Current Management Information System of the LHW’s Program

The process of information collection starts at the lowest level i.e. with the LHW (Lady Health Worker). The LHW collects basic information from the house holds appointed to her. This is raw data collected at the grass root level to be sent to the higher-ups for analysis and policy making.

Each LHW is allotted a Population space of about 1500-2000 people which rounds out to about 150 households. The LHW‘s basically gathers information about the

Births Maternal deaths Still Births (Babies born without signs of life i.e. dead) Vaccination Health Education Sessions Baby Spacing Awareness (formerly called Family Planning) Cleanliness Epidemics occurred in the area

All this information is collected by every LHW and passed on to their respective LHS (Lady Health Supervisor). The LHS is present at the BHU (Basic Health Unit) Facility and each LHS is in charge of about 8-12 LHW’s. She gathers all the information given to her by all the LHW’s of her respective area. This data is sent forward to DPIU (District Program Implementation Unit).

The DC (District Coordinator) and ADC (Assistant District Coordinator) at the DPIU compiles the data once according to Union Council wise and then secondly according to their respective District wise of the covered area of LHW’s. This data is given the shape of information in a system called LHWMIS. This system is used to record all the data regarding

HR Indicators of epidemics Logistics Payroll Medicines

The DPIU sends all this information to the PPIU (Provincial Program Implementation Unit). Here the data is first checked by the MIS coordinator, then sent for further study and analysis by the PC (Program coordinator) and DPC (Deputy Program coordinator).Major Issues are discussed such as

No of Still births Reasons of still birth No of diseases Checking of seasonal epidemics and steps of control.

Policies are made accordingly by the PC, DPC along with the MIS coordinator to deal with these problems effectively and efficiently. These policies are signed and approved by the Health Secretory and the Director General Health Services.

Once signed and acknowledged these policies are sent back using the same information ladder from the PC and DPC to the LHW’s.

PPIU ------ > DPIU ------ > BHU Facility ------ >LHS’s----->LHW’s

In PPIU another system is also used called CLMIS. This system was provided to the PPIU by the USAID and is used for reporting to the federal level. It is a web based system mainly used by the LHW Program for logistics of Contraceptives i.e. Received, Distributed, Consumed etc. Contraceptives include

Medicine (tablets) Injectable Condoms

The reports this system generates are sent to Islamabad for further use at federal level.

Certain steps are taken to assure the authenticity of information provided to the PPIU. A FPO (Field Program Officer) is sent from the PPIU as a representative to make surprise visits to the districts once or twice a month. Each FPO is given 2-3 districts and he/she can visit any district he/she wishes for the surprise inspection. The information the FPO gathers is compared with the reports taken from the LHS and LHW’s.

Monthly meetings of FPO’s are conducted and all stats and checks are discussed with the PPIU officials. If any quick orders or implementations are needed to done they are done by the PC, DPC or MIS coordinator according to their respective rank.

Former Management Information System of the LHW’s Program

The only difference between the former and the current system is the addition of the FPIU (Federal Program Implementation Unit) the rest of the system remained the same but the information gathered by the PPIU was analyzed and sent forward to the FPIU.

Meetings were held at the FPIU and every Province’s respective PC, DPC, MIS coordinator (and a logistic officer if necessary) would come with their complete information on which decisions were taken. Rules and regulations along with policies were set for the future.

These Policies were signed off by the Federal Secretary Health and Federal Minister respectively.

Reasons for Adoption of Current System

Amendment XVIII (the Eighteenth Amendment) of the Constitution of Pakistan was passed by

the National Assembly of Pakistan on April 8, 2010.The amendment bill was passed by the Senate of Pakistan on April 15, 2010 and it became an act of parliament when President Asif Ali Zardari put his signature on the bill on April 19, 2010.

This amendment dictated that health was now a provincial issue, and each province could deal with its health issues as the deemed fit.

This Amendment was a necessary change as it the former system had quite a few problems with the maintenance and smooth running of such a large country wide operation.

System was slow Expensive Waste of Resources and time Large amounts of Backlogging Meetings would get delayed occasionally On spot quick decisions could not be taken

These technicalities are being dealt with quite efficiently in the new system