputer Unit
Reports to StateReports to State Computer UnitComputer Unit
Compiles data forCompiles data forDecision MakingDecision Making
Compiles data forCompiles data forDecision MakingDecision Making
Compiles data forCompiles data forDecision MakingDecision Making
Compiles data forCompiles data forDecision MakingDecision Making
Reports
• Reports are used at monthly Block meetings
• Reports help in the monitoring of activities
• Additional reports can be programmed if needed
Health Performance IndicatorsHealth Performance IndicatorsHealth Performance IndicatorsHealth Performance IndicatorsServices Percentage Recorded
1 ANC cases registered
2 Pregnant woman with 3 ANC check-ups
3 Registered pregnant woman receiving all ANC services
4 Registered high risk pregnant woman referred
5 Deliveries conducted by trained health personal
6 Deliveries conducted by TBA
7 Woman received 3 Post Natal Check-ups (PNC)
8 Male sterilization to total sterilization
9 Eligible couples covered by IUD
10 Births notified to Local Registrar
11 Still Births notified to Local Registrar
12 Maternal Deaths notified to Local Registrar
13 Utilization of health facility (O.P.D.)
14 Average per day O.P.D. workload per doctor
15 Infant Mortality Rate (IMR) per 1000 live births
16 Maternal Mortality Rate (MMR) per lakh live births
Male Female
17 Infant (0 to 1 year) fully immunized out of the eligible infants.
18 Incidence of Measles cases per 1000 population
19 Incidence of Whooping Cough cases per 1000 population
20 Diarrheal cases registered under 5 years per 1000 under 5 years population
21 Birth weight recorded less than 2.5 Kg
22 Birth weight recorded 2.5 Kg or more
23 High risk new born referred
24 Acute Diarrhea Disease under 5 years given ORS
25 Acute Diarrhea Disease cases referred
26 ARI cases treated with Co-trimaxozole
27 ARI cases referred
28 Infant Mortality Rate (IMR) per 1000 live births
Data Available in Form 6 (all health facilities)
1. Number of OPD cases2. Ante Natal Care3. Natal Care4. Pregnancy Outcome5. Post Natal Care6. Immunization7. Booster Immunization8. Childhood Diseases9. Child / Infant Deaths10. Contraceptive Services11. Abortions12. Communicable Diseases 13. Number of Blind14. IDD control (Iodine Deficiency)15. Leprosy Cases16. Registration of vital events (births, deaths)17. Interaction with the community
Data Available in Form 7 (PHC only)
1. Post natal care
2. RTI/STI
3. Contraceptive Services
4. Abortions
5. Communicable Diseases
6. Blindness Cases
7. Leprosy Cases
8. School Health
9. Equipment
10.Vacancy Position
11.Inventory of Drugs, Vaccines, Lab consumables and Equipment
Data Available in Form 8 (Add. for CHC, CH,
Dist. Hops., Zonal Hosp.)
1. Natal care
2. Post natal care
3. Contraceptive Services
4. Abortions
5. Leprosy Cases
6. Prevention of food adulteration
7. Inventory of Drugs
8. Staff Position
General Findings
• HMIS is their reporting, monitoring and supervision tool
• Situation with data transfer has improved
• User refresher training has to be intensified
• Maintenance of computers not secured
• Need to change form 6,7 and 8
General Findings: Data Analysis
• HMIS is a rich basis for additional data analysis
• Data analysis is limited (meaning no trends,
correlations, regressions) at the moment
CONCLUSIONCONCLUSION
• The vision of a new HMIS is that it is simple to operate & valuable to health staff.
• The system has been designed in such a way that health workers who collect the information must be able to use it also. The forms & formats developed should not be too many, bulky and complicated so as to avoid the temptation of not filling them.
• The system has been developed & pre-tested in 3 districts for a year.
Outlook and Perspectives: Reports
• Reports have improved, some calculations need to be corrected (in process).
• Visualisation of data/reports (graphs/charts) is available but has to be improved.
• Ranking of health services for selected indicators has been programmed and works
Outlook and Perspectives: Training and Maintenance
• Statisticians should be trained in additional software (Excel, Access, Windows).
• Statisticians are and will be trained in same basic hardware maintenance
FRIENDLY REMINDER:
• The purpose of HMIS is to improve health care delivery through improved monitoring, supervision and planning!
• HMIS is an essential tool to achieve that purpose
Challenge Ahead
• New Forms in NRHM
• Integrate HMIS proposed HIS(Health Information System) and other softwares to produce comprehensive reports.
• To take HMIS up to PHC level.
Top Related