Optimizing the Health Management Information System in Uttar Pradesh, India: Implementation Insights and Key Learnings

Abstract

An effective health management information system (HMIS) that captures accurate, consistent, and relevant data in a timely fashion can enable better planning and monitoring of health programs and improved service delivery, in turn helping increase the impact of different interventions. In 2009, the Government of Uttar Pradesh (GOUP) implemented HMIS, India's national-level health information platform. However, key challenges, including difficulties in accessing the data through a web-based portal and its limited relevance to decision making and managerial needs, reduced its usability at the district and state levels. In 2015, with the support of the Uttar Pradesh Technical Support Unit, the GOUP created its own data platform, the Uttar Pradesh HMIS (UP-HMIS), to capture data elements missing from HMIS but important to UP decision makers. The UP-HMIS was redesigned to capture these data elements to holistically measure and monitor the performance of health programs and inform decision making at the district and state levels. In addition, the GOUP implemented complementary initiatives to improve data quality and data use processes. To improve HMIS data quality, the GOUP established data validation committee meetings at the block, district, and state levels. To promote the use of these validated data, in 2017, the GOUP developed and implemented the UP Health Dashboard, which ranks each of UP's 75 districts on a set of key HMIS priority health indicators. These policy guidelines have brought greater attention to UP-HMIS data quality and use; however, additional strengthening is required to improve the quality and use of HMIS data. There is a need to increase the overall capacity and understanding of HMIS data, not only for staff with specific data-related responsibilities but also for program managers and senior decision makers.

FIGURE 1

Mapping of Activities Conducted by UP-TSU, in Collaboration With the GOUP to Strengthen the Inputs and Processes to Enhance Overall Quality and Use of HMIS/UP-HMIS Data in Uttar Pradesh Abbreviations: HMIS, health management information system; M&E, monitoring and evaluation; PS/MD-NHM, Principal Secretary/Mission Director- National Health Mission; UP-HMIS, Uttar Pradesh Health Management Information System.

FIGURE 2

Timeline of the Implementation of Major Activities and Policy Guidelines to Strengthen the Performance of UP-HMIS Abbreviations: GOUP, Government of Uttar Pradesh; HMIS, health management information system; M&E, monitoring and evaluation; UP, Uttar Pradesh; UP-HMIS, Uttar Pradesh Health Management Information System. ^aPolicy guidelines released by the GOUP.

District program manager in Etah district, with support of the monitoring and evaluation specialist, facilitates a district review meeting using the Uttar Pradesh Health Dashboard. © 2022 Shekhar Dutt Sharma, Department of Medical Health and Family Welfare, Uttar Pradesh

FIGURE 3

Process of Enhancing the Use of Data for Decision Making During Program Review Meetings at the District Level Abbreviation: UP-HMIS, Uttar Pradesh Health Management Information System.

FIGURE 4

Percentage of All Facilities in Uttar Pradesh Reporting Data^a,b in the UP-HMIS and HMIS Portals, September 2014–March 2021 Abbreviations: HMIS, health management information system; UP-HMIS, Uttar Pradesh Health Management Information System. ^aOn-time reporting defined as “% of facilities which have uploaded data on portal as on 30th of the month.” This indicator was tracked for HMIS portal (before April 2017) and UP-HMIS portal (after April 2017) from across the 75 districts in the state. ^bTotal reporting defined as “% of facilities which have ever reported for the specified month on the portal.” Prior to 2017, the “total report” refers to total reports of HMIS formats. Following 2017, the “total report” refers to the UP-HMIS format, which include both HMIS and new UP-HMIS data elements.

FIGURE 5

Percentage of Total Facilities With Greater Than 80% Non-Blank Data Element (Data Completeness)^a,b Abbreviation: UP-HMIS, Uttar Pradesh Health Management Information System. ^aSource: UP-HMIS data quality analysis. ^bCompleteness data after March 2020 is not comparable because HMIS data began being captured using a mobile/tablet application at the source in phased manner across districts (as opposed to being entered on paper and then reentered on the web-based UP-HMIS portal).