Overview of Urban Health MIS Health Management Information

Overview of Urban Health MIS Health Management Information System Second Urban Primary Health Care Project Local Govt. Division, Ministry of LGRD&C www. uphcp. org Zia Hoque MIS & Data Management Officer

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 www. uphcp. org Continued. . .

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 costcenter (intra partner) comparison of health progress difficult • Development partners seriously feel this limitation for monitoring progress of the achievement, particularly of MDGs www. uphcp. org Continued. . .

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 www. uphcp. org Continued. . .

Urban Health MIS HMIS in UPHCP-II • 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 … www. uphcp. org Continued. . .

Urban Health MIS Web-based HMIS • 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 www. uphcp. org Continued. . .

Urban Health MIS Web-based HMIS • 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. www. uphcp. org Continued. . .

Urban Health MIS Web-based HMIS • 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. www. uphcp. org Continued. . .

Urban Health MIS Fine tuning • 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. www. uphcp. org Continued. . .

Urban Health MIS Fine tuning • 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. www. uphcp. org Continued. . .

Urban Health MIS Fine tuning • 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 www. uphcp. org Continued. . .

Urban Health MIS DMIS Support • The Data Management Information System (DMIS) support to Mo. HFW 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 DHIS 2 for UPHCP-II. But still UPHCP is providing data to DMIS in regular interval. www. uphcp. org

System Entities and Activities www. uphcp. org

Data Flow of UPHCP-II 1 st working day of following month PIU for Collation and vetting 8 th to 13 th working day of following month PMU for Approval, processing and compilation SMQAO | Review MIS&DMO | Approve DPD (Tech) | Approve, Publish HMIS DPs, LGD, Mo. HFW, DGHS, DGFP, PAs, PIUs, PMU etc. Approved and Published over web-based HMIS Shared with stakeholders/ Feedback www. uphcp. org (S)MEO | Review Project Officer | Approve Forward for approval/ Feedback Review Feedback MIS Officer | Data Entry Project Manager | Approval Send Hardcopy Feedback Counselor Paramedic Field Supervisor Clinic In-Charge 4 th to 7 th working day of following month PA HQ for Entry, Edit and Validation Data recording and monthly compilation by CRHCC, PHCC, Satellite, PECC, VCCT, DOTS 2 nd to 3 rd working day of following month LGD, ADB, DFID, SIDA, UNFPA, ORBIS, PPME Firm Quarterly Progress Report Preparation & Publication

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 management, dissemination and storage. data • 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 Status As per 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 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 Gateway (www. uphcp. org) HMIS www. uphcp. org

Screen Shot Index Page (www. uphcp. org) Review Report Center Operation (data entry) www. uphcp. org

Screen Shot Data Entry Screen (www. uphcp. org) Age group wise client info Medicine Sub-Component-wise Record www. uphcp. org Error Message Service Head-wise Patient info