Health management information system in Nepal

1. Health Management Information System
(HMIS) in Nepal
PRESENTED BY: PRAKASH GHIMIRE
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2. Management information system
(MIS)
 It is a system designed to provide managing an organization.
 A system which provide the requirement information to each level
of management at the right time, in the right form, covering
desired quantity and quality, so that it may form the basis of
decision making.
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3.  It is an information system that integrates data from all the
departments it serves and provides operations and management
with the information they require.
 It can be computer- based or manual system that transforms data
into information useful in the support of decision making.
Contd..
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4.  Before the integration of all health programme in 1993, various
vertical projects were using their own information system using
separate recording and reporting formats.
 Those programs specific recording/reporting resulted in; lack of
uniformity and standardization, duplication, need of more
resources, unnecessary information collection etc.
Health Management Information System
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5. Contd..
 To address this issues integrated health management system was
established in 1993.
 It is organized system of collecting, storing, processing, recording,
reporting and feedback of information.
 HMIS, one of the nine routine information systems, provides
service statistics related to the health program.
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6.  HMIS is only one component of a large program of monitoring and
evaluation (M&E) within the health sector.
 It monitors performance of health programs, health facilities and
health work force, provides monthly, quarterly and annual reports.
 It has been one of the key sources for monitoring and evaluation of
health programs and health policy formulation.
Contd..
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7. Objectives of HMIS
 To manage and collect the health service delivery statistics from
grassroot health service delivery points to the center.
 To review the collected data for data processing, analysis and
drawing inferences through appropriate indicators.
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8.  To assist in monitoring of program performances by providing the
periodical feedback regarding achievement, coverage, continuity and
quality of services through co-ordination with program
divisions/centers, managers and service provides.
 To provide necessary information to policy-makers for developing
appropriate health policies.
Contd..
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9.  To publish a comprehensive annual report.
 To enhance the dissemination of health information to all concerned
authorities using efficient methods and technologies.
 To support PME(planning, monitoring and evaluation) of all health
programs.
Contd..
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10. Process of HMIS
 Collection
 Transmission
 Storage
 Retrieval
 Analysis
 Interpretation
 Preparation for utilization
 Presentation of information 12/21/2015BPH Ist Batch, CMC
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11. Important of HMIS
 For the periodic revision of objectives.
 Identification and allocation of manpower and other resources.
 Effective and efficiency use of resources.
 Process implementation.
 Performance evaluation of a programme.
 Timely warnings about emerging health process.
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12. Institutional framework of HMIS
NPC
Ministry of health
Central Hospital
Department of health services
MD/HMIS
Centers/Divisions
RHD Regional / Zonal hospital
Hospital DHO
Reporting Line
Feedback Line
PHC/HP
SHP
VHW/MCHW
Level
National / Central
Regional
District
Catchment area
and community
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13. Department of Health Services
Management Information Section
DPHO/DHO
HMIS 33a District Reporting FormRegional Health Directorate
Ilaka HP/PHC
HMIS 32 PHC/HP/SHP
reporting form
(SAHW or HA)
Districts Hospitals
HMIS 34 Hospital Based
Reporting Form
(Medical Recorder)
Regional/ Zonal Hospitals
HMIS 34 Hospital Based
Reporting Form
(Medical Recorder)
VHW/MCHW
HMIS 31 VHW/MCHW
Reporing Form
FCHV
HMIS 27 FCHV Register
Sub HP/Non-Ilaka HP
HMIS 32 PHCC/HP/SHP
Reporting Form
(AHW,VHW or MCHW)
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14. HMIS TOOLS
HMIS 1 Master Register
HMIS 2 Multipurpose Contact card
HMIS 3 Child Health Card
HMIS 4 OPD Ticket
HMIS 5 Immunization Register
HMIS 6 TT Register
HMIS 7 <5 Nutrition Register
HMIS 8 Referral Slip
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15. HMIS 9 Maternal Health Card
HMIS 10 Maternal Health Register
HMIS 11 Abortion Register
HMIS 12 Family Planning Service card (Face Sheet)
HMIS 13 Family Planning Service Register
HMIS 14 Sterilization Register
HMIS 15 IUD/Norplant Removal Register
HMIS 16.a CBIMCI Register
HMIS 16.b OPD Register
Contd..
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16. HMIS 17 Outreach Clinic Register
HMIS 18.a Specimen collection and result information form of malaria, kalazar and leprosy
HMIS 18.b TB Sputum Specimen collection and result information form
HMIS 19 Laboratory Examination Register
HMIS 20.a TB treatment Card(HF)
HMIS 20.b TB Treatment Card (Patient)
HMIS 21 TB Treatment Register
HMIS 22 Leprosy Examination and Treatment Card
HMIS 23 Leprosy Treatment Register
Contd..
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17. HMIS 24 Malaria Classification and Treatment Register
HMIS 25.a National Health Training Program
HMIS 25.b National IEC program Register
HMIS 26 Defaulter Follow-up Slip
HMIS 27 FCHV Ward Register
HMIS 28 VHW/MCHW Diary
HMIS 29 Closed Tally Sheet
HMIS 30 Open Tally Sheet
Contd..
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18. HMIS 31 VHW/MCHW reporting form
HMIS 32 PHCc/HP/SHP Reporting form
HMIS 33 DPHO/DHO Reporting form(monthly)
HMIS 34 Hospital monthly Reporting Form
HMIS 35 Admission Register
HMIS 36 Discharge Register
HMIS 37 Hospital Tally Sheet
HMIS 38 Emergency Service Register
Contd..
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19. Key findings of the reviews, assessments and feedback
 Reporting: irregular, incomplete and inconsistent
 Weak coverage of non-government sector
 Mere collection and reporting of data to higher level
 Aggregation of unused data
 Discrepancy between data reported and recorded in registers in the health facilities
 Independent data collection and reporting requirements of different programmes and
partners
 Inconsistency of information in HMIS and programmes
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20.  Duplication of efforts
 Different definitions of indicators among different programmes and partners
 Weak practice of evidence based planning, monitoring and evaluation
 Learning by doing: no HMIS training to health work force
 Software is not efficient and user-friendly for data entry and report generation
 Urgent need of expanding and improving use of ICT
Contd..
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21. The objectives of HMIS reform
 Strengthen HMIS
 Meet data demands of NHSP2 and different programmes; and
 Have improved single health management information system
across all 75 districts
 Have a health management information system across all 75
districts
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22. Key features of revised HMIS
 Address needs of NHSP-II, policy & programmes
 Enable selected indicators to be disaggregated by caste/ethnicity
 Enable health facility level data reporting
 Integrate vertical reporting systems : EOC, Aama, CB-NCP, TB, HIV,
population activities
 Enable electronic data entry at district and hospital level and web-based
reporting to central level
 Improve hospital information system
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23.  Ensure all public and non-public facilities report to HMIS
 Improve data quality
 Minimise any duplication of work and burden on staff
 Improve use of HMIS data at different levels for PME
 Improve review process
 Link HMIS to other MIS using a uniform coding system
Contd..
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24. Revised HMIS Tools
1. Common tools
1.1 Master Register
1.2 Health Service Card
1.3 Outpatient Register
1.4 Referal/Transfer Slip
1.5 Defaulter/Discomtinuation Slip
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25. 2. Infant and Child Health
2.1 Child health Card
2.2 Immunization Register
2.3 Nutrition Register
2.4 IMCI Register
2.5 IMAM Child health Card
2.6 IMAM Register
2.7 IMAM Register Hospital
Contd..
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26. 3. Family Health
3.1 FP Face Sheet
3.2 Pills, Depo Service Register
3.3 IUCD/Implant Service Register
3.4 Sterilization
3.5 Maternal and Newborn health Card
3.6 Maternal and Newborn health service Register
3.7 Safe Abortion Service Register
Contd..
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27. 4. Community Services
4.1 ORC Register
4.2 FCHV Service Register
4.3 Vitamin A Register
Contd..
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28. 5. Malaria, Kalazar,, Leprosy
5.1 Malaria, Kalazar,, Leprosy Sample Collection Form
5.2 Malaria, Kalazar, Leprosy Laboratory Register
5.3 Malaria, Kalazar Treatment Register
5.4 Leprosy Examination and Treatment Card
5.5 Leprosy Treatment
Contd..
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29. 6. Tuberculosis
6.1 Sputum Sample Collection Form
6.2 TB Laboratory Register
6.3 TB Treatment Card(HF)
6.4 TB Treatment Card(Patient)
6.5 TB Treatment Register
6.6 PAL: Smoking Cessation Register
6.7 DR TB Laboratory Register
6.8 DR TB Treatment Register
Contd..
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30. 7. HIV/AIDS and STI
7.1 HIV Testing and Counselling Register
7.2 STI Treatment Register
7.3 PMTCT of HIV Service Register
7.4 HIV Treatment and Care Register
7.5 HIV Patient Treatment Card
7.6 OST Register
Contd..
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31. 8. Hospital
8.1 Emergency Service Register
8.2 Admission Register
8.3 Discharge Register
Contd..
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32. 9. Monthly Reporting Form
9.1 FCHV Reporting Form
9.2 ORC Reporting Form
9.3 PHCC/HP/SHP Reporting form
9.4 Public Hospital Reporting form
9.5 Private and NGO Health Facility Reporting Form
Contd..
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