Issues for Second Common Review Mission, 2008

1. Ministry of Health & Family WelfareMonitoring & Evaluation (M&E)under National Rural Health Mission Issues for Second Common Review Mission, 2008

2. National Rural Health Mission Integration of Health Care delivery systems … necessitating An integration of Monitoring of Information and Evaluation Systems (MIES)

3. Ministry’s Requirement of Data • Performance Monitoring • Physical Monitoring • Financial Monitoring Emphasis on • Outcomes, Impact, Convergence • Reach • sub-district, community, household • Equity • gender, vulnerable groups • Performance based funding in programs … ever growing

4. Limitations in Health Information • Similar data sets for Various Central Agencies • Parallelism, Respondent Burden on Data Provider • Affects consistency and reliability of information • Lack of involvement, ownership, belongingness • Delays, integrity, quality aspects etc • Information Flow is upward biased • Data viewed as a by-product • Increased participation of Private Sector • Challenge for collecting information • Weak Evaluation systems • Low IT Penetration

5. HMIS Challenges • Optimum automation to reduce manual processes • Integrating/consolidating information needs of various agencies • Rationalising formats for data capture • Reducing frequency of data capture • Needs to be evolving and dynamic, not static • Adequate flexibility to States

6. HMIS Challenges - cont’d • Poor Infrastructural support at the Centre, State and District • Facilitate / motivate data flow • A need to appreciate the data load on the system – Manpower x Time matrix • IT readiness of the data reporting machinery in States and Districts

7. Multi-pronged strategy • Identifying Nodal (M&E) Information Officer at all levels • Structuring the Information flows • Infrastructural strengthening- IT, Networking, Manpower • Improving the quality of information • Earmarking 2-3% of the State’s Budget in M&E (including IT) • Strengthening evaluation work and improving validation of data. Approved by EPC – January, 2008

8. Developments in M&E ..(1) • MIS Formats earlier sent to States- 2006 • Delays: Paper form – some through e-mail • Formats changed by states • Only 25 States reported data on new form with varying regularity • Enhancing orientation on M&E • A Budget Line for M&E • Workshops and Training – National/Regional • Multi-Dimensional Workshop on M&E – June, 2008 • HMIS, QA, AHS, Concurrent Evaluation, Triangulation

9. Developments in M&E ..(2) • Rationalisation of Formats - 2008 • Final Formats sent to States in September, 2008 • Soft copy on MoHFW’s Website • HMIS portal launched on 21st October, 2008 • Web-based Software Application Developed • Dedicated Web-site for HMIS http://nrhm-mis.nic.in • All State Prl Secy (HFW) and MD (NRHM) given dedicated e-mails

10. Developments in M&E ..(3) • Surveys and Evaluation • DLHS-III Provisional Data available • Results to be released on 08th December, 2008 • Concurrent Evaluation through independent agencies to begin in December • Field, Zonal and National Agencies identified • All Districts to be covered in 2 years

11. Key Features of HMIS project • Web-based Data capturing system • Entry of Physical performance at District level / facility level • Entry of Financial reports (FMRs) at District Level • Automatic aggregation and report generation • Emphasis on Facility based performance • Key indicators to be generated for local level use • Intelligent analysis for use at all levels • Standard and Custom Reports • National, State and District Fact Sheets • Integration of health related information across programmes

12. MIES Reporting Formats – key features • Periodicity • Monthly • Quarterly • Annual • Rationalised according to • Usage/Need for information Vs Collectability • Frequency of change (major chunk shifted to Annual) • Facility Based

13. Will to... • Capture and send data • Analyze and Use data • Send feedback down to data source/aggregation point

14. Summarising • Web-based Data Capturing application • Launched on 21st October, 2008 • Hands-on-Training to State MIS & Accounts officers on 21-22 October, 2008 • Draft Instructions –at-a-Glance for formats available on the portal. • Application User Manual also available on web. • HMIS Portal to have information on all M&E related activities • Data • Reports • Notifications etc

15. Key issues to be seen by CRM... 1 1. States need to Notify Nodal Information Officers HMIS 2. HMIS Data to be sent in revised forms only • Printing and distribution of forms • Information for Sept. 08 onwards in consolidated formats • Facility based information to flow from Dec. 08 onwards 3. Training for State/ District level users

16. Key issues to be seen by CRM... 2 3. Concurrent Evaluation: • Issue instructions to District Authorities for cooperating with Agencies. 4. PIP Preparation for 2009-10 • Budget for M&E Activities • MIS, Printing of forms, Training • Quality Assurance 5. M&E Related queries be sent on hmis-nrhm@nic.in

17. In a nutshell … Monitoring & Evaluation activities needs to lead to … … Information and Data for Action!

18. Thanks Pravin Srivastava Director (Statistics) Ministry of Health & Family Welfare Government of India dirstat-mohfw@nic.in pravin.srivastava@nic.in