The document discusses the Health Management Information System (HMIS) in India, highlighting its role in monitoring health programs and facilitating evidence-based decision-making. It outlines the objectives, data collection processes, and recent upgrades like HMIS 2.0, which enhances data accessibility and quality. The HMIS is crucial for health policy formulation, program evaluation, and improving healthcare delivery efficiency.

1. Dr. Noor Islam Bag
2nd year PGT
MD (Community
Medicine)
AIIH & PH
1

2. 2
 Some definitions
 Information System A system that provides information support to
the decision-making process at each level of an organization
 Health Management Information System HMIS is a tool which helps
in gathering, aggregating, analyzing data and using information for
taking actions to improve performance of health systems

3. 3
o A monitoring & evaluation systems
o HMIS 1.0
o HMIS 2.0 and new features
o Data sources
o HMIS generate database
o HMIS captured data items
 Brief Idea about HMIS

4. 1. What is HMIS?
2. Objectives of HMIS
3. Data captured by HMIS
4. Follow of data in HMIS
5. Data quality measures
6. Organization/Person responsible for HMIS
7. Uses of HMIS data
8. Maintenance of HMIS
9. Constrains of old HMIS web portal
10. New HMIS web portal
4

5. Health Management Information System (HMIS) is a Government
to Government (G2G) web-based Monitoring Information System
has been put in place by Ministry of Health & Family Welfare
(MoHFW), Government of India to monitor the National Health
Mission and other Health programmes and provide key inputs for
policy formulation and appropriate programme interventions.1
HMIS 2.0 (http://hmis.nhp.gov.in)
What is
5

6.  To Monitor the performance & quality of health care services
under the National Health Mission
 A tool for evidence based health planning
 Used for testing the effectiveness, efficiency of health
programs and schemes
 To improve availability and access of health care to the
population
6

7. 1946 (Bhore committee report) - The necessity of a sound
information system was felt
National Health Policy -1983 - Decision making and program
planning in health and related fields are not possible without
establishing an effective health information system
NHP-2002-focused self to the programme for putting in place a
modern and scientific health statistics database
NRHM-2005 – felt need of strong component of technical support
as an effective health information systems for the success of the
NRHM2
7

8. 8
Development of HMIS with WHO collaboration and National Informatics Center
(NIC)
HMIS version 1.0 in four participating state of Gujarat, Haryana, Maharashtra and
Rajastan
Field testing of the HMIS in one district of Gujarat, Haryana, Maharashtra and
Rajastan
Implementation efforts in 13 states and Union Territories in phased manner
The brief outline of the development of HMIS process
by WHO

9.  Evaluation of HMIS Web Portal
21st
October
2008
28th
December
2020
2010-11
District level
Facility
based
HMIS 1.0 HMIS 2.0
9

10. Sources of data:
SC
1,61,019
PHC
31,296
CHC
12,923
SDH
2,430
DH
1,249
HMIS
data
As of 2019-20, there were around 705 districts and
around 2.08 lakh health facilities mapped and
reporting on HMIS Portal.
17

11. Fig. All India Distribution of Health Facilities by
type(2019-20)
18
Table : All India Distribution of Public and
Private Health Facilities

12. Data captured under HMIS
Types of Data Frequency of data
uploading
Types of facility
1. Service Delivery Data Monthly District HQ, DH,
CHC, PHC, SC
2. Infrastructure & HR Annually DH, SDH, CHC
PHC, SC
3. Service Delivery data Daily DH, SDH, CHC
PHC, SC

13. Monthly Service delivery data:-
Reproductive and Child Health
Health Facility Services
Monthly Inventory
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Service delivery
data
Part C
Stock
related
Part B
Health
Facility
Services
Part A
Reproduct
ive and
Child
Health
Major
Category
Data
element
Major
Category
Major
Category
Data
element
Data
element

14. M1. Ante Natal Care (ANC)
M2. Deliveries
M3. Number of Caesarean (C-Section)
deliveries
M4. Pregnancy outcome & details of new-
born
M5. Complicated Pregnancies
M6. Post Natal Care (PNC)
M7. Reproductive Tract
Infections/Sexually Transmitted Infections
(RTI/STI) Cases
M8. Family Planning
M9. CHILD IMMUNISATION
M10. Number of cases of Childhood
Diseases (0-5 years)
M11. NVBDCP
M12. Adolescent Health
M13. Directly Observed Treatment, Short-
course (DOTS)
M14. Patient Services
M15. Laboratory Testing
M16. Details of deaths reported with probable
causes:
M17. Vaccines
M18. Contraceptives
M19. Other Items
M20. Syringes
M21. Rashtriya Bal Swasthaya Karyakram
(RBSK)
M22. Adolescent Health
M23. Coverage under WIFS JUNIOR (Weekly
Iron Folic Acid Supplementation Programme
for children 6 – 1
M24. Maternal Death Reviews (MDR) Done
M25. Janani Shishu Suraksha Karyakram
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15. 22
Data Element
'1.1 Total number of pregnant women registered for
ANC
'1.1.1 Out of the total ANC registered, number
registered within 1st trimester (within 12
weeks)
'1.2.1 Number of PW given TT1/ Td1
'1.2.2 Number of PW given TT2 / Td2
'1.2.3 Number of PW given TT Booster/ Td Booster
'1.2.4 Number of PW provided full Course 180 Iron
Folic Acid (IFA) tablets
'1.2.5 Number of PW provided full Course 360 Calcium
tablets
'1.2.6 Number of PW given one Albendazole tablet
after 1st trimester
M1. Ante Natal Care(ANC)
Data Element
'1.2.7 Number of PW received 4 or more ANC check
ups
'1.2.8 Number of PW given ANC Corticosteroids in
Pre Term Labour
'1.3.1 New cases of PW with hypertension detected
'1.3.1.
a
Out of the new cases of PW with hypertension
detected, cases managed at institution
'1.3.2 Number of Eclampsia cases managed during
delivery
'1.4.1 Number of PW tested for Haemoglobin (Hb )
4 or more than 4 times for respective ANCs
'1.4.2 Number of PW having Hb level<11 (out of
total tested cases)(7.1 to 10.9)

16.  Manpower
 Equipment
 Cleanliness
 Building
 Availability of Medical Services, Surgery
etc.
 Super Specialties services such as
Cardiology etc.
 Para Medical andClinical Services etc.
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17. In new HMIS
Five data items are also collected on daily basis which are mainly
linked to COVID-19
1) Total number of outpatients (OPD)
2) Total number of inpatients (IPD)
3) Total SARI - Severe Acute Respiratory Infection (OPD +IPD)
4) Total ILI - Influenza Like Illness (OPD + IPD)
5) Total fever cases >= 7 Days (OPD + IPD)
 Data captured under HMIS- Daily
basis
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18. In new HMIS
1. Total number of OPD attendance
2. Total number of IPD admission
3. Number of patients provided diagnostic chemical test
4. Number of patients provided diagnostic radiography test
5. Number of patients provided medicine
6. Number of cases of AEFI-deaths
7. Number of infant deaths
8. Number of maternal deaths
 Data captured under HMIS: daily
basis
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19. (Case-I)
Data Entry
Operator at
Block
SC
Health
Worker
Health
Worker PHC
CHC
Health
Worker
SDH DH
HMIS Portal
Enters Data for
each facility
DHQ
Enters DHQ and compiles the
data
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20. HMIS Portal
SC
Health
Worker
Enters Data
Health
Worker
PHC
Enters Data
CHC
Health
Worker
Enters
Data
SDH
Enters Data
DH
Enters Data
DHQ
Enters DHQ
data and
compiles the
data
(Case-II)
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21. Subcentre
SDH
CHC
PHC

22.  Data Quality Measures in HMIS
a. Completeness
b. Accuracy/correctness
c. Consistency of data reporting
d. The timeliness
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23.  Data Quality Measures in HMIS
1. Timeliness: Each facility is supposed to enter the data by 5th of
the following month in case of monthly MIS data and by 30th
April of the reporting year in case of Annual Infrastructure data.
2. Accuracy:
a. Compare Option: To compare data with previous month (in case
of monthly data)
b. Inter-Data Validation Checks: While saving data, as per prior
inbuilt validation rules, error highlighted in red colour for the
erroneous data elements. 31

24.  Data Quality Measures in HMIS
(cont…)
3. Completeness:
a. Data Entry Status Report: Completeness of reporting of the
facility.
b. Percentage Filled Report: Completeness of data entry by the
facility.
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25. Organization/Person responsible for HMIS
Location/Hospital Person responsible
Sub-center ANM, LHV
PHC Pharmacist, MO, DEO
CHC DEO, Block Program Manager, BMO
District District statistical officer-Health/DEO, District Program Manager, District level
HMIS nodal officer
State State level HMIS nodal officer
Dy/Joint director- Vital statistics
Surveillance unit
State Level Data Manager
Central government Central Bureau of Health Intelligence
Statistics division- Department of family welfare
Statistic division- Department of Health
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26.  Uses of HMIS data
 HMIS data is widely used by States in preparing Program
Implementation Plans (PIPs) under NHM.
 Indicators from HMIS (like Institutional Deliveries, C –
Section deliveries, Immunization, IPD, OPD, Surgeries, etc.)
are used to evaluate the States’ performance
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27.  Uses of HMIS data(cont..)
 Facility wise data of PHCs is used for grading the facilities
(Grading of PHCs). NHM started grading of PHC in 2018-19
 CHC Grading (started in 2013-14) & DH Ranking is also
being done.
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28.  The grades assigned to PHCs are 0/5, 1/5, 2/5/, 3/5, 4/5 and 5/5.
• 1. Human Resource availability Mandatory criteria
• 2. Infrastructure & Service Availability
• 3. Essential Laboratory Services ( Assignment of 3 grades out of 5)
• 4. Drug & Supplies availability
• 5. Service Utilization/ Performance Indicators. (Assignment of 2 grades out of 5)
 In case a facility does not fulfills the mandatory criteria it would not be
eligible for grading and would be categorized as Not Eligible (NE)”.
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29. Fig. Status of PHC Grading across India
2019-20
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30. Performances of States and UTs have been categorized and color
coded as follows:
 Uses of HMIS data:
Categorization of State Performance:-
39

31. Categorization of State Performance:-
Indicators for Performance:
1. % 1st trimester ANC registration to total ANC registrations
2. % Pregnant Woman received 4 ANC checkups to total ANC
Registrations
3. % Institutional delivery to estimated delivery
4. % C-section per Institutional delivery
5. % SBA attended home deliveries to Total Reported Home Deliveries
6. % Pregnant women received TT2 + Booster to total estimated
Number of Annual Pregnancies
7. Sex Ratio at births 40

32. Indicators for Performance: cont..
8. % Women who had institutional deliveries and accepted PPIUCD
9. Sterilization rate ( for per 1000 estimated no. of Sterilized Couples
15-49 years))
10. % fully immunized children (9-11 months) to Estimated Infants
11. Average OPD per 1000 Population per month
12. %IPD of OPD
13. Bed Occupancy Rate (BOR %)
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33. 42

34. HMIS Indicators 1ST Rank State West Bengal
% 1st trimester ANC registration to total ANC
registrations
Tamil Nadu 5th
% Pregnant Woman received 4 ANC checkups to
total ANC Registrations
Andhra Pradesh 17th
% Institutional delivery to estimated delivery Jammu And
Kashmir
10th
% SBA attended home deliveries to total reported
home deliveries
Telangana 20th
% Pregnant women received TT2+Booster to total
estimated number of pregnancies
Telangana 5th
% Fully immunized children (9-11 months) to
Estimated Infants
Andhra Pradesh 9th
Tamil Nadu, Andhra Pradesh, Karnataka, Telangana and Kerala are
top five States and Haryana, Uttar Pradesh, Jharkhand, Delhi, and
Bihar are bottom five States. It is to mention that States which
are coming under bottom five, may need to improve their
indicator specific programme performances. 43

35.  Random checks at Facility Level is undertaken during field visits.
 During Common Review Mission, HMIS data is extensively used and
verified.
 Population Research Centre (PRCs) are also involved in the data
verification.
 State and District level HMIS nodal officers also visits health facilities
and verify HMIS data for providing supportive supervision to the field
staff
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36. • HMIS Division of MoHFW has a structured training programme on various
technical
issues for the personnel involved in data recording, reporting, aggregation,
verification
and uploading of data.
• Training is imparted on data definitions, various indicators and new
features/ aspects.
• As per State/UT
 State Level - two training cum review of three days /year
 District Level -one training cum review of three days /quarter
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37.  The Ministry conducts Annual National level HMIS review
meeting with an objective to discuss the data quality issues with
the State Level Data Manager and HMIS nodal officers and orient
them about new development in HMIS.
 3-4 Regional review meetings for a group of States/districts
are conducted every year.
 The major focus of these review meetings is data quality.
46

38.  Constrains of old HMIS Portal
 No API (Application Program Interface)
 Daily Reporting not available
 Dashboard not available
 Outdated Software and Hardware Technology
47

39.  The key features of new HMIS (HMIS 2.0)
portal
Person Specific User Credentials (mapped to an Individual) for
fixing responsibility to user for entering complete and correct
data in the system.
National Identification Number (NIN) and Local Government
Directory (LGD) have been used for unique identification of
health facilities at village/block.
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40.  The key features of new HMIS (HMIS 2.0)
portal
Provision for real time data entry and real time monitoring of the
system
Compatibility with multiple devices such as Mobile, Tab etc.
API (Application Program Interface) developed to ensure direct
linkage of HMIS online portal with other programme/software
application of the ministry.
Advanced data analytics such as GIS Integration with layer of
village boundary is developed.
49

41.  The key features of new HMIS (HMIS 2.0)
portal
Interactive Dashboards has been developed
 Infrastructure data to be entered only once in the new system,
later to be auto populated and monthly basis updated.
Alerts system is developed which will provide alert to the
programme managers at various level for appropriate and timely
action.
50

42. Homepage of HMIS 2.0:
51

43. HMIS dashboard is an information management tool that
visually tracks, analyzes and displays key performance
indicators (KPI).
53

44. • Geographical Information System (GIS) in a Health Management
Information System (HMIS) is a powerful tool to manage health
care delivery system
• Currently two reports are available on GIS:
1. Facility reporting Status.
2. Indicator performance
55

45. Decreased
completeness &
timeliness
Poor internet
connectivity
Lack of hardware
in some facilities
Lack of staff
Lack of
supervision
Poor data reliability
Ambiguity
about data
element
Data entry
errors
Systemic errors
Dishonesty in
reporting
56

46. 1. HMIS-Health Management Information System [Internet]. [cited 2022 Jan 7]. Available from:
https://hmis.nhp.gov.in/#!/aboutus
2. Dehury RK. The progress and impact of Health Management Information System (HMIS) in monitoring and
evaluation of health programs in India. 3(4):7.
3. Pacific WHORO for the W. Developing health management information systems : a practical guide for
developing countries [Internet]. Manila : WHO Regional Office for the Western Pacific; 2004 [cited 2022
Mar 20]. Available from: http://iris.wpro.who.int/handle/10665.1/5498
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