Healthy link
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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