TABLE 1.

Barriers Affecting the Availability, Quality, and Use of India National HMIS Administrative Data, and Subsequent Activities and Policies Addressing the Barriers,a 2020

Barriers Affecting Existing Availability, Use, and Quality of National HMIS DataMajor Activities Implemented During Landscape Analysis to Understand and Address BarriersGOUP Policy Actions Taken to Address Barriers
Data availability

  • Untimely or no reporting of data from both public and private facilities; many were absent from HMIS

  • Duplication of data and reporting across different manual paper-based forms (several data elements included in existing routine data sources were considered irrelevant or duplicative)

  • Data elements that program managers found useful in daily decision making were not listed in the existing national HMIS or paper-based reports

  • Mapped all public and private health facilities in UP

  • Reviewed and reduced duplication of data elements across 80 reporting forms

  • Revised reporting forms to include relevant data for decision making

  • Developed a definition guide for each data element

  • Conducted auxiliary nurse midwives orientation workshops to increase familiarity with forms and data elements

  • Established state data portal allowing easy data download and analysis

  • Outlined reporting timelines for all the health facilities

  • Required private health facilities to report data to UP-HMIS

  • Required updated UP-HMIS formats to be printed and made available to all facilities

Data quality

  • Processes for data quality review were absent, poorly implemented, and inadequate

  • A routine platform to review the quality of routine data missing from block, district, and state levels

  • Manual paper-based data collection reduced the timeliness, completeness, and accuracy of reporting

  • Conducted training sessions for data-related managers at the block and district levels on how to implement data validation checks

  • Required the establishment of data validation committee meetings at the block, district, and state levels

  • Replaced manual paper-based reporting with digital UP-HMIS reporting across all districts

Data use

  • Difficulty downloading data from the national HMIS to conduct analysis

  • No uniform framework for review meeting and data use

  • Review mostly focused on logistics issues rather than using data to address utilization/coverage issues

  • Complexity of data made analysis difficult

  • Lack of human resources (both in number and skill) to analyze the data for use

  • Developed UP Health Dashboard and shared login with all block, district, and state level program managers

  • Shared monthly district-level rankings with districts

  • Disseminated guidelines, including a framework on how to use data to address program barriers, develop action plans, and conduct review meetings

  • Directed all programs to review data based on UP-HMIS and the UP Health Dashboard to promote a culture of data-informed decision making

  • Abbreviations: GOUP, Government of Uttar Pradesh; HMIS, health management information system; UP, Uttar Pradesh; UP-HMIS, Uttar Pradesh Health Management Information System.

  • ↵aSource: Authors’ analysis.