Electronic Health Management Information System to Improve Recording and Reporting for TB Control in Bangladesh: Roll-out Experience and Opportunities *Mohammad Kibria; Senior Technical Advisor- HIS, SIAPS Sanaul Bashar, Senior Technical Advisor- TB, SIAPS Liza Talukder; Technical Advisor- Communication, SIAPS Abu Taleb, Technical Advisor- TB, SIAPS

December, 2015

Despite the concerned efforts of National Tuberculosis Control Program (NTP) and

its partners, tuberculosis (TB) still remains a considerable public health concern in

Bangladesh. One of the most significant challenges for NTP is to maintain accurate

recording and up-to-date reporting of TB case data. Lack of timely case reporting

leads to delays in treatment, and ultimately contributes to increased rate of drug-

resistant TB.

The USAID-funded Systems for Improved Access to Pharmaceuticals and Services

(SIAPS) Program, implemented by Management Sciences for Health (MSH),

collaborated with the Ministry of Health and Family Welfare (MOHFW) to assess the

needs of NTP’s information management system. After an option analysis, NTP

adopted the web-based e-TB Manager (e-TBM- http://etbmanagerbd.org/) to better

manage TB patients and medicines while generating key reports and indicators.

NTP, in partnership with WHO, piloted e-TBM at 6 sites in November 2010 which

was then rolled out to 240 sites including all MDR sites in Bangladesh. Realizing the

enormous potentiality during the initial experience of implementation, NTP

acknowledged e-TBM as mandatory tool for recording and reporting of TB cases and

recently issued notification to 20 districts’ (having full coverage of e-TBM in all sub-

districts) authorities to generate reports (TB10, TB11 and TB12) through this system.

For e-TBM to replace inefficient paper-based recording and reporting system, it was

necessary to enter all TB cases into the system to improve data quality. Since the

issuance of Govt. notification, 20 districts are routinely entering data into e-TBM and

33,227 cases were entered in 2015 (Data as of 30 September, 2015; Source: eTB

Manager) as oppose to total registered cases (n=37,968) in TB cards (Source: NTP

MIS report, 2015). It is observed that, difference between paper-based and

electronically generated reports is gradually decreasing (18% in 1st quarter vs 8% in

3rd quarter).

“e-TBM allows me to

ensure recording and

reporting of the

quality data.”

Mr. Bahauddin

Performance rate for data quality aspects (timeliness, completeness, accuracy) in

these 20 districts has progressively improved. 89% of sites in 3rd quarter of 2015 falls

under “A ”Category from 62% in 1st Quarter of 2015, representing an increase of 27

percentage points. (“Category A” denotes high performing site and “Category D”

represents low performing site.

SIAPS has also provided training to its TB partners’ (NTP, BRAC, HEED, Lepra,

URC, Challenge TB and Damien Foundation) staffs (n~200) on e-TBM.

Mr. Bahauddin1, TB

and Leprosy Control

Assistant-TLCA and

e-TBM focal person

for one sub-district,

received training in

2010 and describes

this tool as “life

saver.”

“I can easily find out

an old registered case

when it comes as a

relapse case to

complete the previous

information.

Preparation of

quarterly reports and case analysis by type, sex, age, category, facility etc. became

easier and takes only few seconds which took minimum two days previously,” He

happily added. “e-TBM allows me to ensure recording and reporting of the quality

data.”

1 Mr. Bahauddin’s role has now been changed as national trainer for e-TBM. He is

contributing significantly to NTP’s countrywide expansion process

*Corresponding author: mkibria@msh.org

0%

25%

50%

75%

100%

1Q 2Q 3Q

Site performace as per category

A B C D