District Health Information System (DHIS) DR. WAQAR ALI 1

 How do you know that health system is providing services and achieving its objectives? 2

 By knowing whether health system is achieving its targets, such as 80% of people have access to health service or 50% of people are coming to the clinic, or 60% women are receiving ANC service etc., we can tell that health system is achieving its objectives. 3

 The purpose of the routine health information system is to assist in developing performance targets and monitor them on regular basis. 4

DHIS Vision  To improve the health care services through evidence- based management of service delivery. Improved service delivery will contribute to the improvement of health status of the population 5

DHIS Objectives  To provide information for management and performance improvement of the district health system. More specifically, the DHIS will: 1. Provide selected key information from FLCF( first level care facility ), secondary hospitals and sub-systems such as logistics, financial, human resource and capital asset management systems for improving the district health system’s performance. 6

2. Cater to the important routine information needs at the federal and provincial levels for policy formulation, planning and M&E of health programs 7

Changes introduced by DHIS 1. Updated dataset more responsive to the current information needs. 2. Expansion of coverage of information system by including the secondary level hospitals. 3. Introduction of simplified data collection tools and clear instructions on how to use them. 4. Improvement in data processing and reporting software 8

5. Re-organization of HIS management structure to correspond to decentralized health delivery system. 6. Introduction of mechanisms to facilitate use of information generated through DHIS. 7. Revision of supervisory mechanism to ensure production of high quality data. 9

Comparison between HMIS/FLCF & DHIS HMIS/FLCFDHIS 1. Only FLCF levelFLCF + Secondary hospitals 2. Outdoor/outreach (vertical programs) Outdoor/outreach + Indoors + diagnostic services + Resource (HR, Finance, logistics) indicators for BHU FLCF required to capture 446 variables Rationalized indicators responsive to Health Managers needs - 43 indicators for BHU (monthly 34 + yearly 9) - 79 indicators for hospitals - RHC required to capture 276 variables 10

HMIS/FLCFDHIS 4. Reporting on only 18 diseasesReporting on 42 diseases from OPD, 50 diseases from Indoors 5. Complex record keeping toolsSimplified record keeping tools, redundancies reduced 6. DOS based software, rigid design Software flexible to accommodate present and future needs 11

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Scenarios:  1. Patient named Mr. Mohammad Ramzan s/o Mr. Bashir aged 38 years r/o Risal wala District Rawalpindi is admitted in Male Medical Ward on Bed no. 05 by Medical Specialist with the diagnosis of Bronchial Asthma on October 06, He was discharged from hospital on October 09,  2. Mr. Afzal s/o Mr. Abdullah aged 62 years r/o Mozo a Ambar Khunda was admitted unconscious on bed no 10 in Male Medical Ward from Prison on October 07, 2005 with diagnosis of Diabetes Mellitus. He died next day.  3. Mr. Mohammad Latif s/o Mr. Mohammad Sharif aged 28 years r/o Din Kot is admitted in Male ward at bed no. 08 as patient of Schizophrenia on October 09, On October 12, 2005 Charge Nurse of the ward found that the patient along with his belongings is missing from his bed.  4. Ms. Kosaur w/o Mr. Khuda Bux aged 22 years r/o Amber Khunda was admitted in Female ward on bed no. 04 on October 12, 2005 with provisional diagnosis of Clinical Malaria. At the time of discharge on October 16, 2005, she was finally diagnosed as a patient of Acute Urinary Tract Infection 16

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Thank You 19