Strengthening Routine Health Information System 2012-2014 January 13, 2015 January 13, 2015 MIS Auditorium, DGHS
Summary of RHIS Initiatives Undertaken Strengthening RHIS of DGHS and DGFP by USAID-supported partners (MEASURE Evaluation, icddr,b, MaMoni/HSS, MSH/SIAPS) has been directed to • support to M&E functions of HPNSDP with particular focus on 6 OPs (MNC&AH, NNS, CBHC, MCR&AH, CCSDP, and FSDP) • streamline MIS tools to minimize information gaps and duplication, and reduce the burden of data collection and compilation • design and use a supply chain management portal for efficient and effective logistics management of RMNCH commodities • improve capacity of MIS Units of DGHS and DGFP to generate reliable information on time. • improve use of information at the local level and promote evidence-based decision
SUPPORT TO M&E FUNCTIONS OF HPNSDP HPNSDP
Support to M&E functions of HPNSDP Streamlining of OP indicators by MEASURE/icddr,b includes • Review of 342 indicators across 32 OPs and development of PMP • Developing indicator reference sheets for 342 indicators • Developing indicator reference sheets for 342 indicators with detailed information: – Definition, Calculation, Unit of measurement, Frequency, Source of information, Level of data generation • Categorized 342 indicators by types (i.e training, service, facility readiness, drug/logistic, infrastructure, workshop/meeting etc.)
S TREAMLINING MIS T OOLS A Key Focus of A Key Focus of MaMoni/HSS & MEASURE Evaluation/icddr,b
Review of OP indicators and assessment of MIS tools 6 priority OPs were reviewed where routine MISs covered only 50% of original OP-level service indicators Service providers and field-workers overburdened with recording and reporting requirements, e.g., • 14 registers for FWVs 14 registers for FWVs • 11 key sections in FWA register • 5 in-patient monthly reports manually aggregated • 5 (at least) monthly reports by HA Inadequate data accessibility as computer-based database not fully functional Inadequate use of RHIS data for local-level decision making
MIS tools streamlined Revision and development of tools/systems from community to hospital level Community Community Old system Old system Revised system Revised system - No structured HA - Structured HA & CSBA register registers DGHS/MIS DGHS/MIS - No structured CSBA - Revised monthly reports register register online online - Review of FWA register (in process) adding missing - Paper-based FWA register has separate pregnant information + pregnant and women and birth list and birth list replaced by piloted missing a number of OP ‘pregnancy registration DGFP/MIS DGFP/MIS indicators (i.e ANC, PNC, handbook’ delivery) - Online pregnancy registration - No structured CSBA - Review of MIS 1 & 2 forms register are in process - Structured CSBA registers
MIS tools streamlined Revision and development of tools/systems from community to hospital level Community Clinics Community Clinics Old system Old system Revised system Revised system - Revised paper-based registers included NNS indicators Paper-based CC service DGHS/MIS DGHS/MIS register register - Online reporting formats - Online reporting formats - PW & U5 children registration system
MIS tools streamlined Revision and development of tools/systems from community to hospital level Union Union Old system Old system Revised system Revised system - Unstructured g eneral - Structured register outpatient register - Simplified monthly report DGHS/MIS DGHS/MIS - Paper-based disease + online reporting at profile report profile report upazila level upazila level
MIS tools streamlined Revision and development of tools/systems from community to hospital level Union Union Old system Old system Revised system Revised system -Reduced FWV registers Separate FWV registers for (MNH, OCP/Pill, IUD) by every service, viz. delivery, merging relevant registers DGFP/MIS DGFP/MIS ANC, PNC, birth, pill, condom, IUD and IUD follow -MIS 3 reporting form is under up up revision revision Single register for FWV for MNH services (MNH register)
MIS tools streamlined Revision and development of tools/systems from community to hospital level Upazila & District Upazila & District Old system Old system Revised system Revised system - Paper-based in-patient Online in-patient MIS with DGHS/MIS DGHS/MIS reports ICD-10 classification MIS 4 reporting form is Existing MIS 4 DGFP/MIS DGFP/MIS under revision
Implementation of tools/systems Tools/Systems Nationwide by With support from Other DGHS-MIS icddr,b and MaMoni partners Directorate General of Health Services (DGHS) District and sub-district Provided ToT to All UHCs and DH of Tangail UNICEF: level: statisticians and and Chunarughat UHC and SCANU part of Online hospital in- instructed to give in- DH of Habiganj (logistics, the system in patient system patient data entry, training and onsite support) 16 DH Developed manual inc. Developed manual inc. + central level monitoring + central level monitoring ICD 10 by M&E staff Union level: General DGHS-MIS developed Paper-based register and patient register for data entry guideline. reporting format, trainings SACMO and Monthly Currently, 60 districts were provided in entire progress report reporting in DHIS2 Tangail district and (aggregated) in DHIS2 Chunarughat (Habiganj) upazila CC: Online monthly Provided laptops with Entire Tangail and reporting (aggregated) connectivity, training to Chunarughat (Habiganj) format in DHIS 2 CHCP, developed upazila (onsite support), manual central level monitoring by ~8,000 CCs reporting M&E staff
Implementation of tools/systems Tools/Systems Nationwide by With support from Other DGHS-MIS icddr,b and MaMoni partners Directorate General of Health Services (DGHS) CC: Pregnant women Provided ToT, Training and onsite support UNICEF: in 3 and U5 registration developed manual, in 3 upazilas of tangail + ToT districts system (as part of COIA Intensive monitoring to UNICEF + central level JICA: in initiative) from central level and monitoring by M&E staff Satkhira workshop at divisional workshop at divisional Plan: in Plan: in level Dinajpur ++ Household level: DGHS-MIS developed a. HA register and data entry guideline. reporting tool + online PHC circulated GO Paper-based register and reporting format in Currently, 62 districts reporting format, trainings DHIS2 are reporting in DHIS2 were provided in entire Tangail district and b. CSBA register and DGHS-MIS developed CARE: in Chunarughat (Habiganj) reporting tool (both FP data entry guideline. Sunamganj upazila and Health) + online PHC circulated GO ++ reporting format in Currently, 62 districts SNL: Kushtia DHIS2 (health) are reporting in DHIS2
Implementation of tools/systems Tools/Systems Nationwide by With support from Other DGFP-MIS icddr,b and MaMoni partners Directorate General of Family Planning (DGFP) Sub-district level: Revision of MIS4 is Technical assistance in the Aggregated national done and awaiting for review process reporting form-MIS 4 approval Union level (for FWV): -Review Committee has Paper-based register and SNL: MNH - Single register for MNH revised and finalized trainings were provided in register in services reduced MNH and FP entire Tangail and Kushtia - OCP, Condom and ECP registers for FWV. Chunarughat (Habiganj) register These registers were upazila - IUD register piloted in icddr,b and - Facility reporting MaMoni areas Technical assistance in the format-MIS 3 - Revision of MIS 3 is review process of MIS 3 done and awaiting for approval
Implementation of tools/systems Tools/Systems Nationwide by DGFP-MIS With support Other from icddr,b and partners MaMoni Directorate General of Family Planning (DGFP) Community level: MCH-Services initiated online Paper-based SNL: Kushtia a. Pregnancy registration format has been handbook, training , Registration accepted and DGFP-MIS has onsite support in Handbook + online Handbook + online circulated GO to do online circulated GO to do online entire Tangail and entire Tangail and registration format pregnant women registration Chunarughat (Habiganj) upazila b. FWA register 8 th Review committee has revised icddr,b provided and finalized 8 th edition of edition and monthly technical assistance in reporting form - MIS 1 FWA register and MIS forms 1 the review process and 2. (Piloted pregnancy registration handbook has been added in 8 th edition of FWA register) Icddr,b in collaboration with GIZ providing technical support to DGFP-MIS to transfer their service statistics (monthly report) into DHIS 2 platform. Initially, new system will be piloted in two districts before national scale up.
Quality of reporting improving Community micro-planning in MaMoni areas: HA-FWA-CV network to share MNH/FP information, update registers and reduce inconsistencies in reporting 120 120 100 100 100 80 80 Number Number 60 60 40 40 20 20 0 0 Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec FWA report HA report FWA report HA report Neonatal deaths, Habiganj, 2012 Neonatal deaths, Habiganj, 2013 16
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