ORISSA HMIS Towards an equity based monitoring system

ORISSA HMIS Towards an equity based monitoring system

ORISSA HMIS Towards an equity based monitoring system Institute of Public Health Bangalore (with the support of DFID, Delhi) July 2007 Objectives of this assignment STATE Rationalisation of the HMIS PERIPHERY 2

Methodology 3 Methodology Level Number State / National level 15 District level 29

PHC / CHC level 13 Subcentre level 7 4 Results status of HMIS Have introduced a comprehensive NRHM reporting format But this a copy of Form 6 with some additions e.g. ASHA, JSY, NLEP, NPCB, IMNCI and details of infant deaths All other reports and registers continue

5 Results status of HMIS Level Number of registers Number of reports Number of variables Sub centre level

32 33 ~ 444 PHC level 20 35 ~ 492 CHC level 43

74 ~ 532 District level 19 46 ~ 680 TOTAL 114

188 ~ 2148 6 NRHM New registers 8, of which 5 are at the block level New reports 22, of which 8 are at the SC level, 10 are at the PHC / CHC level and 4 at the District level. More on the pipeline NRHM GoI apparently wants to monitor the programme, down to SC activities 7 Results status of HMIS

Severe shortage of statistical staff at all levels Quality of data is unsatisfactory Data overload, so very little analysis Feedback is limited - mostly irregular, critical and occurs only when there are problems Validation of data is adhoc, NRHM staff are interested in monitoring, but require capacity building 8 Recommendation I Rationalisation of registers & reports

Comprehensive NRHM is a good first step Not clear what is the use of adding national programmes when they are being monitored separately Reduce duplicate registers and reports. Have already recognised 26 A lot of reduction possible if national programmes can be rationalised, especially malaria Need to start with the GoI and work oneself down Beware of increasing more because of NRHM. 9 Framework of indicators Quarterly analysis at State / district level

Child health 1. % of children fully immunised 2. % of children with malnutrition 3. % of low birth weight babies 4. Number of months that there was stock out of measles vaccine 5. 10 Framework of indicators Quarterly analysis at State / district level Reproductive health 1. Proportion of women how have delivered and who have received full antenatal check up 2. Proportion of deliveries attended by skilled

providers 3. Proportion of deliveries in institutions 4. Proportion of deliveries in government institutions 5. Proportion of BPL mothers who received JSY funds 6. 11 Framework of indicators Quarterly analysis at State / District level Malaria 1. 2. 3. 4. 5.

Incidence rate of malaria Mortality rate due to malaria Case fatality ratio due to malaria Malaria treatment failure rate Proportion of pregnant women who have received full dose of CHQ chemoprophylaxis 6. % of facilities that did not have CHQ / PMQ at least once in the quarter 12 Framework of indicators Quarterly analysis at State / District level TB 1. 2. 3. 4.

Case detection rate NSP case detection rate TB cure rate % of NSP cases put on DOTS within 7 days 13 Framework of indicators Quarterly analysis at State / District level Performance of hospitals 1. 2. 3. 4.

% of Institutions with BOR > 75% Mortality rate in institutions by depts Infection rate in institutions by depts ALOS in institutions by depts 14 Framework of indicators Quarterly analysis at State / District level ASHA 1. % of Gram sabhas that have selected ASHAs 2. % of selected ASHAs who have been trained 3. % of trained ASHAs who have accompanied women for delivery 4. % of trained ASHAs who are DOTS providers 5. % of ASHAs who motivated mothers for the BCG immunisation

15 Framework of indicators Annually at State level 1. 2. 3. 4. 5. 6. 7. 8. Crude Birth rate Crude Death rate Infant mortality rate (by cause of death) Neonate mortality rate

Still birth rate Child mortality rate (by cause of death) Maternal mortality ratio Incidence of near miss events 16 Framework of indicators Annually at State level 9. Total fertility rate 10. Couple protection rate 11. 12. 13. 14.

15. 16. Incidence of TB Mortality rate due to TB Incidence of Malaria Mortality rate due to Malaria Prevalence of leprosy Prevalence of HIV 17 Framework of indicators Annually at State level 17. 18. Outpatient contact rate in government hospitals

Inpatient admission rate in government hospitals (by depts) 19. 20. 21. 22. % of SGDP allocated to health % of health budget on primary care Per capita public health expenditure % of Districts with integrated societies, QA committees and RKS in place % of districts who have submitted UC on time 23.

18 Framework of indicators Annually at State level 24. 25. 26. 27. 28. 29. 30. 31. 32. Ratio of doctor to population Ratio of ANM to population

Vacancy rate (at various levels) % of Directors who were in position for more than 6 months in a year % of District staff who were in position for more than 6 months in a year % of districts with full time DPM in place % of districts that did not having at least one months stock of essential drugs (ATT, measles vaccine, ORS, OC) % of CHCs upgraded to IPHS % of CHCs / SDH / DH providing EmOC 19 Recommendation III Special studies Health seeking behaviour Health expenditure studies

Awareness Patient satisfaction studies Utilisation studies Mortality studies 20 Recommendation IV Strategy for monitoring Not enough to collect information Need to analyse it systematically and regularly Good to have an operational manual detailing on how to interpret the indicators and what action to be taken Important to supervise, triangulate and validate the data also 21

Thank you Dr. N. Devadasan, Dr. Lalnuntlangi Ralte Dr Upendra Bhojani

Recently Viewed Presentations

  • zeus.vwu.edu

    zeus.vwu.edu

    The Web Wizard's Guide to PHP by David A. Lash Objectives To understand what PHP is and how a PHP script works with a Web Browser and a Web Server To learn what software and components you need to get...
  • Hacia un Sistema de Cooperación Universitaria en el Perú

    Hacia un Sistema de Cooperación Universitaria en el Perú

    APCI - Agencia Peruana de Cooperación Internacional Cooperación Internacional en el Perú Óscar Schiappa-Pietra C. Director Ejecutivo Víctor Lora R.
  • Speciation: Basic Concepts

    Speciation: Basic Concepts

    Fusion barriers are not strong enough hybrids are more likely murky water resulting in interspecies mating Stability the hybrid production is stable barriers haven't happened or are too weak still hybrids are not the norm because the location where they...
  • ELEMENTS OF PLOT STRUCTURE - SharpSchool

    ELEMENTS OF PLOT STRUCTURE - SharpSchool

    ELEMENTS OF PLOT STRUCTURE. Told by. The Three Little Pigs. Once upon a time, three little pigs said goodbye to mama pig and went off to seek their fortunes in the world. EXPOSITION. What is this stage called? Once upon...
  • Co-Limitation of Phytoplankton by Light and Multiple Nutrients

    Co-Limitation of Phytoplankton by Light and Multiple Nutrients

    Bozec et al, manuscript in preparation Comparison of nutrient stoichiometry of the November 2000 Polarstern experiment in the Southern Ocean, versus the previous Ironex II experiment in the equatorial Pacific, the classical Redfield stoichiometry, and similar anomalies published by Takeda.
  • FDA: History and Organization - Louisiana State University

    FDA: History and Organization - Louisiana State University

    FDA: History and Organization Edward P. Richards Harvey A. Peltier Professor of Law ... Agency Under the Secretary of HHS Senate Confirmation Much More of a Political Appointment than in the Past Early Laws The Vaccine Act of 1813 Bad...
  • Journal Entry #41 Title: Free Write Friday - WordPress.com

    Journal Entry #41 Title: Free Write Friday - WordPress.com

    Be sure to write in complete sentences and use correct punctuation. This is an extra credit opportunity. Mug Shot 2.5. Mug Shot 2.5 Answer. Created Date:
  • The End of Farm Labor Abundance - California

    The End of Farm Labor Abundance - California

    US workers stopped doing hired farm work in the 1900s. A few US kids dream of being farmers, but not . hired farmworkers. Immigration solved our farm labor problem. Mexico was at an earlier stage of the farm labor transition....