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: UNICEF along with the State Government of Bihar launched a computer tablet‑based Mother and Child Tracking System (MCTS) in 2014, to capture real‑time data online and to minimize the challenges faced with the conventional MCTS. Objective: The article reports the process of implementation of tablet‑based MCTS in Bihar. Methods: In‑depth interviews with medical officers, program managers, data managers, auxiliary nurse midwives (ANMs), and a monitoring and evaluation specialist were conducted in October 2015 to understand the process of implementation, challenges and possibility for sustainability, and scale‑up of the innovation. Results: MCTS innovation was introduced initially in one Primary Health Centre each in Gaya and Purnia districts. The device, supported with Android MCTS software and connected to a dummy server, was given to ANMs. ANMs were trained in its application. The innovation allows real‑time data entry, instant uploading, and generation of day‑to‑day work plans for easy tracking of beneficiaries for providing in‑time health‑care services. The nonlinking of the dummy server to the national MCTS portal has not lessened the burden of data entry operators, who continue to enter data into the national portal as before. Conclusion: The innovation has been successfully implemented to meet its objective of tracking the beneficiaries. The national database should be linked to the dummy server or visible impact. The model is sustainable if the challenges can be met. Mobile technology offers a tremendous opportunity to strengthen the capacity of frontline workers and clinicians and increase the quality, completeness, and timeliness of delivery of critical health services.
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.