National HMIS Support: India Experience. Prof. Sundeep Sahay

Transcription

1 National HMIS Support: India Experience Prof. Sundeep Sahay

2 Mandate Supporting National HMIS Ministry in HMIS Design and Planning Supporting National Programme Divisions with HMIS Inputs (Maternal Health, Child Health, TB, Malaria etc) Facilitating & Supporting States in implementation of HMIS reforms and integration Providing Technical & Capacity Building Support to states on HMIS Creating National HMIS Resource Pool Providing support to National Level & States on new ICT based interventions, where identified Providing low cost sustainable e-health solutions

3 Presentation Overview Section 1- National HMIS Implementation Section II - Sustainable e-health solutions

4 SECTION 1 National HMIS Implementation

5 Support on HMIS: Guiding Principles Perspective on HMIS as a tool to support: Decentralized planning and monitoring, empowering district, Blocks & facilities Integration across levels and programs Promote use of Free and Open Source software to enable large scale use of software and avoid vendor lock in to properietary software Data warehousing approach built on principle of integration Synergies between informatics and public health Focus on processes of standardization Promote the analysis and use of information of action Focus on scalability and sustainability of systems Principles of flexibility and local control inscribed in software design and implementation approach

6 Framework for Re-design Simplification of existing data collection formats Reducing work load on field staff Promoting information for action Strengthening processes of decentralization Strengthening processes of integration technical & institutional: Data flows Software support Resources

7 Situation analysis: Issues raised Data related unreasonable number of data elements high % of blank or zero values duplications and gaps systemic ambiguities indicator to data mismatch lack of uniformity & standards in naming conventions Systems related disproportionate attention to hardware/software undue burden of reporting on field staff weak support for supervision and feedback inadequate quality assurance mechanisms fragmentation and verticality of systems

8 Implementation Framework Phase I: Making systems operational (6 months) Objective: Establishing systems required for routine information processing, (including data entry, processing, reporting and transmission) starting district level and progressively going down Phase II: Strengthening use of information for action (6 months) Objective: Strengthening and institutionalizing processes for the use of information for action Phase III: Ensuring sustainability and building advanced skills (6 months) Objective: Ensuring sustainability by building state ownership of HMIS process, and building advanced skills in selected technical staff

9 Scope of Implementation Support 1. Institutional Support Formation of HMIS teams at national, state, district level & sub-district level Orientation on HMIS reforms Integration of information flow Rationalization of HMIS resources 2. Technical Support Setting-up standard state application corresponding to revised datasets and reporting formats in DHIS2 Customizing additional state specific needs: organization units, data-elements, indicators, reports & modules Mapping & importing legacy data into national database Setting-up state specific server based application and its maintenance

10 Scope of Implementation Support 3. Capacity Building Support Orientation of State, District and Sub-District teams on revised formats in all states Over 20,000 persons trained on HMIS, including 30-40% attended training more than once Over 1500 master trainers identified and trained

11 Scope of Implementation Support 4. Resource/Reference Material Support 1.Guidelines: Data guidelines Indicator dictionary Implementation framework Operational & support guidelines Guidelines of manpower requirements Software certification 2.Formats In English and Hindi Guidelines for use 3. Manuals DHIS-2 Web portal Use for information Use of computers

12 Scope of Implementation Support 5. Dissemination Material: Hard copies during training sessions Distribution of CDs Access over the web Use of information workshops National level workshops State level workshops

13 Progress So Far Largest FOSS implementation in the world Most extensive HMIS reform implementation National, State (35), Districts (642), Blocks (8000+) & upto facilities First ever Computer based data capturing at nationwide level First ever digitized data capturing right upto facility/ sub-centre level Over people trained 35 state HMIS applications customized on DHIS2, in use upto facility level

14 SECTION II Sustainable e-healthe Solutions

15 Mobile-based Data Reporting & Transmission

16 m-health Implementation m-health application accepted at National Level by Ministry Pilot tested in 5 states On-going state wide implementation in 8 states for : Capture facility level reporting facilitate communication/ community participation in health services SMS alerts to frontline workers SMS alerts to frontline workers Integrated reporting of health programs

17 Technology Background

18 Information Flow Mobile Phone ANM at Subcentre Feed-back 1 2 GSM Gateway SERVER Computerized PHC PHC GSM Gateway SERVER Block

19 JavaME (MIDP2.0) Application

20 Community Based Health Information System: Name Based Tracking

21 Community Based Information Tracking System CBITS formats and application accepted at National Level by Ministry CBITS formats implemented nation-wide State-wide implementation of CBITS on DHIS2 starting from January 2009 Features: Integrated with National Unique Identification (UID) project Covers tracking of all pregnant woman & children for immunization SMS alerts to frontline workers

22 Case registration and Identification UUID If identifier is UUID Case Identifier Identifier name Identifier No Case attribute Husband name Telephone No Address Village Case register First Name Last Name Date of Birth Pregnant women (PW) Gender

23 Information flow case to mother care program Pregnant women (PW) Gets registered Case register PW enrolls in mother care program Program Stage Instance ANC Registration ANC 1 Visit ANC 2 Visit PW is checked for eligibility for JSY Scheme Is eligible for JSY Payment Verified Mother Care ANC 3 Visit Program Instance Delivery JSY Payment PNC Payment details are recorded Amount paid to mother Date of JSY payment to mother Amount paid to accredited worker Date of payment to accredited worker

24 Information flow case to mother care program and its stages Pregnant women (PW) Gets registered Program Stage Instance ANC Registration PW is checked for eligibility for JSY Scheme Is eligible for JSY Payment Verified by Case register PW enrolls in mother care program Mother Care ANC 1 Visit ANC 2 Visit Amount paid to mother Date of JSY payment to mother Amount paid to accredited worker Program Instance ANC 3 Visit Date of payment to accredited worker Delivery PNC JSY payment completed

25 Case wise output JSY Payment One time payment Stage wise payment

26 Aggregate Output of JSY Payment

27 Hospital Information Systems

28 Patient Registration with Biometrics & Digital Images

29 Patient Summary Printed after Biometric Identification

30 Searching Patient-Based on Programs, Drug regimens & Visits

31 e Health Integrated Architecture: Design & Development

32 Implementing integrated e- Health architecture HANDICAP TELEMEDICINE GPS 108 ICDS DLIMS OTHER PROGRAMMES SCHOOL HEALTH DHIS HMIS HANDICAP CRS UNIQUE ID NO.

33 Integrated Portal for Bihar showcasing HMIS, Infrastructure, Drugs, Patient-based, Financial, HR and Licensing

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