HEALTH MANAGEMENT INFORMATION SYSTEM

Col Naila Azam

NOTE
DATA- discrete observations as collected, little meaning , no use in planning; NEEDS TRANSFORMATION

INFORMATION- Data processed by reducing, summarizing, adjusting ; NEEDS PROCESSING INTELLIGENCE- integration with perceptions and socio political values

M.I.S
M--- MANGEMENT = process of designing and maintaining an environment in which people working together in groups accomplish defined objectives efficiently by their decisions I--- INFORMATION= processed meaningful data that conveys some message which is accurate, complete, concise ,intelligent and timely S--- SYSTEM = a collection of components/subsystems that work together to achieve a common objective

LEARNING OBJECTIVES at the end of session

To be able to identify the functions & objectives for HMIS To be able to identify the elements & sources of HMIS To be able to enumerate the qualities of an efficient HMIS To be able to understand the FLCF reporting system in Pakistan and enumerate the priority health problems identified for reporting

DEFINITION
An organized system ( of people, procedures and devices) Designed to generate, store,process and disseminate Information on health events to managers, decision makers, policy makers, planners, healthcare personnel for DECISION MAKING

ELEMENTS OF A MANGEMENT INFORMATION SYSTEM

INPUT
Data on selected activities to produce required information of all events(relevant & standardized)

PROCESS
Means used to transform data into information. Collated, aggregated, analyzed, presented on time, in legible ,understandable formats

OUTPUT
Processed information for use at required level for decision making

FUNCTION OF HMIS
Describe and determine nature and extent of disease burden in community Provide information on the 18 priority diseases Provide information on service related indicators Monitoring and evaluation of the efficiency and effectiveness of PHC system components and programs

OBJECTIVES OF HMIS
To provide information support to health managers at various levels To compare performance over time with other provinces , districts and facilities To identify facilities in need of support To monitor trends in disease patterns, coverage, quality and population at risk ; and record information on health systems

OBJECTIVES OF HMIS
To monitor availability of drugs, contraceptives, functionality of equipment, repair and maintenance of facilities and utilities To provide monthly, quarterly, annual basis information on all the events

PHC management information

community Community health worker Individual records Lady health visitor Aggregation sheets Nurse Doctor

HMIS

LEVELS OF INFORMATION

PRIMARY health centers

Rural health centre

District health HQ

Provincial health HQ

SOURCES OF HEALTH INFORMATION

Census Registration of vital events Sample registration system Notification of diseases Hospital records Disease registers/ record linkage Epidemiological surveillance

Sources of health information-contd

Health service records(OPDs, MCH centres, GP clinics, school health records,) Environmental health data Health manpower statistics Population health surveys Routine health related statistics (demographic,economic,social security schemes) Non- quantifiable information

QUALITIES OF EFFICIENT HMIS

Relevance at design
Only data essential for monitoring be made part of routine data collection

Standardization
Quality control achieved by uniformity of definitions of variables

DATA collecting and aggregating instruments

Simple and easy to understand and complete by lay workers

QUALITIES OF HMIS- contd

DATA formatting
Processed data is presented for easy understanding

Timely flow of information

Collection ,processing and flow must be timely for appropriate action when and where it is required

Filtration of information
For use at appropriate levels only be released accordingly

QUALITIES OF HMIS- contd

Feedback
At all levels to create interest among users and data generators by communicating progress to all concerned

Choice of indicators
Valid Reliable According to goals and objectives According to community /country

HEALTH SYSTEM REPORTING FLCF in Pakistan

Facility record keeping system- 19 registers Facility reports- 3 comprehensive reports
Immediate reports for epidemic diseases Monthly report Yearly report

Report transmission and data processing system on 18 priority diseases Feedback mechanism

PRIORITY HEALTH PROBLEMS

comparable reporting

Standard definitions and Standardized recording for each problem Coding system special 3 digit code with provision for a fourth digit after a dot
E.g 101.1 for diarrhoea with some dehydration and 101.2 for diarrhoea with severe dehydration,while, 102 for dysentry and 103 for acute respiratory infections

WEAKNESS OF HMIS IN PAKISTAN

Lack of information on management issues Poor quality of data Lack of timely reporting and feedback Inadequate information usage Lack of universal launch of HMIS Lack of information system for hospitals, personnel, logistics

TASK
Enumerate the diseases that in your opinion should be in priority reporting list in Pakistan Enlist at least six categories of indicators for inclusion in the HMIS

ASSESS AND REVIEW YOUR ANSWERS

HMIS/FLCF CODE 101 101.0 101.1 101.2

HEALTH PROBLEM Diarrhoea (for children < 5 years) Without dehydration With some dehydration With severe dehydration

101.9
102 103 104 105 106

Dehydration status not specified

Dysentry Acute respiratory infections Fever (clinical malaria) Cough more than 2 weeks Suspected cholera

107

Suspected meningococcal meningitis

108 109

Probable poliomyelitis Probable measles

110
111 112 113 114 115 116 117 118

Probable/confirmed neonatal tetanus

Probable diphtheria Probable whooping cough Goitre Suspected viral hepatitis Suspected AIDS Snake bite with signs & symptoms of poisoning Dog bite scabies

INDICATORS
AVAILABILITY OF HEALTHCARE
Ratio between population under study , the health facilities and healthcare manpower

ACCESSIBILITY OF HEALTH CARE

Percentage of population within 5 Km or 1 hour walk of trained health worker

ACCEPTABILITY AND QUALITY OF HEALTHCARE

Proportion of cases of vaccine preventable diseases with history of immunization /otherwise

INDICATORS
SOCIAL AND ECONOMIC INDICATORS RELATED TO HEALTH
rate of population increase Adult literacy rate

INDICATORS OF PROVISION OF PRIMARY HEALTH CARE

Percentage of pregnant women receiving ante natal care Percentage of children 12 months to 5 years fully immunized or underweight

GOOD LUCK