Computerized System In Himachal Pradesh

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Computerized System In Himachal Pradesh

• Health Management Information System (HMIS)

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Health Management Information System in Himachal
Pradesh
Presentation by Ms. Harinder Hira Principal
Secretary-Health Govt. of Himachal Pradesh
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Before

• Data was available but not accessible
• Summary of data was calculated by hand and
  therefore prone to errors
• Long delay to produce reports

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Data Storage
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Need for the New HMIS

• Reform health information system
• Transition from reporting system to conscious use
  of information
• Managerial decision making
• Accuracy of Data
• Facility wise performance
• New computerized HIMS is expected to increase
  coverage improve quality of services

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Existing MIS Flow
Health Workers at SC Level
Collects and fills data
Form 6
Other Health Program Forms
Reports to PHC
Form 7
A
7
A
Reports to Block
Form 8
Reports to District H.Q.
Form 9
Monthly Bulletin on Process of
Different Districts
Reports to Directorate
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Today

• Data is accessible at all levels
• Reports are produced on time
• Reports are used for monitoring and decision
  support

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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

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Computerized HMIS
Data Collection at Health Facilities Form 6, 7
and 8)
Through Floppy
District Computer Unit
Block Computer Unit
Through FTP, using phone lines
Decision Support System
State Directorate
Health Managers / Program Officers
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New Computerized HIMS Flow
SC, PHC, Block PHC, CHC and Other Health Facility
Collects and fills data
Feedback on Indicators
Form 6
PHC fills additional data On form 7
Reports to Block Computer Unit
Hospitals fill additional data On form 8
Reports to District Computer Unit
Compiles data for Decision Making
Reports to State Computer Unit
Compiles data for Decision Making
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Reports

• Reports are used at monthly Block meetings
• Reports help in the monitoring of activities
• Additional reports can be programmed if needed

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Health Performance Indicators
Services Percentage Recorded 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    
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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    
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Data Available in Form 6 (all health facilities)

1. Number of OPD cases
2. Ante Natal Care
3. Natal Care
4. Pregnancy Outcome
5. Post Natal Care
6. Immunization
7. Booster Immunization
8. Childhood Diseases
9. Child / Infant Deaths
10. Contraceptive Services
11. Abortions
12. Communicable Diseases
13. Number of Blind
14. IDD control (Iodine Deficiency)
15. Leprosy Cases
16. Registration of vital events (births, deaths)
17. Interaction with the community

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Data Available in Form 7 (PHC only)

• Post natal care
• RTI/STI
• Contraceptive Services
• Abortions
• Communicable Diseases
• Blindness Cases
• Leprosy Cases
• School Health
• Equipment
• Vacancy Position
• Inventory of Drugs, Vaccines, Lab consumables and
  Equipment

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Data Available in Form 8 (Add. for CHC, CH, Dist.
Hops., Zonal Hosp.)

• Natal care
• Post natal care
• Contraceptive Services
• Abortions
• Leprosy Cases
• Prevention of food adulteration
• Inventory of Drugs
• Staff Position

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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

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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

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CONCLUSION

• 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.

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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

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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

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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

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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.