Role and Scope of MIS in Monitoring and Surveillance Systems of HPNSDP


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Presented by Karar Zunaid Ahsan, MEASURE Evaluation's Sr. Resident M&E Advisor for Bangladesh, at the Global Conference on Community Health in March 2013.

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Role and Scope of MIS in Monitoring and Surveillance Systems of HPNSDP

  1. 1. Role and Scope of MIS inMonitoring and Surveillance Systems of HPNSDP Karar Zunaid Ahsan Sr. Resident M&E Advisor for Bangladesh MEASURE Evaluation, USA
  2. 2. HPNSDP and Sector-wide Approaches (SWAp) in Bangladesh’s HNP Sector Fund GOBName Duration (Billion % US$)Health and Population Sector 1998- 3.2 61%Program (HPSP) 2003Health, Nutrition and 2005-Population Sector Program 4.3 73% 2011(HNPSP)Health, Population and 2011-Nutrition Sector Development 7.7 76% 2016Program (HPNSDP) 2
  3. 3. Structure of the Health Services Delivery System in the MOHFW Secretary for Ministry of Health & Family Welfare Central DGHS DGFP Medical Colleges (18 public, 41 Institute private) Specialty Hospitals (7) Director 7 Divisions Divisional Divisional Specialist Hospitals (31) Director Director 64 Districts Civil Deputy District Hospitals (61), Surgeon Director FP MCWC (95) 481 Upazilas Upazila Health Upazila FP Upazila Health Complex (460) & FP Officer Officer 4,498 Unions Assistant Family Family Medical UHFW (2,500), Rural Sub-center Health Assistant Welfare Planning (1,449) Inspector Visitor Inspector 40,482 Wards Family Health Welfare Community Health Clinic (9,722) Assistant AssistantSource: MIS-DGHS 2010. 3
  4. 4. Monitoring System in HPNSDP• HPNSDP has a robust Results Framework that enables effective tracking of results o 8 impact-level indicators; 33 outcome-level indicators.• HPNSDP incorporated OP level indicators to monitor implementation progress o 342 process/output-level indicators for 32 OPs.• Following sources are used for monitoring progress: o MISs from the two directorates and specific programs o Household and health facility surveys o Administrative records from OPs o Expenditure data from ADP review.• Program Management & Monitoring Unit (PMMU) in the Planning Wing of MOHFW manages results from different sources. 4
  5. 5. Survey Matrix for HNP SWAps 2017 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016Survey name ImplementerBangladesh Demographic and Health Survey (BDHS) X X X X NIPORTMultiple Indicator Cluster Survey (MICS) X X X X BBSUtilization of Essential Service Delivery (UESD) X X X NIPORTSurveyBangladesh Maternal Mortality Survey (BMMS) X X NIPORTBangladesh NCD Risk-factors Survey X X X X DGHSBangladesh Urban Health Survey (UHS) X X NIPORTBangladesh Medical Equipment Survey X X WBODBangladesh Health Facility Survey (BHFS) X X X X X NIPORTNational HIV Serological Surveillance X X X DGHSIntegrated bio-behavioral Survey (IBBS) X X X DGHSCoverage Evaluation Survey (CES) X X X X X X X X X X X X DGHSSource: Updated from HSDP PAD 5
  6. 6. Role of MIS in Monitoring HPNSDP Progress• The existing MISs in MOHFW collect facility-based health service statistics.• Routine MISs are primarily used for o Updating 5 out of 33 RFW indicators o Monitoring output indicators at OP-level o Validating DAAR achievements.• OP-level indicators are currently being revised to foster the role of MISs in monitoring implementation progress.• Data Warehouse DMIS currently stores data from HIS, MIS-FP, IMCI, EPI, TB-LC, and UPHCP with the aim of consolidating data from different sources.• A number of initiatives currently ongoing to streamline routine Health Information System. 6
  8. 8. Building Blocks of a Health SystemSource: WHO 2007 8
  9. 9. Why Strengthening the Scope of MIS?• SWAps, and the principles outlined in the Paris Declaration, focus on improving the effectiveness of development assistance in developing countries.• It is not possible to demonstrate any impact of the donor investments in the health system, let alone on the health of the population, without reliable routine health information systems• Result-based budgeting and monitoring through process and output indicators are growingly being used for managing the implementation of SWAp rather than relying on structural reforms as indicator of success. 9
  10. 10. What Needs to be Done?• Focus to be expanded from public facility-based services to community characteristics (morbidity, mortality, risk factors)• Need comprehensive community surveillance o HA/FWA to collect data on regular basis o Sentinel surveillance o Multi-site Health & Demographic Surveillance Systems (HDSS)• Ensure coverage and timely processing of information o data collection through mobile devices (smartphone, PDA, tablets)• Use routine data to address major system issues o PMIS to monitor vacancy and absenteeism o LMIS to ensure stock and supply of essential drugs. 10
  11. 11. What Needs to be Done? (contd.)• Strengthen stewardship and regulatory role of MOHFW o Make routine data submission from private and NGO- run facilities as a part of the accreditation process• Collaborate with private sectors to strengthen monitoring and surveillance system o NNS and Brac University’s FSNSP as an example• Coordinate with other GOB activities o Compare results of SVRS and other surveys by BBS with other national surveys (BDHS, MICS, UHS)• Lastly, put emphasis on physical progress for regular monitoring o Expenditure against ADP allocation is primarily used for reviewing progress of the operational plans under HPNSDP. 11
  12. 12. Thank you.Questions? Comments?Email: