MTY1106 LEC: HEALTH INFORMATION SYSTEM

MODULE 7: HMIS MONITORING AND EVALUATION

2nd Semester | SY 2021-2022 TRANSCRIBED BY: NINA RICCI O. DELA PAZ
LECTURER: Mr. Theo Segismundo
o Better alignment and monitoring of
TOPIC fundings
SUBTOPIC o 4 components: indicator domains,
SUB-SUBTOPIC data collection, analysis and
synthesis, and communication use
HMIS M&E o Indicator should be tracked to assess
Ø Assist planning and management of national processes and results associated
health strategy plans with various indicator domains
Ø Continuous monitoring and evaluation is § Provide strength and
necessary weaknesses for
Ø Monitoring- collection, analysis, and use of troubleshooting
information gathered o Outcomes and impact indicators-
o Learning from acquired experiences changes may not be directly caused
o Accounting internal and external by serviced delivery efforts
resources § Useful in understanding
o Obtaining results and making current health status and
decisions context
Ø Evaluation- systemic assessment of § Understand the ways in which
completed programs or policies packages of interventions can
o Gauge effectiveness of program to lead to impact over time
make adjustments
o Learning function- incorporate M&E PLAN
learning to future proposals Ø Address components of framework
o Monitoring function- review Ø Establishes foundation for regular reviews
implementation based on objectives during implementation
and resources Ø Local M&E- generate info for global
monitoring based on health sector review
PURPOSE processes
Ø Assess effect of integrated service delivery o Key factors in monitoring progress
Ø Appropriate indicators, data collection Ø Hospital are monitored and evaluated
systems, and data analysis guide successful through assessments of reports, surveys,
implementation and measure effect on both HMIS, and other evaluation studies
service delivery and use of services Ø National Health Mission of India- identifies
strategies which help in successful
FRAMEWORK implementation
Ø Developed by various global partners and Ø Framework should be:
countries o Localized
Ø From Paris declaration on aid harmonization o Address needs for multiple users and
and effectiveness and the International purposes
Health Partnership (IHP+) o Facilitate identification of indicators
o Place health strategy and related and data sources
M&E processes at center o Used in disease-specific programs
Ø Core framework: strengthening of common
country platform for M&E of HSS
 INDICATORS 14. PLWHA currently
Ø Measures the value of change in units that on ART
can be compared in past and future units
Ø Focus: single aspect of a program such as Resource Utilization 15. Trace drug
input and output availability (in stock)
Ø United States Agency for International 16. OPD attendance
Development classifies indicators into five per capita
broad categories 17. In-patient
o Reproductive health admission rate
o Immunization Data Quality 18. Average length of
o Disease prevention and control stay (in-patient)
o Resource utilization 19. Bed occupancy rate
o Data quality 20. Reporting
completeness rate
CATEGORIES 21. Reporting
KEY PERFORMANCE KEY INDICATOR timeliness rate
AREA
Reproductive Health 1. Family planning QUANTITATIVE INDICATOIRS FOR
acceptance rate MONITORING FAMILY
2. Antenatal care PLANNING/IMMUNIZATION INTEGRATION
coverage INDICATOR DATA PURPOSE
3. Proportion of SOURCE
deliveries attended by INPUTS
skilled health personnel Vaccine HMIS, Service Monitor
4. Proportion of stockouts in a statistics vaccine
deliveries attended by single month stockouts.
HEWS (YES/NO, by
Immunization 5. DPT-3 (Pentavalent- type of
3) coverage (>1 child) vaccine)
6. Measles
Immunization coverage
(>1 child)
Disease Prevention 7. Malaria case fatality
and Control rate among patients
under 5 years of age Contraceptive HMIS, Service Monitor
8. New malaria cases stockouts in a statistics contraceptive
per 1,000 population single month stockouts
9. New pneumonia (YES/NO, by
cases among children type of
under 5 per 1,000 contraceptive)
population of < 5 yrs. Number of Training Monitor reach
10. TB case detection service records of EPI/FP
rate 4. providers integration
11. TB cure rate f trained in training as an
12. Clients receiving provision of input for
VCT services EPI/FP effective
13. PMTCT treatment integrated integrated
completion rate services service
delivery.
 OUTPUTS immunization Ledger
Number of Service Coverage of services who [Monitored for
service statistics and integrated accept a demonstration/
delivery points Supervision service referral to pilot programs
offering delivery family only]
integrated FP planning
and services
Immunization Number/perce Comparison of Follow
services nt of women supplemental through on FP
offered attending tracking column referrals
Number of Service Availability of routine added to provided by
days per Statistics and co-located FPI Immunization Immunization the vaccinator
month when Supervision immunization services who ledger, and
both (Observation + services follow through supplemental
immunization Interviews) on a FP tracking column
and family referral from a added to FP
planning vaccinator ledger
services are at [Monitored for
the same site demonstration/
Number/perce Supplemental Quality pilot programs
nt of women tracking column continuity of only]
attending that can be implementatio Number/perce Comparison of Follow
routine child added to n of integrate nt of women supplemental through on
immunization existing service attending tracking column immunization
services who immunization delivery family added to FP referrals
received register planning ledger, and provided by
information on (Monitored for services who supplemental the family
family demonstration/ follow through tracking column planning
planning from pilot programs on referral to added to provider
a vaccinator only) immunization Immunization
INDICATOR DATA PURPOSE services from ledger
SOURCE a family [Monitored for
Number/perce Supplemental Purpose planning demonstration/
nt of women tracking column Quality/contin provider pilot programs
(with children added to FP uity of only]
<12 months) Ledger implementatio OUTCOMES
going for [Monitored for n of integrated Number of Immunization Use of
family demonstration/ service children ledger/HMIS, immunization
planning who pilot programs delivery receiving DTP and population- services,
receive only] 1. DTP 3, based survey dropout
information on measles, and data
Immunization DTP 1-3
from the family dropout
planning Immunization HMIS and Percentage of
provider coverage for population- children <12
Number/perce Supplemental Acceptance of DTP1, DTP3, based Survey months in a
nt of women tracking column FP referrals and measles Data given
attending added to provided by population
routine child Immunization the vaccinator who have
 received Ø Maternal survival intervention, child mortality
DTP1 and and child survival intervention, and Stop TB
DTP3 program
Number of Family Planning Uptake of
new family ledger/HMIS family MATERNAL SURVIVAL INTERVENTIONS
planning planning Ø 5th MDG- reduce maternal mortality ratio by
acceptors by services 75% and achieve universal access to
method type reproductive health
and Ø None of the maternal survival intervention
demographic/ alone can reduce maternal mortality rate
age group Ø Campbell and Graham (2006)
Contraceptive Population Contraceptive o Complexity of country contexts and
prevalence Survey Data use within a maternal health determinants makes
rate given it complicated to choose the best
population strategies in achieving this goal
Total financial Program Cost of inputs o Packaging of health facility-oriented
cost of inputs data/Special required for interventions is highly effective and
required to costing studies integration. has high coverage
integrate FP This may be Ø HMIS- provide some of core input, process,
and helpful in and output indicators to routinely monitor
immunization planning for progress towards implementation
services (per decisions Ø HMIS indicators are related to the following:
facility, per related to 1. Pregnancy care intervention
client sustainability o 1st antenatal care attendances
exposed, per and scale-up o 4th antenatal care attendances
new FP of integrated o Cases of abnormal pregnancies
acceptor) services. attended at out-patient departments
IMPACT (OPD) health facilities
Maternal, Studies on Measure o Institutional cases of maternal
infant, and maternal and improvement morbidity and mortality due to
child mortality infant mortality in health antepartum hemorrhage (APH),
rates IMPACT status hypertension and edema reported by
in-patient departments (IPD) of
Ø Input- information you should collect before health facilities
the implementation of program o Cases of abortion attended at health
Ø Output- once you start the program itself facilities
Ø Outcome- program has ended o Cases of medical (safe) abortions
conducted at health facilities
INDICATORS & HEALTH PROGRAMS 2. Intrapartum care
Ø HMIS- source of routine data necessary for o Deliveries by skilled attendants (at
monitoring different aspects of various health health facilities)
programs o Deliveries by health extension
Ø HMIS indicators should be carefully selected workers (HEW) (at home of health
to meet essential information necessary for posts)
monitoring and present an overview o Institutional cases of maternal
Ø Used for monitoring program performance morbidity and mortality due to
and how it encourages similar in-depth obstructed labor
analysis 3. Postpartum care
o 1st postnatal care attendance
 o Institutional cases of maternal
morbidity and mortality due to
postpartum hemorrhage (PPH) and
puerperal sepsis
4. Interpartum care
o Family planning method acceptors
(new and repeat)
o Family planning method issued by
type of method

CHILD MORTALITY AND CHILD SURVIVAL

INTERVENTION
Ø Pneumonia- leading cause of under-5 child
mortality in the Philippines in 2012 (DOH) STOP TB PROGRAM
o 2,051 cases Ø Envisions a TB-free world
Ø Various strategies to ensure good health of Ø Goal: dramatically reduce global burden of
Filipino children by 2025 tuberculosis by 2015
1. Child 21 Ø In line w/ WHO’s MDG and push TB up the
o Child 21 or the Philippine National world political agenda
Strategic Framework for Plan Ø Main objective: Achieve universal access to
Development for children 2000 to high-quality health care for all people w/ TB
2025 serves as a framework for Ø Core strategy: TB case detection and
policymaking and program planning successful completion of treatment/cure
and as a roadmap for interventions Ø Target by 2050: reduce prevalence of and
aimed at safeguarding the welfare of deaths due to TB by 50% compared w/ 1990
Filipino children. This is part of the baseline
Philippines commitment to the United Ø HMIS indicators:
Nations Convention on the Rights of o TB patients on DOTS (Number of
the Child (UN CRC). new smear-positive pulmonary TB
2. Children’s Health 2025 case enrolled in the cohort)
o This is a subdocument of Child 21 o TB case detection (Number of new
which focuses on the development of smear-positive pulmonary TB case
Filipino children and the protection of detected, number of new smear-
their rights by utilizing the life cycle negative pulmonary TB case
approach. detected, number of new extra-
3. Integrated Management of Childhood pulmonary TB case detected)
Illness (IMCI) o HIV-TB co-infection (Proportion of
o strategy that aims to lower child newly diagnosed TB cases tested for
mortality caused by common HIV)
illnesses. o HIV + new TB patients enrolled in
4. Enhanced Child Growth DOTS
o intervention aimed to improve the o TB treatment outcome (Treatment
health and nutrition of Filipino completed PTB+, Cured PTB+,
children by operating community- Defaulted PTB+, Deaths PTB+)
based health and nutrition posts all
throughout the country