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Health Management Information System
Second Urban Primary Health Care Second Urban Primary Health Care ProjectProject
Local Govt. Division, Ministry of Local Govt. Division, Ministry of LGRD&CLGRD&C
www.uphcp.orgZia Hoque
MIS & Data Management Officer
Overview of
Urban Health MISUrban Health MIS
www.uphcp.org
Urban Health MIS Legacy System
• The first Urban Health Management Information
System of Bangladesh was established in 1998
• UHMIS was started as truly paper based system
• Routine data recorded in registers.
• Analyzing data, Quarterly Performance Report
was prepared by PA NGOs and sent to UPHCP
HQ for compilation
• UPHCP HQ compiled all together and produced
QPRs
Continued . . .
www.uphcp.org
Urban Health MIS Problem with Data
• There was no uniform framework upon which all
NGOs & development partners can collect,
analyze, report & use health data
• This makes inter-partner and even inter cost-
center (intra partner) comparison of health
progress difficult
• Development partners seriously feel this
limitation for monitoring progress of the
achievement, particularly of MDGs
Continued . . .
www.uphcp.org
Urban Health MIS Problem with Data
• Due to huge problems with data quality
development partners noticed several times within
the 9 years life time of the legacy system about lack
of consistency among variables. Few are following:
– Timeliness in data acquisitions, transportation, process and analysis as well as dissemination
– Dissimilar rates on same variable between organizations were common
– Poor reliability of data discouraged policy makers & managers to use health information for decision making
Continued . . .
www.uphcp.org
• There were a provision to recruit a 1.2 million USD budgeted heavy weight consulting firm for HMIS development & Implementation
• Unfortunately the recruitment was dropped in the mid way
• At this stage there were no single penny budgetary provision for any changes in HMIS
• But still then huge pressure remained from development partners to furnish HMIS to increase availability, reliability, timeliness …… ….. and so on …
Urban Health MIS HMIS in UPHCP-II
Continued . . .
www.uphcp.org
• In this scenario, still there was no budget for any
improvements of HMIS in UPHCP.
• By an alternate way we took an initiative to pool
a marginal fund and looked for the most cost
effective IT enabled solution (Software as
Service, i.e. a rental system)
• The first web based Health Management
Information System of Bangladesh was
established in late 2007 in this way
Urban Health MIS Web-based HMIS
Continued . . .
www.uphcp.org
• A web based Health Management Information System with integrated data approval mechanism has been developed and deployed.
• This is the starting point of a new era in the establishment of automated Health Management Information System in Bangladesh.
• This HMIS for UPHCP-II is a managed hosted application with basic objective to enhance data acquisition, approval and publishing process. It allows data to be route, verified and approved to PMU in a transparent manner.
Urban Health MIS Web-based HMIS
Continued . . .
www.uphcp.org
• Established a full functional web based HMIS• Automated data cross-checking & validation
mechanism has been introduced• A successful e-Governance application has
been integrated for data verification, approval and publication
• Current scope of the system is Services Statistics
• We are able to publish regular QPRs (Quarterly Performance Reports) within 21 days after a quarter passed.
Urban Health MIS Web-based HMIS
Continued . . .
www.uphcp.org
• The UHMIS was then equipped with the web
based HMIS in front layer and a paper based
data recording system in the background
• Still then the paper based data record keeping
system was not uniformed in 24 PAs. They
developed their own data recording system.
• UPHCP started working on developing Unified
Record Keeping System (URKS) from 2008.
Urban Health MIS Fine tuning
Continued . . .
www.uphcp.org
• The Unified Record Keeping System (URKS)
Development and Implementation Committee
was formed consisting of
– Representative of Director (MIS), DGHS
– Representative of Director (MIS), DGFP
– Representatives from NGOs and Consulting Firms
– Representatives from PIU and PMU
• URKS developed in line with the national
requirements.
Urban Health MIS Fine tuning
Continued . . .
www.uphcp.org
• URKS is now finalized, approved and in use.
• Therefore UHMIS is now equipped with the web
based HMIS in front layer and the URKS in the
background
• URKS is developed in a way that UPHCP might
switch over to a 100% automated system in no time
• Hopefully by its third phase UPHCP might be able
to develop and implement the automation by a
sophisticated HMIS
Urban Health MIS Fine tuning
Continued . . .
www.uphcp.org
• The Data Management Information System
(DMIS) support to MoHFW was working under
the Planning Wing, Ministry of Health & Family
Welfare
• The aim of DMIS is to develop the central Data
Warehouse for HMIS of Bangladesh
• However, DMIS was unable to customize the
DHIS2 for UPHCP-II. But still UPHCP is
providing data to DMIS in regular interval.
Urban Health MIS DMIS Support
www.uphcp.org
HMIS
Data Flow of UPHCP-II
DPs, LGD, MoHFW, DGHS, DGFP,
PAs, PIUs, PMU etc.
2nd to 3rd working day of following month
Forward for approval/ Feedback
Shared with stakeholders/ Feedback
Data recordingand monthly compilation by CRHCC, PHCC, Satellite, PECC, VCCT, DOTS
CounselorParamedicField Supervisor Clinic In-Charge
PA HQ for Entry, Edit and Validation
MIS Officer | Data Entry Project Manager | Approval
PIU for Collation and vetting
(S)MEO | Review Project Officer | Approve
PMU for Approval, processing and
compilationSMQAO | Review
MIS&DMO | ApproveDPD (Tech) | Approve, Publish
1st working day of following month
Sen
d
Har
dco
py
F
eed
bac
k
Fo
rwar
d f
or
app
rova
l/
Fee
db
ack
4th to 7th working day of following month
Rev
iew
F
eed
bac
k
Rev
iew
F
eed
bac
k
Quarterly Progress ReportPreparation & Publication
8th to 13th working day of following month
Approved and Published over web-based HMIS
LGD,
ADB,
DFID,
SIDA,
UNFPA,
ORBIS,
PPME
Firm
www.uphcp.org
Purpose for Developing a HMIS
• To initiate automation for a complex and challenging project with widely distributed locations
• To utilize the technological advantages offered by internet for data communication
• To provide an effective tool for data management, dissemination and storage.
• To act as a pilot for a comprehensive HMIS. This one is the first web-based HMIS of Bangladesh.
www.uphcp.org
System Characteristics• A quantum improvement on quality, volume and accuracy
for report generation
• Attempts to meet the information requirements of the executing and donor agencies by producing improved and comprehensive QPRs
• Authenticity and acceptability of MIS reports.
• It is a substantially cost-effective solution for creating a distributed networked system in terms of investment on cost of equipment, development, manpower requirement and training.
• Ease of implementation and operation
• Effective means of introducing computer culture among the participating agencies.
www.uphcp.org
Current StatusAs per the the scope of the system, only services statistics has been automated from PA level. All partners are uploading their center-wise monthly performance record to the central website. Core advantage of this application can be summarized as follows:
– PAs are able to enter center-wise monthly data in a central database
– Stakeholders at higher levels (PIU/PMU Officials) are able to review, forward or return documents, submitted by the lower formations.
– Donor representatives/Consultant firms can keep track of the information flow.
– Centralized System is administered by Project Management Unit of UPHCP-II
– Status of a specific document is visible/transparent to all relevant users.
– Effective for monitoring & supervision of the project.
www.uphcp.org
Strength• Ready availability i.e. web based system
• Logical validity checks
• Reviewed and approved by PIU
• Speeded up the report preparation.
• Improved data quality due to cross verification between
database and physical registers during monitoring visits by
PIU and PMU officials as well as ISI conducted by PPM&E.
• Flexibility in report generation.
• Availability of legacy data from inception i.e. July 2005.
www.uphcp.org
Limitations/Constraints• Data coverage confined to only services statistics. There
are scope for introducing many other modules.• Data entry is from PA level. It may be extended up to
center level and even in some extend up to satellite level.
• Data accuracy still suffers due to inadequate monitoring at the field level.
• DMIS was not able to provide the technical support as per requirement.
• Recruitment of HMIS firm has been dropped. In the absence of budget it is impossible to develop a sophisticated MIS.
• Though we are talking about Urban HMIS, there are a lot of different type players are in the same field. All should come under one umbrella to depict the actual scenario of Urban Health.
www.uphcp.org
Screen Shot
Age group wise client info
Medicine
Service Head-wise Patient info
Sub-Component-wise Record
Error
Message
Data Entry Screen (www.uphcp.org)
www.uphcp.org
Screen ShotSample Output (www.uphcp.org)
www.uphcp.org
Screen Shot
Summary Info(Auto generated)
Audit Trial(Action Log with
date-time and Note)
Sample Output cntd (www.uphcp.org)
www.uphcp.org
Open Session
• Question & Answer
• Thanks for all
Zia HoqueMIS & Data Management Officer