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Bangladesh Health Information System

Bangladesh Health Information System. 2 nd IFHRO SEAR Conference Perth, Australia, Tuesday, October 13, 2009 GTZ Health Programme Muhammed Emranul Haq, M&E Advisor ( emranul.haq@gtz.de ). Background.

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Bangladesh Health Information System

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  1. Bangladesh Health Information System 2nd IFHRO SEAR Conference Perth, Australia, Tuesday, October 13, 2009 GTZ Health Programme Muhammed Emranul Haq, M&E Advisor (emranul.haq@gtz.de)

  2. Background • Bangladesh is located in the northeastern part of South Asia with land area of 147,570 square kilometers. Population of about 150 million, more than 920 persons per square kilometer. • Administratively, the country is divided into 6 divisions, 64 districts, and 496 upazilas (sub districts). • Currently (2005-2011) the government is implementing one of the biggest SWAP Health Nutrition and Population Sector Programme (HNPSP) of estimated 3.5 - 4 Billion USD. Bangladesh HIS Update

  3. Regional Location Bangladesh HIS Update

  4. Administrative Distribution Bangladesh HIS Update

  5. Existing Health System Bangladesh HIS Update Significant progress in recent times in many of its social development indicators particularly in health. Achieved important gains in providing primary health care since the Alma Ata Declaration in 1978. Infant, maternal and under-five mortality rates have all decreased over the last decades, with a marked increase in life expectancy at birth. Due to a good health infrastructure and dedicated workers it has been possible to make those successes

  6. Ministry of Health and Family Welfare (MOHFW) Director General of Health Services (DGHS) Director General of Family Planning (DGFP) National Nutrition Programme (NNP) Directorate of Drug Administration (DDA) Directorate of Nursing Services (DNS) Director General 38 Line directors for programmes implementation Director 64 District Level Facilities Civil Surgeon 469 Upazila Level Facilities Upazila Health Officer Union and Community Services and Facilities Bangladesh HIS Update

  7. Existing Health System Bangladesh HIS Update The Public Sector Primary: Upazila Health Complex (UHC) at sub-district level which works as a health-care hub. Secondary: Responsible for preventive healthcare services Tertiary: Above sub district are district hospitals, medical colleges, providing secondary care and national tertiary level care facilities. The Private Sector Both specialized and general hospital, clinic, diagnosis facilities are provided

  8. Current Health Information System Bangladesh HIS Update • Mostly vertical data collection, less integration, no quality control, lack of regular dissemination, less utilization for decision making • Logical flow of data and availability is fairly absent • Whereas, in other places, it needs attention

  9. HMIS Assessment using the HMN approachOverall assessment of Data Sources Bangladesh HIS Update

  10. Use of MIS by type of health facility(Health Facility Survey, 2009) Bangladesh HIS Update

  11. Existing MISs in Health Sector • MIS of Directorate General Health Services (DGHS) • MIS of Directorate General Family Planning (DGFP) • MIS National Nutrition Program (NNP) Bangladesh HIS Update

  12. GTZ Support in HIS Bangladesh HIS Update Realizing the need currently GTZ is providing support to bridge the gap Through building a national data warehouse Following a participatory process Increased inter collaboration within the system Meet the need to the policy makers level Create a model for future HIS Supporting the existing M&E Unit under the MOHFW

  13. GTZ Support in HIS Bangladesh HIS Update “Data Management and Information System (DMIS) is a technical support to Ministry of Health and Family Welfare (MOHFW) which has started its activities on the 1st of March, 2009. Critically analyze and identify the need, provide training and capacity building Phased basis implementation

  14. Conceptual Diagram of DMIS Bangladesh HIS Update

  15. Different Phase of DMIS Bangladesh HIS Update

  16. Bangladesh HIS Update

  17. Remaining weaknesses / challenges • Lack of coordination between Departments, Programmes, and Directorates • Multitude of reporting forms and requirements • Focus on activity (input) reporting • Lack of ownership (at service / facility level) and consequently poor quality of data • Limited use of indicators (percentage, rate or ratio with a clearly defined denominator, allowing for setting targets and eventually performance measurement with regard to outputs and outcomes) Bangladesh – MOHFW – M&E Framework Bangladesh HIS Update

  18. Leading to… • Programme and sector M&E mainly based on non routine (e.g. survey) data • Non availability of data for (comprehensive and continuous) M&E of programme activities and results • Lack of use of data and information in decision making process at all levels Bangladesh – MOHFW – M&E Framework Bangladesh HIS Update

  19. Present HIS Problem Bangladesh HIS Update • Use of large numbers of forms and data elements, slow down processes and reduce data quality • Manual data compilation at District and below levels and centralised entry into the data base is a main source for errors • Training in data management and analysis is almost absent across all MISs;

  20. Existing problems Bangladesh HIS Update Lack of understanding or reluctant about ICT among the most of the health professionals Less use of data for policy decision Lots of computer and related equipments have been procured but there is no presence of an efficient system Acute shortage of IT efficient technical Human Resources both at operator and specialized level

  21. Existing HIS Problem Bangladesh HIS Update Manual data collection mechanism is predominant Even data is collected but those are not properly analyzed as per need or requirement Weakness of national sector programme not be able to indicate specifically about the ICT in Health sector Individual or donor level interests are not well coordinated or facilitated by the high level decision makers

  22. Opportunities Bangladesh HIS Update Commitment from the present democratic government to implement “Digital Bangladesh” vision by 2021 Increased global network e.g. HMN, PHIN, HIMAA, IFHRO, e-Health etc. Interest among the donor community e.g. DMIS initiative, WHO’s mandate Data demand from the highest policy makers Present development of ICT in local market & availability of skilled manpower World class system have been introduced by several private Hospital level, who are eager to collaborate Increased motivation of data use

  23. Thank you all Bangladesh HIS Update

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