ABSTRACT
Background: In 2005, the Government of India implemented the National Rural Health Mission for reduction of maternal mortality. One of the major impediments in improving maternal health since then has been a poor management of the Health Management Information System (HMIS) at grass-roots level which could integrate data collection, processing, reporting, and use of information for necessary improvement of health services. Objective: The paper identifies the challenges in generating information for HMIS and its utilization for improvement of maternal health program in the tribal-dominated Jaleswar block in Odisha, India. It also aims to understand the nature and orientation of the HMIS data generated by the government for the year 2013–2014. Methods: The study is a cross-sectional type which used observation and interview methods. Primary data were gathered from health professionals to understand the challenges in generating information for HMIS and its utilization. Next, to understand the nature and orientation of HMIS, data pertaining to tribal block were analyzed. Results: The findings show that there are challenges in generation of quality data, capacity building of workforce, and monitoring of vulnerable tribal population. The discrepancies between HMIS data and field reality display the gap in formulation of policy and its implementation. Conclusion: The study unearths the existing politics of knowledge generation. This shows highly standardized procedures and information gathering by use of dominant biomedical concepts of maternal health with limited inclusion of local birthing conceptions and needs of vulnerable tribal pregnant women.
ABSTRACT
Background: Effective monitoring and supervision of health care programs depend on complete, accurate, and timely flow of data. Mother and Child Tracking System (MCTS) is a centralized information technology (IT)-based application launched in 2009 for improving the delivery of maternal and child health care services through name-based tracking. There is minimal evidence in the literature evaluating the operational aspects of such a name-based tracking system even after 5 years of its implementation. Objective: The present study was thus conducted to understand the opportunities and challenges in the operationalization of MCTS strategy in a district in Haryana and to understand the stakeholder's perspectives. Materials and Methods: Performance of Routine Information System Management (PRISM) framework was used. This cross-sectional study was conducted in Shahzadpur block of Ambala district, Haryana, India involving in-depth interviews of health care providers and clients in 12 subcenters (SCs) and two primary health centers (PHCs). Results: Lack of appropriate training, overburdened data entry operator (DEO) and auxiliary nurse midwife (ANM), poor Internet connectivity, slow server speed, and frequent power failures were revealed as major limitations for the effective implementation of MCTS. Nearly 18% of the clients reported receiving short message service (SMS) and only 6% could understand the SMS. Conclusion: MCTS has led to accountability and improved supervision of health workers, apart from empowering the community.