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Authors
Dr. Lo Veasnakiry, DPHI Director
Dr. Khol Khemrary, DPHI
Mr. Buth Saben, DPHI
Dr. York Dararith, DPHI
Dr. Meas Vanthan, DPHI
Mr. Sek Sokna, DPHI
Dr. Mean Reatanak Sambath, URC
Mr. Hong Roith, URC
Ms. Oeng Sothary, URC
Health Management Informa! on System (HMIS) Launching
HMIS launching on October 6, 2011.
Photographer: Mr. Pen Darith
On 6 October 2011, Cambodian Ministry of Health
(MoH) with supports of USAID (US Agency for
Interna! onal Development) through URC- Be" er
Health Services Project (BHS) launched the
MOH Health Management Informa! on System.
The launch was organized and prepared by the
technical team of the Department of Planning and
Health Informa! on (DPHI) and URC Cambodia. It
was presided by HE Prof Eng Huot, Secretary of
State, Ministry of Health, and representa! ve of
USAID Cambodia. HE Prof Eng Huot appreciates
the support of USAID and URC on HMIS work
in Cambodia. A total of 134 par! cipants (30
females) a" ended the launch. The par! cipa! ons
are representa! ves of the MoH departments,
na! onal programs, na! onal hospitals, provincial
health departments, opera! onal district, private
www.hiscambodia.org
Eff ec" ve health informa" on system management is a contribu" ng factor in be# er
decisions and quality health service provision.
Kingdom of Cambodia
Na! on - Religion - KingPlanning And Health Informa! on Department
Health Informa! on Bureau
Ministry of Health
Issue No. 3 | May 2012Quarterly Bulle" n
providers and health development partners. URC
staff presented the general concepts of the HMIS
database integra! on. Ten HMIS users (3 MoH
department, 1 URC, 2 PHD, 1 MCH-PHD, 1 OD,
Contents
Health Management Informa! on System
(HMIS) Launching 1
The Pa! ent Electronic Medical Record System 2
Cambodian Health Management
Informa! on System 3
Background 3
Outcomes 3
HMIS Users 4
HMIS Daily Users 6
Hospital Coverage 6
MCH Health Sta! s! cs 7
2 • Cambodian Health Management Informa� on System
Pa ent Electronic Medical Record System
URC Cambodia has an area where the MoH has
specifically nominated the BHS Project to take
lead in developing Pa" ent Electronic Medical
Record System. The ini" al project is star" ng
from pa" ent registra" on, payment record and
pa" ent informa" on record. URC team have
been working at field level with the Siem Reap
provincial hospital in which is level 3 (called
CPA3- Complementary Package of Ac" vi" es)
in Cambodia. URC developed hospital based
pa" ent registra" on database along with other
work of the technical team who is consulted
and discussed about medical requirement
and pre condi" on for hospital based database
implementa" on. Finally the hospital pa" ent
database was launched on 16-11-2011. Hospital
enrolled 197 pa" ents at first day and 196 pa" ents
at second day, 213 pa" ents at third day.
The five database worksta" ons are now located
in registra" on room and cashier room. The
registra" on services are worked 24 hours including
weekend days. This is an integra" on pa" ent
database that will track mul" ple pa" ent related
data such as pa" ent demographic, payment,
diagnosis and other supported services. This is a
first MoH public hospital at the field level who
implement one way pa" ent entry and centralize
pa" ent registra" on database. Hospital director and
hospital staff are very happy and demonstrated
strong collabora" on with URC and ownership to
manage hospital pa" ent database. URC team also
reported this process to DPHI/MoH and keeps
them informed about the success.
URC staff explained data clerk for gathering and entering
pa� ent informa� on through computerized system at first day
of launches in Siem Reap provincial hospital in Cambodia on
16-11-2011. Photographer: Ms. Oeng Sothary
2 private providers) presented their experience
and prac" ce of the HMIS web based database.
All presenters accounted that HMIS web based
database is a useful and appropriate solu" on
for managing the health informa" on system in
Cambodia. The director of Kien Svay OD presented
a data quality check prac" ce and how they use
HMIS web based database system.
As of September 2011, the HMIS covers 5 different
data sources: public health facility health sta" s" cs;
private and NGO health sta" s" cs, the PMTCT and
Linked Response programs, the Maternal Death
Surveillance System; and results from the health
facility assessments conducted by the QAO Office.
The launch was close with frui% ul results and Dr.
Lo Veasnakiry, DPHI director, made a remark in the
closing sec" on.
Nov-11
Nu
mb
er
Dec-11 Jan-12 Feb-12 Mar-12
OPD IPD Total
0
500
1,000
1,500
2,000
2,500
3,000
3,500
4,000
4,500
5,000
Figure 1: Number of Siem Reap Provincial hospital
pa"ents
Issue No. 3 | May 2012 • 3
Background
Department of Planning and Health Informa� on
of the Ministry of Health with technical support
of the URC Be� er Health Services Project in
Cambodia upgraded HIS Access database to
the HMIS (Health Management Informa� on
System) web based database since mid-2010.
BHS harnessed new technologies, such as open-
source so� ware and dynamic scrip� ng languages
(namely, MySQL and PHP) to build a new, user-
friendly web interface.
The result was a full-featured, web-based
applica� on for entering, reviewing, and edi� ng
health informa� on at all system levels. The
new HMIS also has advanced func� onality
for repor� ng to reflect the key indicators in
Cambodia’s second Na� onal Strategic Plan
(HSP2). Cambodia Health Management
Informa� on System Web based Databases were
developed to organize large web sites and
allow data capture via browser-based forms. By
enabling users outside a closed network, access
to a central or standalone database, they permit
greater flexibility than through using tradi� onal
‘client-server’ systems.
Accordingly, web-enabled databases have
introduced a new tool for health managers,
health staff and officers, permi! ng direct data
capture at source and thus avoiding many of the
delays and errors arising from paper forms, data
transmission and mul� ple data entry. In addi� on,
real-� me data collec� on permits sophis� cated
decision support and repor� ng, and thus
improved project co-ordina� on, planning and
par� cipa� on.
Outcomes
A� er one year of implementa� on, HMIS
shows great results as shown by the following
outcome indicators:
Cambodian Health Management Informa! on System
Pe
rce
nta
ge
of
Mo
Hh
ea
lth
fa
cili
�e
sre
po
r�n
g H
MIS
da
ta
Pe
rce
nta
ge
of
Mo
Hh
ea
lth
fa
cili
�e
s w
ith
�m
ely
re
po
r�n
g
HM
IS d
ata
qu
ali
tyin
HM
IS
Pe
rce
nta
ge
100%100%
87%
0%
20%
40%
60%
80%
100%
Nu
mb
er
of
Mo
H
he
alt
h f
aci
li�e
s
rep
or�
ng
HM
IS d
ata
Nu
mb
er
Nu
mb
er
of
pri
vate
an
d
NG
O h
ea
lth
fa
cili
�e
s
rep
or�
ng
HM
IS d
ata
Nu
mb
er
of
Mo
H
he
alt
h f
aci
li�
es
rep
or�
ng
PM
TC
T/LR
da
ta t
hro
ug
h H
MIS
0
200
400
600
800
1000
12001097
1090
162
Figure 2: Data quality as percentage
Figure 3: Number of health facility reported
through HMIS
4 • Cambodian Health Management Informa� on System
HMIS User
The figure 4 shows about the top- ten PHD used HMIS for the last 9 months that started from April,
2011 to December, 2011. The top three provinces are Prey Veng, Kampong Cham and Kampong
Chhnang.
The figure 5 displays the top-ten of Opera" onal Districts used HMIS among the 77 ODs in the whole
country. For number one goes to Memut , number two goes to Pearaing and for number three goes
to Ba# ambang.
4768
3757
3030
2777
2133
2011
1951
1871
1786
1785Banteay Meanchey
Pailin
Siemreap
Takeo
Preah Vihear
Fre
qu
en
cy
Ratanakiri
Kampong Thom
Kampong Chhnang
Kampong Cham
Prey Veng12
34
56
78
91
0
10518
8964
8336
7911
7101
6915
6874
6774
6706
6495
12
34
56
78
91
0 Kampong Thom
Tbong Khmum - Kroch Chhmar
Svay Antor
Boribo
Choeung Prey - Batheay
Sampov Meas
Kean Svay
Fre
qu
en
cy
Ba!ambang
Pearaing
Memut
Figure 4: Top Ten PHD Used HMIS , April -Dec 2011
Figure 5: Top Ten OD Used HMIS , April -Dec 2011
Issue No. 3 | May 2012 • 5
The figure 6 shows about the top ten hospital used HMIS for the last nine months. For number one
run to Prey Veng Provincial Hospital, number two run to Cheychumnash Hospital and the number
three run to Pailin Provincial Hospital.
The figure 7 displays the top-ten HC used HMIS started from May, 2011 to December, 2011. Ta Sanh
HC in ba� ambang OD, Banteay Neang HC and Russei Kraok II HC in Mongkol OD are remarkably
achieved of highly using HMIS in HC level.
2025
1540
1488
1353
1324
1309
1298
1033
1019
1003
12
34
56
78
91
0 Kra e Prov. Hosp.
Stung Treng Prov. Hosp.
Svay Rieng Prov Hosp.
Kampong Trabek Hosp.
Kampot Prov. Hosp.
Preah Sihanouk Prov. Hosp
Na onal Pediatric Hosp.
Fre
qu
en
cy
Pailin Prov. Hosp.
Cheychumnash Hosp.
Prey Veng Prov. Hosp.
970
784
747
732
715
676
617
604
556
517
12
34
56
78
91
0 Ponley
Chamkar Samrong
Ro!anak
Ou Russei
Poipet I
Preas ponlea
Malai
Russei Kraok II
Fre
qu
en
cy
Banteay Neang
Ta Sanh
Figure 6: Top Ten Hospital Used, April -Dec 2011
Figure 7: Top Ten HC used HMIS, May-Dec 2011
6 • Cambodian Health Management Informa� on System
HMIS Daily Users
The HMIS daily users have been significantly increased since it had been officially introduced for
na# onal usage.
Hospital Coverages
The fi gure 9 iden# fies the
categories of hospitals which
provide complementary care
in 2011 in Cambodia. The base
graph demonstrates that 45%
of hospitals has implemented
CPA1, 32.5% used CPA2, and
22.5% used CPA3. It means
that around half of all hospitals
in Cambodia has provided
CPA1 services, especially at
the countryside.
0
1000
2000
3000
4000
5000
6000
7000
8000
Nu
mb
er
Tu
e 1
2-A
pr-
20
11
Su
n 1
7-A
pr-
20
11
Fri
22
-Ap
r-2
01
1
We
d 2
7-A
pr-
20
11
Mo
n 0
2-M
ay
-20
11
Sa
t 0
7-M
ay
-20
11
Th
u 1
2-M
ay
-20
11
Tu
e 1
7-M
ay
-20
11
Su
n 2
2-M
ay
-20
11
Fri
27
-Ma
y-2
01
1
Th
u 0
2-J
un
-20
11
Tu
e 0
7-J
un
-20
11
Su
n 1
2-J
un
-20
11
Fri
17
-Ju
n-2
01
1
We
d 2
2-J
un
-20
11
Mo
n 2
7-J
un
-20
11
Sa
t 0
2-J
ul-
20
11
Th
u 0
7-J
ul-
20
11
Tu
e 1
2-J
ul-
20
11
Su
n 1
7-J
ul-
20
11
Fri
22
-Ju
l-2
01
1
We
d 2
7-J
ul-
20
11
Mo
n 0
1-A
ug
-20
11
Sa
t 0
6-A
ug
-20
11
Th
u 1
1-A
ug
-20
11
Tu
e 1
6-A
ug
-20
11
Su
n 2
1-A
ug
-20
11
Fri
26
-Au
g-2
01
1
We
d 3
1-A
ug
-20
11
Mo
n 0
5-S
ep
-20
11
Sa
t 1
0-S
ep
-20
11
Th
u 1
5-S
ep
-20
11
Tu
e 2
0-S
ep
-20
11
Su
n 2
5-S
ep
-20
11
Fri
30
-Se
p-2
01
1
We
d 0
5-O
ct-2
01
1
Su
n 0
9-O
ct-2
01
1
Fri
14
-Oct
-20
11
We
d 1
9-O
ct-2
01
1
Mo
n 2
4-O
ct-2
01
1
Sa
t 2
9-O
ct-2
01
1
Th
u 0
3-N
ov
-20
11
Tu
e 0
8-N
ov
-20
11
Su
n 1
3-N
ov
-20
11
Fri
18
-No
v-2
01
1
We
d 2
3-N
ov
-20
11
Mo
n 2
8-N
ov
-20
11
Sa
t 0
3-D
ec-
20
11
Th
u 0
8-D
ec-
20
11
Tu
e 1
3-D
ec-
20
11
Su
n 1
8-D
ec-
20
11
Fri
23
-De
c-2
01
1
We
d 2
8-D
ec-
20
11
Tu
e 0
3-J
an
-20
12
Su
n 0
8-J
an
-20
12
Fri
13
-Ja
n-2
01
2
80
36
26
18
0 10 20 30 40 50 60 70 80 90
Total
CPA
Nu
mb
er
1
CPA 2
CPA 3
Figure 8: Daily Rate of HMIS Page Visits. April 2011-Jan 2012
Figure 9 : Hospitals by Categories in Cambodia 2011
Issue No. 3 | May 2012 • 7
MCH Sta! s! cs
• Antenatal care visits
• Antenatal care visit in 2011
The fi gure 10 represents the percentage
of progress of ANC2/ANC4 from 2006
and 2011. The line graph shows that
pregnancy women who visited hospital
for 2nd antenatal care gradually increased
from 64%-89% in 2006 to 2009, but it
slowly decreased at the beginning of
2010 (80%) then went up to 86% in 2011.
The figure 11 shows the number and
percentages of the cascade of ANC in
2011. This graph clearly indicates, the
101% (371,445) of pregnancy women
a! end their first antenatal services, 86%
(315,717) for ANC2, 64% ( 235,187) for
ANC3 and 53% (191,298) for ANC4 during
the specific pregnancy.
For the 4th antenatal care visited was
progressively gone up from 25% to 52% in
2006 -2011. It could be the effec# ve of the
health awareness educa# on through or more
understanding of the advantage of pregnancy
preven# on.
This indicates that maternal women in Cambodia
regards antenatal care as a one-# me service,
while in fact they should make several visits
before their delivery.
64%69%
75%
89%
80%
86%
25% 26%30%
45% 46%
52%
0%
10%
20%
30%
40%
50%
60
Pe
rce
nta
ge
%
70%
80%
90%
100%
2006 2007 2008 2009 2010 2011
ANC 2 ANC 4
Figure 10 : Trend of Antenatal Care Visits from 2006 to 2011
8 • Cambodian Health Management Informa� on System
• Births
The fi gure 12 represents the percentage
of deliveries by trained health personnel
and health facili" es in2006 to 2011. The
line graph displays that the percentages
of delivered by trained health personnel
gradually increased from 40%-72% in
2006-2011. The percentage of deliveries by health
facili" es increased parallelism from 19%- 61% by
2006-2011 with the trained health personnel. It
means that more than 60% of delivered respond
by trained or skill health personnel.
Delivered by trained health personel Delivered at health facility
40%
46%
53%
64%70% 72%
19%24%
35%
50%
59%61%
0 %
10 %
20 %
30 %
40
Pe
rce
nta
ge
%
50 %
60 %
70 %
80 %
2006 2007 2008 2009 2010 2011
Number Percentage
371445N
um
be
r
315717
235187
191298101 %
86 %
64 %52%
ANC 1 ANC 2 ANC 3 ANC 4
Figure 11 Antenatal Care Visits Cascade in 2011
Figure 12: Percentage of Deliveries
Issue No. 3 | May 2012 • 9
• Post partum care cascade
• Post partum care cascade in 2011
To be strengthening the health
care of women post partum, MOH has
encouraged all women should be
received at least 2 � mes of post partum
care a� er their delivery. The chart shows
the 2nd post partum care follow up from
It is quite good that our women have
con� nued their post partum care
services. The figure 14 shows the
result of Post partum care in Cambodia
in 2011. The base-chart displays that
the percentages of post partum care
visit is 60% (221,427) in the PNC1,
37% (135,784) in PNC2, 16% ( 60,074)
in PNC3 and 6% (22,843) in PNC4
a� er delivery. It would be be" er if all
maternal women could complete their
four post partum visits to ensure their
medical well-being.
2006-2011. This line graph indicates that the
percentages of post partum care progressively
increased from 22% to 37% in 2006-2011. The
result shows the posi� ve outcome, but it is not
reach the MOH target.
PNC 2
22%24% 25%
29%
34%
37%
0%
5%
10%
15%
20
Pe
rce
nta
ge
%
25%
30%
35%
40%
2006 2007 2008 2009 2010 2011
Number
Nu
mb
er
Percentage
PNC 1 PNC 2 PNC 3 PNC 4
221427
135784
60074
22843
60%
37%
16%6%0
50000
100000
150000
200000
250000
Figure 13: Percentage of Post Partum Care from 2006 to 2011
Figure 14: Post Partum Care Cascade in 2011
10 • Cambodian Health Management Informa� on System
• Family planning
• Bed occupancy rate in 2011
Hospital management is very important;
Data analysis is more value to evaluate
the progress of quality of bed occupa! on
in hospital. The fi gure 16 indicates the
over all of percentage of bed occupa! on
rate is over the 50%, the majority of
its is 92.7% in Pediatric ward, then 87.2%
The figure 15 represents the sta! s! cal
of birth spacing current user in 2011
(N=5810910). Pill is the main most
popular method that is being used by
in surgery, 86.1% in maternity, 83.9 in Medicine,
57% in Gynecology and other wards is 67.5%. It
mean that the most of services are occupied at
least 57% in hospital in 2011. Other meaning is
in this year, the most common of pa! ents who
infected is children.
women (51 %). The second choice method is
injec! on (36 %) but for Tubal Liga! on method
is rarely used by women 0.12% according to the
chart above.
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
51%
36%
4%8%
1% 0.12%
Pills
Pe
rce
tag
e
Injec!ons Condoms IUD Norplant Tubal Liga!on
83.9%87.2%
92.7%86.1%
57.0%
67.5%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Medicine
Ra
te
Surgery Pediatric Maternity Gynecology other
Figure 15 : Percentage of Birth Spacing Current Users in 2011 (N=581901)
Figure 16: Bed Occupancy Rate in 2011
Issue No. 3 | May 2012 • 11
• Average Length of Stay (ALS)
In order to evaluate the quality of health
care services or measure the outcome of
treatment, it would be monitor the length
of pa� ent staying in hospital. The base-
chart below shows that among 6 main
wards, the surgery ward is taken longer
than other wards, it took 7days in average
compared to medicine is 5.4 days, gynecology is
5days, pediatric is 4.9 days, maternity is 3.7 days
and other wards is 4.3 days in 2011. In generally,
all kind of diseases that admi� ed in hospital
were taken 4-7 days in average. It means that all
cases are the acute diseases.
5.4
7.0
4.9
3.7
5.0
4.3
0.0
1.0
2.0
3.0
4.0
5.0
6.0
7.0
8.0
Medicine
Ave
rag
e
len
gth
of
sta
y
Surgery Pediatric Maternity Gynecology other
6.2
6
5.8
5.6
5.4
5.2
5
4.8
4.6
2006
Ave
rag
e l
en
gth
of
sta
y
2007 2008 2009 2010 2011
6.13
5.645.52
5.53
5.255.24
Figure 17 : Average length of stay in Hospital in 2011
Figure 18 : Average length of stay in Hospital from 2006 to 2011
12 • Cambodian Health Management Informa� on System
Events:
= January 17, 2012 : Workshop on Reviewing
HMIS Implementa! on in Siem Reap Province
= March 14-15, 2012 : HMIS training Course
for Private and NGO provider in Ba" ambang
Province
= March and April 2012: Mee! ng on reviewing
and revising HMIS registers (Maternal and
Newborn Health) in Phnom Penh
= April 20, 2012: HMIS Management Training
Course at URC Phnom Penh Offi ce
= March 21-22, 2012 : HMIS Training Course
for PMTCT/LR at Kampong Cham Province.
Siem Reap Provincial Hospital staff discussed on Pa� ent
Electronic Medical Record on Dec 2011.
Photographer : Ms. Oeng Sothary
Siem Reap Provincial Hospital staff discussed on Pa� ent
Electronic Medical Record on Dec 2011.
Photographer : Ms. Oeng Sothary
Photographer : Ms. Oeng Sothary
This bulle� n was made possible by the support of the American people through the United States Agency for Interna� onal Development
(USAID). The contents of this bulle� n are the sole responsibility of the Ministry of Health, and do not necessarily reflect the views of
USAID or the United States Government.
Supported by
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