Strengthening information systems
We support the health sector's need for accurate, comprehensive and disaggregated data to gauge the performance, identify disparities in use of services between social groups and geographical areas, and plan future interventions.
The Health Management Information System (HMIS) within the Department of Health Services (DoHS), plays an important role in providing data but it needed to be strengthened to meet demands. Health facilities across Nepal are linked by internet with the HMIS and are required to report on 200 indicators. We supported the DoHS to revise the HMIS to improve data collection, reporting, analysis and its use at different levels across all 75 districts of Nepal.
We initiated the process of revising HMIS indicators and recording and reporting tools by focusing on use of the data at different levels, particularly at the point of data generation. Under the leadership of the Management Division within the DoHS, we facilitated the consultation and the overall revision process in coordination with all the programme divisions, centres and other stakeholders.
We supported field testing of the revised recording and reporting tools and provided quality assurance of the training given to health workers on the revised system. We also supported the distribution of the revised tools to the districts for a smooth roll out of the system across the country.
We worked with the Ministry of Health to customise the District Health Information System 2 (DHIS2), an open source software developed by the University of Oslo and used in 30 countries to record, analyse, report and disseminate HMIS data. We are now working with the MoH to build capacity, and ensure roll-out and institutionalisation of DHIS2.
To ensure more consistent and reliable data collection, we are supporting the MoH to initiate electronic reporting for health facilities and gradually move towards having an electronic health record system at every health facility.
Key achievements of the revised system
- Addresses the data needs of the Nepal Health Sector Programme and the programme divisions and centres
- Integrates indicators on Aama, Emergency Obstetric Care monitoring, TB, HIV/AIDS, critical management of acute malnutrition, community based new-born and child programme
- Allows data from individual health facilities to be analysed
- Allows disaggregation of data based on caste, ethnicity, age, sex and disease
- Improved use of data at different levels
- Improved quality of the data, with a focus on the point of data generation, i.e. at the facility level.
We included 11 additional indicators not previously captured into the HMIS
The revised HMIS was rolled out across 75 districts
We linked the data from the revised HMIS with 9 other MIS within the Ministry of Health through a unified coding system