Developing a Web-based Integrated Dashboard for Health Information Systems,

Department of Health, Government of Sindh

Session 4328.0: Systems Thinking (ID=50443)

Tuesday, November 7, 2017: 2:30 p.m.-4:00 p.m.

Arshad Mahmood Deputy Chief of Party

Health Systems Strengthening USAID’s MCH Program Pakistan

• Demonstrate the web-based, interoperable, integrated dashboard for health information, that is currently being used by the Department of Health, Government of Sindh, Pakistan

• Describe steps taken to ensure quality data, and built in mechanisms to track data quality

• Discuss the importance of transparent data to increase accountability in health care financing and delivery

Objectives

Health System Strengthening Project

• One of the five components of USAID’s MCH Program;

• The goal is to support innovative, cost‐effective, quality programs around reproductive, maternal, and child health services for improved outcomes;

Health System Strengthening: Approach Adopted

• Assessment of health systems strengths and weaknesses

• Identified key constraints and interventions required

• Identified potential solutions & developed concept papers

• Presented to DOH to build consensus

• Worked with DOH, no Parallel Infrastructure

District Health

Systems Strengthening

Health Systems Strengthening Package

Health Care Commission

District Health

& Population

Management

Teams

(DHPMT)

Leadership/

Management

Capacity

Building

Health

Information

System

Monitoring

&

Supervisory

System

District Action Plan with/MTBF

• District wise DHIS performance reports were not accessible

• Non availability of Provincial DHIS reports

• Baseline assessment shows data accuracy was less than 50% of DOH facilities

• Data utilization was limited

• Monitoring and supervisory system not existed

• No evidence based decision making

Baseline Assessment Findings

Objectives of online Dashboard (A managerial perspective)

What: Identify Key Information

To Provide Information for Management & Performance Improvement

of Healthcare Services at all levels

• Policy formulation

• Planning

• Monitoring

• Decision making

• Health facilities • Service Delivery • Stock outs of commodities • HR position • Financial utilization

• Community workers

Why: Assist Managers in

1 2

• Aggregation to

unit level

How: Drill Down

3

Integrated Dashboard Covers

Integrated SHIS

Dashboard

M&E KPIs Dashboard (Performance

Ranking of Districts KPIs)

DHIS Dashboard &

Analytical Report

CMW-MIS Dashboard &

Analytical Reports

LHW-MIS Dashboard &

Analytical Reports

Consolidated FP Dashboard of all Sources

vLMIS and cLMIS

Dashboards

Dashboard of periodic

surveys PSLM, PDHS, MICS,

Nutrition

Online M&E System: Ranking of Districts on KPIs

M&E: District Ranking based on KPIs

Lady Health Workers Reporting Compliance

Lady Health Workers: Dashboard

Monitoring and Supervisory System: Pre-requisites

• Dedicated health managers team with the technical skills, knowledge and motivation to improve the quality of services;

• Availability of monitoring tools, guidelines and protocols;

• Resources required for monitoring and supervision (Vehicle, POL, Daily Allowances)

Supervisory Checklist Planned vs. Conducted vs. Confirmed

766

984 1047 1031 1036

992 952 941 935

534

729 669

735 740

560

748 752 756

24 101

155 173 207 243 239 257 290

Jan Feb Mar Apr May Jun Jul Aug Sep

Planned Visits Visits Held Visits Confirmed

Monitoring and Supervisory System: Validation of Data

• Standardized checklists/tools of all programs available online

• District teams trained on Monitoring & Supervision and Validation of data

• Checklists are filled on-line

• Continued capacity building of district management and M&E Cells

Visit Verification through Mobile App

Findings of Supervisory Visits

District M&E Cells Established

Ensure effective DHPMT meetings

Track progress on DAP implementation

Improve MIS reporting compliance

Ensure use of M&S online system

Use of information beyond numbers: focus on challenges of coverage and quality

Significant Increase in Health Facilities Reporting Complete, Accurate and Timely Monthly Reports

15

56

69

Dec, 2013 March, 2016 August, 2017

28.1%

71.0% 75.6%

187.1%

0.0%

50.0%

100.0%

150.0%

200.0%

2013-14 2014-15 2015-16 2016-17 2017-18

Increase in Non Development Annual Budget

13,049 13,251

16,712

22,317

22,910

37,469

10,000

15,000

20,000

25,000

30,000

35,000

40,000

Figures in Millions (PAK Rs.) Percent Increase from Baseline 2013-14

Conclusion • Health Facilities Reporting Compliance is

approaching 100%;

• LHW reporting compliance in over 95%;

• Error reports significantly reduced over time;

• DOH started using Dashboard for evidence based decision making;

• Primary Health Care Budget increased significantly

• DOH supervisory visits improved;

• Data quality improved significantly;

Thank you!