Objective="Establish web-based health management information system."
Details for Reform Option "Management of Public Health Information System, Rajasthan."
The State Government planned to harness the potential of Information Technology (IT) for efficient and cost-effective management of health programmes in Rajasthan. This initiative was started with financial support from the European Commission’s Sector Investment Programme and technical expertise of National Informatics Centre (NIC), Rajasthan. The aim of the project was to facilitate a reliable and cost effective mechanism for better decision making, monitoring and efficient service delivery.
(i) With assistance from NIC, Rajasthan, the Department of Health and Family Welfare identified the necessary requirements for setting-up an IT network. A detailed plan to link the directorate to district and sub-district office of health and family welfare was prepared and approved.
(ii) Identification of an appropriate place in Swasthya Bhavan (Directorate of Health Services Headquarters) to establish the central computer system in the state capital (Jaipur city).
(iii) Established local area network in Secretariat and Swasthya Bhavan (directorate office) with 20 and 150 nodes respectively.
(iv) The central cell housed in Swasthya Bhavan has two central servers and 55 client computers set-up. In addition, 15 computers to different sections of secretariat, 12 computers for all 6 Joint Directorates (2 each) and 104 computers for all 104 Deputy CMHO offices.
(v) High speed leased line for Internet at Secretariat and Directorate. E-mail connectivity for Secretariat, Directorate, 6 Joint Directorates, 32 Chief Medical Health Officer and 32 Reproductive and child health officers. The state is now sustaining it through NICSI.
(vi) Developed web-based health management information system (HMIS) for the department with suitable customization for different levels.
(vii) Deployment of a team of computer professionals in the department for application development and technical support.
(viii) The web site of the department (http://rajswasthya.nic.in) has been developed and is maintained by NICSI. This site contains all information regarding the state including grievance redressal. The site was launched by the Chief Minister.
(iix) Six resource persons given extensive training to run the central cell.
(ix) In order to facilitate operationalising web-based HMIS, NIC provided training to all the district officials on the use of computers including HMIS. About 300 officers up to deputy CMHO have so far been trained.
(x) Nineteen software packages have been developed so far by NICSI called HEALING. It is a part of a website called www.rajmedical.nic.in. This is only for internal use of the department. Each given officer can access the website through the given password. The data is entered at the district level and is accessed at the State level in the Central server room.
(xi) Integrated formats for monitoring developed for mobility and Eligible Couple Register (ECR) have been developed. Software for the same
(xii) NICSI has been made responsible to provide technical support for the next 5 years.
(xiii) HMIS system was developed in phased manner. The pre-testing of proposed system has been completed.
The HMIS is being used by the districts to send the requisite information to the Directorate of Health Services on a regular basis. The Central computer cell was established in the directorate, where in monitoring is being done through reports collected via internet in the prescribed formats. The computer cell is maintained by NICSI and all data is compiled by staff recruited for the cell. The software for monitoring for mobility and ECR is to be developed soon. Though NICSI is providing internet connections in the districts, there is need for broadband connection at district and block level office of Deputy Chief medical health officer. Video-conferencing through NIC network between the district officials and for training is planned to take place more frequently.
It was observed during a HS-PROD field visit to a Sanjivani camp at Sethia Hospital (Community Health Centre (CHC)), Sardarshahr, Churu, in September 2005 that the HMIS was being used consistently. Even though an internet connection was not available at the CHC, the requisite data was recorded in the existing e-based HMIS format available in the hospital computer and then emailed from the district headquarters (which does have an internet connection) to the directorate office at Jaipur.
Rs. 200 lakhs.
Paper less: Information from the district can reach faster to the state headquarter. It is easily to store the information.
Monitoring the programme: The e-system will facilitate better management of data on public health care delivery system.
Transparency: Easy availability of information on health services in public domain will improve people’s participation.
Feedback: The feedback mechanism needs to be in-built into the website (state to district and district to health centres) needs to be strengthened.
Update: The culture of sending information through internet by District and DHS has to be evolved for success of e-based HMIS.
Infrastructure: Regular electricity supply, internet facility and maintenance of facility.
Computer and peripherals.
Trained staff to handle the information flow.
Regular electricity supply.
Who needs to be consulted
Directorate of health of services. Rajasthan.
National Informatics Centre, Rajasthan.
State has taken it up.
Chances of Replication
There is a need to continuously monitor the functioning of e-based HSMIS.
Dr. Nandini Roy, HS-PROD Research Consultant, NIMS, May, 2006.