This discussion theme is in continuance to our first discussion titled ‘Health System in India: Bridging the Gap between Potential and Performance’. To review what others have commented on this subject earlier in the first discussion, visit our Blog.

How can we maximize health returns through strengthening Health Information Systems?

1. Issues

1.1. Data systems currently in use are programme specific and lack information on denominators for calculation of meaningful indicators.

1.2. Surveillance data is generated through multiple vertical disease surveillance systems and the Integrated Disease Surveillance Project (IDSP) which is not sufficiently integrated with these programmes.

1.3. There is incomplete disease reporting from the private sector and in urban areas.

1.4. Health information systems are not effectively used for outcome-based monitoring of programmes.

1.5. Low priority is accorded to research for solutions specific to the Indian context for health systems strengthening.

2. Suggestions

2.1. The Management Information Systems of different programs may be integrated into a National Health Management Information System, with electronic health records for every citizen. This database could be anchored in the National Population Registry and could be biometrically enabled.

2.2. Capacities for maintaining and usage of the Health Management Information Systems (HMIS) to address decision making must be strengthened.

2.3. Universal registration of births and deaths must be ensured.

2.4. The IDSP may be strengthened using best practices of the National Polio Surveillance Project to cover all diseases of public health importance, communicable and non-communicable.

2.5. Networking of all health service providers, particularly private sector providers must be effectively improved to strengthen the HMIS.

2.6. The outcomes of all schemes may be tracked and linked to input indicators for effective monitoring. For example, outcomes for Janani Suraksha Yojana can be tracked in addition to the focus on monitoring the disbursement of money under the scheme.

2.7. Existing teaching institutions may be strengthened to provide leadership in research and practice on various themes with a focus on health systems strengthening.