Electronic Health Management Information System to Improve Recording and Reporting for TB Control in Bangladesh: Roll-out Experience and Opportunities

1. Electronic Health Management
Information System to Improve
Recording and Reporting for TB
Control in Bangladesh: Roll-out
Experience and Opportunities
*Mohammad Kibria; Senior Technical Advisor- HIS, SIAPS
Sanaul Bashar, Senior Technical Advisor- TB, SIAPS
Liza Talukder; Technical Advisor- Communication, SIAPS
Abu Taleb, Technical Advisor- TB, SIAPS
December, 2015
Despite the concerned efforts of National Tuberculosis Control Program (NTP) and
its partners, tuberculosis (TB) still remains a considerable public health concern in
Bangladesh. One of the most significant challenges for NTP is to maintain accurate
recording and up-to-date reporting of TB case data. Lack of timely case reporting
leads to delays in treatment, and ultimately contributes to increased rate of drug-
resistant TB.
The USAID-funded Systems for Improved Access to Pharmaceuticals and Services
(SIAPS) Program, implemented by Management Sciences for Health (MSH),
collaborated with the Ministry of Health and Family Welfare (MOHFW) to assess the
needs of NTP’s information management system. After an option analysis, NTP
adopted the web-based e-TB Manager (e-TBM- http://etbmanagerbd.org/) to better
manage TB patients and medicines while generating key reports and indicators.
NTP, in partnership with WHO, piloted e-TBM at 6 sites in November 2010 which
was then rolled out to 240 sites including all MDR sites in Bangladesh. Realizing the
enormous potentiality during the initial experience of implementation, NTP
acknowledged e-TBM as mandatory tool for recording and reporting of TB cases and
recently issued notification to 20 districts’ (having full coverage of e-TBM in all sub-
districts) authorities to generate reports (TB10, TB11 and TB12) through this system.
For e-TBM to replace inefficient paper-based recording and reporting system, it was
necessary to enter all TB cases into the system to improve data quality. Since the
issuance of Govt. notification, 20 districts are routinely entering data into e-TBM and
33,227 cases were entered in 2015 (Data as of 30 September, 2015; Source: eTB
Manager) as oppose to total registered cases (n=37,968) in TB cards (Source: NTP
MIS report, 2015). It is observed that, difference between paper-based and
electronically generated reports is gradually decreasing (18% in 1st quarter vs 8% in
3rd quarter).
“e-TBM allows me to
ensure recording and
reporting of the
quality data.”
Mr. Bahauddin

2. Performance rate for data quality aspects (timeliness, completeness, accuracy) in
these 20 districts has progressively improved. 89% of sites in 3rd quarter of 2015 falls
under “A ”Category from 62% in 1st Quarter of 2015, representing an increase of 27
percentage points. (“Category A” denotes high performing site and “Category D”
represents low performing site.
SIAPS has also provided training to its TB partners’ (NTP, BRAC, HEED, Lepra,
URC, Challenge TB and Damien Foundation) staffs (n~200) on e-TBM.
Mr. Bahauddin1, TB
and Leprosy Control
Assistant-TLCA and
e-TBM focal person
for one sub-district,
received training in
2010 and describes
this tool as “life
saver.”
“I can easily find out
an old registered case
when it comes as a
relapse case to
complete the previous
information.
Preparation of
quarterly reports and case analysis by type, sex, age, category, facility etc. became
easier and takes only few seconds which took minimum two days previously,” He
happily added. “e-TBM allows me to ensure recording and reporting of the quality
data.”
1
Mr. Bahauddin’s role has now been changed as national trainer for e-TBM. He is
contributing significantly to NTP’s countrywide expansion process
*Corresponding author: mkibria@msh.org
0%
25%
50%
75%
100%
1Q 2Q 3Q
Site performace as per category
A B C D