This document discusses Health Management Information Systems (HMIS) and the District Health Information System (DHIS) in Pakistan. It provides definitions of HMIS and describes its objectives, components, data sources, tools and how data flows through the various levels from community to national. It outlines the development, implementation and uses of DHIS, describing the indicators, instruments and how DHIS information can be used to improve health system performance. It also compares HMIS and DHIS tools and instruments and provides details on DHIS implementation in various districts of Pakistan.
Decision Support System Enabled Data Warehouses for Improving the Analytic Ca...MEASURE Evaluation
“Decision Support Systems for Improving the Analytic Capacity of HIS in Developing Countries”
Mike Edwards (MEASURE Evaluation), Presenter. Co-author: Theo Lippeveld (MEASURE Evaluation)
Presentation given
Decision Support System Enabled Data Warehouses for Improving the Analytic Ca...MEASURE Evaluation
“Decision Support Systems for Improving the Analytic Capacity of HIS in Developing Countries”
Mike Edwards (MEASURE Evaluation), Presenter. Co-author: Theo Lippeveld (MEASURE Evaluation)
Presentation given
• Atsu Seake-Kwawu (ICHD presents a study done in four West-African countries in 2012. The study aims at a better understanding of the organisational features of effective and efficient PHC delivery, including the identification and analysis of contextual variables as underlying causes & factors for successful service delivery and key health system bottle-necks to the delivery and scaling up of high impact interventions (HII).
Patient Data Collection Methods. Retrospective Insights.QUESTJOURNAL
Introduction: Multiple classic and modern data collection techniques are presented in the current paper, but only a mix of them provides the appropriate approach to address patient safety problems. The current study aims to reveal the data collection methods applied worldwide. Materials and Methods: All scientific sources of the current article were identified mainly by research on Internet. The matching words used in the search of materials are “data collection methods”, “hospital reporting systems”, “incident reporting systems”, “patient events”, “patient reported data”. Relevant articles and studies covering the 2003-2016 timeframe were selected as a reference. Results: Various data collection procedures are available worldwide. During several years of research, it was concluded that a significant number of patient studies use the following patient data collection methods: retrospective record review, record review of current inpatients, staff interview of current inpatients and nominal group technique based consensus method. Conclusion: New trends in data collection techniques are also discussed, as they reveal the potential of the electronic environment. Future insights on this topic should consider the standardization of different data collection methods in order to improve data comparability aspects.
These challenges are not limited to:
Human resources challenge
Health services challenge
Organizational and management challenges
Health financing
Madical products.
An updated introduction to the PaRIS project, why it matters, how it works, its timeline, and the key issues it addresses. Contact us at paris_survey@oecd.org to learn more.
Diseases that are spread by arthropod or small animal vectors.
Vectors act as the main mode of transmission of infection from one host to another, & as such form an essential stage in the transmission cycle.
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• Atsu Seake-Kwawu (ICHD presents a study done in four West-African countries in 2012. The study aims at a better understanding of the organisational features of effective and efficient PHC delivery, including the identification and analysis of contextual variables as underlying causes & factors for successful service delivery and key health system bottle-necks to the delivery and scaling up of high impact interventions (HII).
Patient Data Collection Methods. Retrospective Insights.QUESTJOURNAL
Introduction: Multiple classic and modern data collection techniques are presented in the current paper, but only a mix of them provides the appropriate approach to address patient safety problems. The current study aims to reveal the data collection methods applied worldwide. Materials and Methods: All scientific sources of the current article were identified mainly by research on Internet. The matching words used in the search of materials are “data collection methods”, “hospital reporting systems”, “incident reporting systems”, “patient events”, “patient reported data”. Relevant articles and studies covering the 2003-2016 timeframe were selected as a reference. Results: Various data collection procedures are available worldwide. During several years of research, it was concluded that a significant number of patient studies use the following patient data collection methods: retrospective record review, record review of current inpatients, staff interview of current inpatients and nominal group technique based consensus method. Conclusion: New trends in data collection techniques are also discussed, as they reveal the potential of the electronic environment. Future insights on this topic should consider the standardization of different data collection methods in order to improve data comparability aspects.
These challenges are not limited to:
Human resources challenge
Health services challenge
Organizational and management challenges
Health financing
Madical products.
An updated introduction to the PaRIS project, why it matters, how it works, its timeline, and the key issues it addresses. Contact us at paris_survey@oecd.org to learn more.
Diseases that are spread by arthropod or small animal vectors.
Vectors act as the main mode of transmission of infection from one host to another, & as such form an essential stage in the transmission cycle.
Zoonoses : are infections which are naturally transmitted between vertebrate animals and people.
The term zoonosis'Derived from the Greek
ZOON (animals) and NOSES (diseases)
People, animals, birds, arthropods and the inanimate environment are all involved in cycles of zoonotic infection
There is no specific format But every institute have their own guideline and instructions,
In preparing Synopsis you should restrict the size of your research area in line with the length of dissertation/Research paper/Theses required by College/University
Screening is the testing of apparently healthy populations to identify previously undiagnosed diseases or people at high risk of developing a disease.
Screening aims to detect early disease before it becomes symptomatic.
Screening is an important aspect of prevention, but not all diseases are suitable for screening.
Lecture for Post and Undergraduate.
From the past two decades Non Communicable diseases are increasing in both developing and developed countries due to which developing are experiencing double burden of diseases.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
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ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
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micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
1. MBBS.ECFMG-99, DPH, Dip-Card, M.Phil, FCPS.(PhD)
Professor Community Medicine
Gujranwala Medical College Gujranwala
Ex- Professor Community Medicine
UmulQurrah University Makka Saudi Arabia
2. Health Information
System
A system that integrates data
collection, processing, reporting, and
use of the information necessary for
improving health service
effectiveness and efficiency through
better management at all levels of
health services”[1]
[1] World Health Organization: Regional Office for the Western Pacific. Developing
Health Management Information Systems - A Practical Guide for Developing Countries
2
PROFf: M TAUSEEF JAWAID
4. A System that Provides
Specific Information
Support to the Decision
Making Process at Each
Level of Health System
Definition
4
PROFf: M TAUSEEF JAWAID
5. What will you learn in this
session?
What is HMIS
Uses of HMIS
HMIS Data Sources
HMIS Data Tools
Type of Data Tools
Reporting System
Feedback System
5
PROFf: M TAUSEEF JAWAID
6. HMIS
On going system of data collection and
processing from health care delivery out-
lets and utilization of this data for
management and improvement of services
at each level of health care system.
6
PROFf: M TAUSEEF JAWAID
7. GENERAL OBJECTIVES OF HEALTH
INFORMATION SYSTEM
To measure the health status of the people and to
quantify their health problems,medical and health
care needs
For local,national and international comparison of
health status
For planning,administration and effective
management of health services and programs
For assessing health services
For assessing the attitudes and degree of satisfaction
of the benificiaries with the health system
For research into particular problem of health and
disease
7
PROFf: M TAUSEEF JAWAID
8. 1. To provide the information support to the
Health Managers at various levels of the
health system.
2. To compare performance overtime, with
districts and facilities etc.
3. To identify facilities, and districts in need
of support .
4. To monitor trends in disease pattern,
coverage, quality and population at risk.
Objectives of HMIS
8
PROFf: M TAUSEEF JAWAID
9. COMPONENTS OF HEALTH INFORMATION
SYSTEM
Demography and vital events
Environmental health statisticts
Health status;mortality,morbidity,disability and
quality of life
Health resources;facilities,beds,manpower
Utilization and non utilization of health
services
Indices of outcome of medical care
Financial statistics; cost, expenditure related
to the particular objective 9
PROFf: M TAUSEEF JAWAID
10. Terms used in HMIS
First Level Care Facility (FLCF)
Referral Level Care Facility (RLCF)
Health Care Provider
Patient
Clint
Data collection tool / instruments
10
PROFf: M TAUSEEF JAWAID
11. HMIS Development Steps
1. Determining the data sources
2. Development of data collection
tools
3. Data Reporting
4. Data Processing
5. Feedback and Utilization of data
based information
11
PROFf: M TAUSEEF JAWAID
12. 1. Population Catchment Area Chart
2. Total Population of the Area
3. Target population Groups
Gross Root Levels Data
Sources
12
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13. Occurrence of Health Problems
Diagnosis / Prevention / Treatment
•Data Collection
•Disease Outbreak Control
•Program Management
•Supervision of Quality of Care
Computer Centers
Health Managers/ Disease Control Programs
TB CDD EPI ARI MCP AIDS Other
Population
First Level
Care Facility
District Level
District /
Provincial
Level
Provincial
/ National
Level
Immediate
Report
Monthly
Report
Yearly
Report
Supervisory
Checklist
Computerized Feedback Reports
Flow Chart Under HMIS/ FLCF
13
PROFf: M TAUSEEF JAWAID
14. District HMIS Cells
Executive District Officer (EDO) Health
Provincial HMIS Cells
Director General Health Offices (DDHS)
National HMIS Cell
(Ministry of Health)
LHW-2 LHW-3 LHW-4
LHW-1
Rural Health Center
(RHC)
Consolidated Report
Basic Health Unit (BHC)
Consolidated Report
Feedba
ck
from
centers
to
periph
ery
Data
flow
from
periphe
ry to
the
Center
14
PROFf: M TAUSEEF JAWAID
15. Information Flow
National Level
Provincial Level
District Level
Facility Level
Community Level
MOH-PHC Cell
Federal PIU National HMIS Cell
Prov. DG Health Services
Prov. PIU Prov. HMIS Cell
EDO/ DHO Office
Dist. PIU Dist. HMIS Cell
First Level Care Facility (FLCF)
Lady Health Workers (LHW)
LHW Reports
Consolidated
Monthly Report
HMIS
Monthly Report
Data on Diskette +
Manual Report
Data on
Diskette
Data on Diskette +
Manual Report
Data on
Diskette
LHW Prog.
HMIS Rpt.
Received at the 1st
week of next month
Reports from all districts
received by the end of
next to reporting month
Reports from all Provinces
received on the 5th week
after the reporting month.
16. HMIS Tools For LHW
1. Family Register (Register Khandan)
2. Treatment Register
3. Family Planning Register
4. Monthly Report Register
16
PROFf: M TAUSEEF JAWAID
17. Information Process
Data Collection
Data Transmission
Data Processing
Data Analysis
Information for use in
planning and management
Indicators
Management
Resources
Organizational
Rules
Components of
National Health Information System
17
PROFf: M TAUSEEF JAWAID
19. Strengths of National HMIS.
• HMIS can provide a summative overview of major
health problems.
• HMIS provides necessary information support both
to information users and managers.
• Reasonably simple and understandable.
• Potential for immediate use at point of data
collection.
• Fully owned and appreciated by end users and
provincial health Departments.
• The only source of routine data collection
mechanism in the health sector.
20. HMIS Data Collection Tools and
sources at FLCF
1. Patient/ Clint Records / Cards
OPD ticket, MCH Card, Vaccination card etc
Referral forms, investigation request form etc
2. Facility Record Keeping System
OPD register, Child health register
Stock register Abstract register
3. Facility Reports
Immediately Reports
Monthly Report
Yearly Report
20
PROFf: M TAUSEEF JAWAID
21. Data Consolidation and
processing Levels
1. Data consolidation at Health Facility
2. Data consolidation at District Level
3. Provincial Data consolidation
4. Federal Data Consolidation
21
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22. Data Utility at Federal
1. Overall situational analysis
2. Disease burden assessment
3. Planning and resources allocation
4. Epidemic Early Warning
5. Data used for research purpose
6. Assessment of health needs
7. Monitoring and Evaluation of health services
22
PROFf: M TAUSEEF JAWAID
23. Data Utility at Province
1. Overall situational analysis at provincial level
2. Disease burden evaluation at provincial level
3. Health Planning of provincial projects
4. resources allocation at provincial level
5. Epidemic Early Warning
6. Data used for research purpose
7. Assessment of health needs
8. Monitoring and Evaluation of health services
23
PROFf: M TAUSEEF JAWAID
24. Data Utility at District Level
1. Diseases profile at district level
2. Health care delivery efficiency and effectiveness
3. Planning and resources allocation
4. Epidemic Early Warning
5. Data used for research purpose
6. Assessment of health needs
7. Monitoring and Evaluation of health services
24
PROFf: M TAUSEEF JAWAID
25. HMIS data is important for every
health worker
1. Medical Officer
2. Dental surgeon
3. MT, LHV, Dispenser and Lab. technician
4. Vaccinator
5. CDC supervisor
6. Sanitary Inspector
7. LHW
8. Dai
25
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26. Data Utility at Facility Level
1. Mapping of disease
2. Assessment of medicine and supplies
3. Supervision and monitoring of staff
4. Monitoring and evaluation of services
5. Epidemic Early Warning
6. Vaccine Coverage
7. CDC supervision
26
PROFf: M TAUSEEF JAWAID
27. SOURCES OF HEALTH INFORMATION
Census
Registration of vital events
Births, deaths, marriages, divorces,
adoptions etc.Union council tehsil.
Council distt. Council,
Notification of diseases
Hospital records
Disease registers
Record linkage
Epidemiological surveillance
Environmental health data
27
PROFf: M TAUSEEF JAWAID
28. Uses of health information
To measure the health status of a
community
For comparison and conclusion
For planning and management
To see performance of a health care
programme
To assess satisfaction of consumer
For research
28
PROFf: M TAUSEEF JAWAID
29. DHIS
To improve the health care services through
evidence based management of service
delivery.
Improved service delivery will contribute to
the improvement of health status of the
population
29
PROFf: M TAUSEEF JAWAID
30. OVERVIEW OF DHIS
DHIS VISION
To improve the health care
services through evidence-based
management of services delivery.
Improved service delivery will
contribute to the improvement of
health status of the population
30
PROFf: M TAUSEEF JAWAID
31. DHIS: OBJECTIVES.
To provide information for management and
performance improvement of the district
health system. DHIS will:-
Provide selected key information from FLCF,
Vertical Programmes, Secondary Care
hospitals, subsystems such as logistics,
financial, human resource and capital asset
management systems for improving the district
health system’s performance.
Cater to the important routine information
needs at the federal, provincial levels for
policy formulation, planning and M&E of health
programme.
31
PROFf: M TAUSEEF JAWAID
32. • Teaching Hospital 19
• DHQ Hospital 37
• Tehsil Headquarters Hospital
77/126
• Rural Health Center 345
• Basic Health Unit
2,744
• MCH Center
287
• Dispensaries( CDs/RDs/GRDs) 434
• TB Clinic 22
Basic Data
(Functional Status)
33
PROFf: M TAUSEEF JAWAID
33. Historical Development of MIS in
Pakistan
A. Pre-independence to 1990.
Annual reporting
Manual System
Annually Based
All Diseases included i.e. out door / indoor
Data collected by Health Facility staff
Consolidated at higher level and submitted
to Federal Government and International
Partners.
No analysis 34
PROFf: M TAUSEEF JAWAID
34. B. 1990-2006 (HMIS)
Automated
Monthly
Manual at facility level
Computerized at district level
Only 18 priority diseases included
Coverage up to OPD only
Historical Development…
35
PROFf: M TAUSEEF JAWAID
35. C. 2006-(DHIS)
Extended up to indoor
Not covering tertiary care level
43 disease
Historical Development…
36
PROFf: M TAUSEEF JAWAID
36. DHIS Information
DHIS
(Improve health status of population)
By
Reduction in:-
• Morbidity,
•Mortality,
•Disability,
• Malnutrition
&
• Improvement in Health Behaviour.
Promotiv
e
Preventive Curative
Rehabilitative 37
PROFf: M TAUSEEF JAWAID
37. Interpret DHIS
information
Identify
performance
gap
Identify causes
of performance
gap
Prioritize causes for
developing solutions
Advocacy and Non-
advocacy based
solutions
Develop an
action plan for
solution
Monitor action
plan and changes
in performance
Use of DHIS Information for Improving Health System
Performance
Guiding Principles
• Problem solving
• Continuous
Improvement
Self-regulation
Culture of information
38
PROFf: M TAUSEEF JAWAID
38. Categories of DHIS Indicators
1. Overall health facility utilization: 15 indicators
2. Preventive and curative service delivery: 48 indicators – 14
preventive care and 34 curative care.
3. Financial management: 3 indicators
4. Logistics: 1 indicator
5. Human resources: 2 indicators
6. Capital assets: 6 indicators
7. Regulation: 1 indicator
8. Information system: 3 indicators
39
PROFf: M TAUSEEF JAWAID
39. DHIS Instruments
There are 25 DHIS instruments for
collection, aggregation and transmission of
data from the primary health care facilities
(BHU, RHC, MCH Centers) and secondary
care facilities (DHQH and THQH).
40
PROFf: M TAUSEEF JAWAID
40. Use of DHIS information model
The mechanisms for implementing this model at district level
include:
Training of the district managers and facility in-charges on Use
of DHIS Information Model
Computer generated data analysis and feedback reporting
Procedures for use of DHIS information at facility, district and
provincial levels
Monthly facility staff meeting
District health system performance review meeting where the
district managers will:
Analysis and interpret DHIS data
Set performance targets/goals
Identify performance gaps using DHIS data
Recognize causes of performance gaps
Prioritize causes
Develop advocacy and non-advocacy based solutions
for improvement
Monitor action plan, and
Conduct self-regulation.
41
PROFf: M TAUSEEF JAWAID
41. Comparison between HMIS & DHIS
HMIS Tools & Instruments:
Total Registers: 19
Facility Record/Registers 10
Administrative Register 9
1. OPD register
2. Abstract Register
3. Mother Health Register
4. Child Health Register
5. Birth register
6. Family Planning Register
7. Tuberculosis Register
8. Laboratory Register
9. Stock Register (medicines, supplies)
10. Stock Register (linen & equipments)
11. Daily Expense Register
12. Meeting Register
13. IDD Register
14. Attendance Register
15. Log Book
16. Stock Register (vaccines)
17. Population Chart of the Catchment Area
18. Daily EPI Register
19. Permanent EPI Register
JICA Tools & Instruments:
Registers: 17
1. Central Registration Point Register (new)
2. OPD Reg.
3. Abstract Reg. (BHU, RHC)
4. Abstract Reg. (DHQ Hospital)
5. Maternal Health Register
6. Family Planning Register
7. Obstetric Reg. (new)
8. Indoor Reg. (new)
9. Daily Bed Statement Register (new)
10. Laboratory Register.
11. Radiology Register (new)
12. OT Register (new)
13. Stock Register (medicines, supplies)
14. Stock Register (linen & equipments)
15. Daily Expense Register
16. Community Meeting Register
17. Facility Staff Meeting Register (new)
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PROFf: M TAUSEEF JAWAID
42. DHIS Implementation
Districts trained in DHIS – 18
Khanewal ( was first Pilot Distt;).
Kasur, Nankana Sahib, Sheikhupura (UNICEF)
Rawalpindi, Chakwal, M.B.Din, Gujrat, Sialkot, Jhang,
Multan, Muzaffargarh, D.G.Khan, Bahawalpur (NHIRC).
Pakpattan & Mianwali ( SOHIP)
Narowal & Khushab ( Govt. of Punjab)
Remaining 17 districts will be trained by Dec-
2008.
Planned Computer Software & data entry
trainings in all districts of Punjab.
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PROFf: M TAUSEEF JAWAID
43. Health Facility (Manual) 1st of each month
District 8th of each month
Province 20th of each month
National
DHIS Data Flow
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PROFf: M TAUSEEF JAWAID
44. DHIS Management Tasks,
Responsibility & Cut-off Dates
No DHIS Management Task Responsibility Cut-off date for
completion
1 Filing-out data collection
instruments
Service providers
2 Data Compilation Service providers 3rd of every month
3 Monthly facility staff meeting Facility OIC 4th of every month
4 Consolidation of monthly report DHIS Focal Peron at
health facility
4th of every month
5 Monthly report sent to District
HMIS Cell
Facility OIC 5th of every month
6 Data entry District HMIS Cell
staff
13th of every month
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PROFf: M TAUSEEF JAWAID
45. Continued:-
No DHIS Management
Task
Responsibility Cut-off date for
completion
7 Compiled district report &
feedback report
District HMIS Cell
staff
15th of every month
8 Submission of district report,
feedback reports & summary
of salient features to EDO (H)
District HMIS
Coordinator
17th of every month
9 Dissemination of report to
Nazims/DCO & facility OIC
EDO (H) 20th of every month
10 Monthly health management
team meeting to review &
discuss monthly report data
for performance monitoring &
identify areas for improvement
EDO (H), DOH,
DDOH, Facility OIC
& HMIS Coordinator
25th of every month
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PROFf: M TAUSEEF JAWAID
46. LIST OF DHISINSTRUMENTS
DHIS Instrument No. DHIS Instrument
DHIS – 01 (R) Central Registration Point Register
DHIS – 02 (F) OPD Ticket DHIS – 02-A (F) Medicine Requisition Slip
DHIS – 03 (R) Outpatient Department Register
DHIS – 04 (F) OPD Abstract Form
DHIS – 05 (R) Laboratory Register
DHIS – 06 (R) Radiology/Ultrasonography Register
DHIS – 07 (R) Indoor Patient Register
DHIS – 08 (F) Indoor Abstract Form
DHIS – 09 (R) Daily Bed Statement Register
DHIS – 10 (R) Operation Theater (OT) Register
DHIS – 11 (R) Family Planning Register
DHIS – 12 (C) Family Planning Card
DHIS – 13 (R) Maternal Health Register
DHIS – 14 (C) Antenatal Card
DHIS – 15 (R) Obstetric Register
DHIS – 16 (R) Daily Medicine Expense Register
DHIS – 17 (R) Stock Register (Medicine/Supplies)
DHIS – 18 (R) Stock Register (Equipment/Furniture/Linen)
DHIS – 19 (R) Community Meeting Register
DHIS – 20 (R) Facility Staff Meeting Register
DHIS – 21 (MR) PHC Facility Monthly Report Form
DHIS – 22 (MR) Secondary Hospital Monthly Report Form
DHIS – 23 (MR) Tertiary Hospital Monthly Report Form
DHIS – 24 (YR) Catchment Area Population Chart
DHIS – 25 (YR) Health Institute Database (HIS) Report Form
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PROFf: M TAUSEEF JAWAID
47. CATEGORIES OF DHIS INDICATORS
1. Overall health facility utilization: 15 indicators
2. Preventive and curative service delivery: 48 indicators – 14
preventive care and 34 curative care
3. Financial management: 3 indicators
4. Logistics: 1 indicator
5. Human resources: 2 indicators
6. Capital assets: 6 indicators
7. Regulation: 1 indicator
8. Information system: 3 indicators
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PROFf: M TAUSEEF JAWAID
52. • Procurement & distribution medicine
• Staff performance
• Planning & development
• Disease patterns
• DEWS
• Performance of Preventive Services
District Level:
• Dev. & Dissemination of Tech.Reports
• Regular Info.on PRSP & MDG .
• Use by MOP for Digital Atlas.
• Use by NIPS for district profiles.
• Use by FBS for Monthly Bulletins.
• Use by WFP for Program Monitoring
• Research by MPH Students
• To De-emphasize FLCFs (e.g. NWFP).
• Responding to Parliamentarian's Queries
• NIH Rabies Project, GIDSAS etc.
National/
Provincial
Level:
Facility Level: • Possible but Very rare
Current Users of HMIS Data
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PROFf: M TAUSEEF JAWAID