India's health sector would be taken care of by efficient computerlsed systems
TO ACHIEVE the goal of "Health For All
by AD 2000" through the Primary
Health Care Approach, the Central
Bureau of Health Intelligence (CBHI)
and National Informatics Centre (NIC),
technically and financially assisted by
the World Health Organization, have
introduced a computerbased national Health
Management Information
System (HMIS). Using Sattelite-based computer network (NICNET), over 450 districts in 13 states are cutrentlylinked on this network
in a bid to raise efficiency of
the country's health sector,
reports World Health Forum
(Vol 16, No 3, 1995).
The need for an actionoriented Management information System as a support
to the health sector was
identified as early as 1982.
The Bhore Committee
report highlighted the deficiencies in the in-built information systems of vari .ous
health and family welfare
programmes which included
lack of linkages among
themselves, ill-coverage,
delay in transmission, bulky
and mostly irrelevent information, difficult retrievability, under-milisation of the
available information and
poor feedback. "The information systems had been
plagued by a tendi
generation of information
for use at higher levels only, which leads
to gross under-utdisation of the informatioD," elaborates Gautam Bose, technical director, NIC.
As a result, the Hmis was designed
and developed during 1986-88 and
field-tested successfully in 1989.
Currently, its computer-compatible
version, called HMLS version 2.0, is being
implemented. Its aim is to gather
monthly information on family welfare,
tuberculosis, malaria, blindness, maternal and child mortality and unimmisation. After compiling it in primary
health centres and subsequently at the
district level, the information is transmitted to the state and national levels
through NICNET.
The Hmis has integrated and synchronised the information flow of various health programmes by eliminating
duplication of information and avoiding unnecessary burden on grassroot
health workers. This could significantly
improve the efficiency of the country's
health service by making plans more
rational, speeding up their implementation and monitoring their i
the grassroot levels this would
health workers to plan their work a
maintain their performance recm
they would not be overburdened
paper work," adds Gautam Bose.
Nevertheless, the HMIS is fraught
with some shortcouns
present. "The HMIS cm
vide gross data in a W
range of fields.' fee
Indrayan of the Univi
College of Medical Sck
Delhi. Information
important diseases I&c
liver diseases and typb
not available. Furthen
as Indrayan puts it,
would not be suffi
expertise and m;
the periphery to
additional infori
is suggested therefore
other agencies curre
collecting data like
Sample Registration Syv
which gathers vain
information on mort
and fertility," should ah
made accessible to NICNET.
It is also felt
health databases shouli
strengthened and expas
is expected the s is fully OF
tional, databases on si
further indicators can an
automatically. "But in
mation on age-specific fi
ity and many other pan
ters will continue
from outside the system," I
Indrayan. Moreover, many cases
not recorded by the computer as
go to private practitioners or are
seen by any physician. This tend
make the incidence and prevalence
rates, underestimates.
Nonetheless, major developments
are underway. The Biomformatics
Information System of the ministry.
Science and technology has established
information centres in some prestigious
by technological institutions, and links
have developed with international
arm like databanks on genetic
sial. The NIC provides the computer
etwork for this system. Meanwhile,
r hospitals have computerised their
afions for improving detection and
iosis of problems, patients and hos
management, and taking prompt
@dial action. Such records contri
to hospital-based research, easyly
rifitted on the national network.
4nce all the information is not
ired at every level, the HMis resorts
aracteristic filteration and addition
formation at each level. The policy
s. usually require aggregated data
vM at the peripheral levels specific,
Wregated data is needed, that too
edixtelv. The Hmis is efficient for all
all such records.
Through NICNET, the health man
bent information system provides
ky relevent information, making
aggregated and non-aggregated
rctrievable. "Informatics technology
ouki be increasingly employed to
eve the functioning of India's hospitals
suggests Indrayan.
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