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 . . .

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• 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

System Entities and Activities

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

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F

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Fo

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app

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Fee

db

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4th to 7th working day of following month

Rev

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Rev

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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

HMIS

HMIS Gateway (www.uphcp.org)

www.uphcp.org

Screen Shot

Review

Report

CenterOperation (data entry)

Index Page (www.uphcp.org)

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 ShotEye Care Data Entry Screen (www.uphcp.org)

www.uphcp.org

Screen ShotQuick Review Panel (www.uphcp.org)

www.uphcp.org

Screen ShotOutput Panel (www.uphcp.org)

www.uphcp.org

Screen ShotOutput List cntd (www.uphcp.org)

www.uphcp.org

Screen ShotSample Output (www.uphcp.org)

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Screen Shot

Summary Info(Auto generated)

Audit Trial(Action Log with

date-time and Note)

Sample Output cntd (www.uphcp.org)

www.uphcp.org

Screen ShotEye Care Output Panel(www.uphcp.org)

www.uphcp.org

Screen ShotSample Eye Care Output (www.uphcp.org)

www.uphcp.org

Open Session

• Question & Answer

• Thanks for all

Zia HoqueMIS & Data Management Officer

ziamcsd@gmail.com