Health Sector Information System (HSIS)

Dr. Kishor Adhikari

Assoc. Professor, SOPH, CMC, Nepal

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 Health Sector Information System (HSIS)

• This is the integrated and comprehensive

information system guided by National Strategy.
• The strategy is endorsed in 2007 by MoHP and
being piloted in three districts Lalitpur, Parsa and
Rupandehi.
• The implementation of HSIS is assigned to MD until
the national health information center is
established.
• The poor performance of recording and reporting
tools and process, lack of intended infrastructure
and institutional set up and resource constraint is
barring to bring out expected results.
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 Milestone
• National Health Policy in 1991 – key for health care
delivery system
• Second Long Term Health Plan (SLTHP) 1997-2017
• Sector wide approach in Health started in 2002
• Health Sector Strategy: An Agenda for Reform 2002
envisaged comprehensive health sector information
using modern Information Technology
• Nepal Health Sector Programme Implementation Plan
(NHSP-IP)2004-2009 output No 8
• Health Sector Information System – National Strategy
(HSIS-NS) in 2006

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 NHSP-IP (2004-2009)
• Output No 8: Integrated MIS and QA Policy
o Develop and establish integrated Management
Information System
o Establish and Implement Quality Assurance (QA)
Policy
o Will be led by Director, Management Division,
DoHS
o Purpose:
• Comprehensive and integrated Management
Information System for the whole health sector
designed and functional at all levels
• Quality Assurance (QA) operational across
4 public and private sectors
 Purpose
o Implementation plan of the newly
developed comprehensive integrated
Health Sector Information system –
National Strategy (HSIS-NS)2006

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 Objective of HSIS - NS
• Support the implementation of NHP, ICPD, SLTHP, MDGs,
HSRS and NHSP-IP
• Establish a legislative and information governance frame
work
• Adopt an integrated and comprehensive national approach to
the development and expansion of information sources and
system
• Establish process and structure that ensures the fuller use of
health information
• Ensure improved access for all stakeholders to quality
information
• Establish health information standard for quality information
• Use of IT

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 Silent Features of HSIS –
NS
• Integrated and comprehensive information
system
• Sector wide approach
• National Health Information Policy Committee
under the Health Secretary
• District Health Information Management
Committee
• A new concept of District Health Information Bank
• A National Health Information Centre instead of central
HMIS Section
• Sentinel Reporting for Disease surveillance

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 Silent Features of HSIS -
NS
• Social Inclusion and Disaggregated data
• Use of IT, periodic reporting through soft copies
• Health Information Governance and Legislation
etc
• Ensuring quality of Health Information Training
• Access to health information
o Personnel Profile
o Community Monitoring Data Board
o Health information portal

• Information Corners

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Source of Health Sector Information System
(HSIS) in Nepal

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The process of data collection in the revised HMIS piloted within HSIS

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HSIS Tools and Information
Dissemination

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 HSIS Tools – Recording
SN Tools
HSIS -1 and 2 Common Tools
Name of the Tools Tools No

1 Master Register/OPD HSIS-1

2 Personnel Health Profile HSIS-2
HSIS -3 Child Health related Tools
3Nutritation register HSIS-3.0
4 Immunization register HSIS- 3.1
5 Integrated Management of Childhood illness (IMCI) Register HSIS- 3.2
HSIS - 4 Family Health related Tools
6 ANC Register HSIS- 4.1
7 Delivery Service register for SHP/HP/PHCC HSIS- 4.2
8 Postnatal Care Register HSIS- 4.3
9 CAC Register HSIS- 4.4
10 Family Planning Register (Temporary) HSIS- 4.5
11 VSC Register HSIS- 4.6
12 IUCD/Norplant Removal Register HSIS- 4.7
13 PHC/ORC Register HSIS- 4.8
14 FCHV Register HSIS- 4.9

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 HSIS Tools – Recording
SN
Tools …
HSIS - 5 Disease related Tools
Name of the Tools

15 Specimen Collection form (Mal/Kal/Lep)

Tools No

HSIS- 5.1
16 Lab. Examination Register (Mal/Kal/TB/Lep/HIV) HSIS- 5.2
17 TB Treatment Card for Health Institution HSIS- 5.3 (a)
18 TB Treatment Card for Patients HSIS- 5.3 (b)
19 TB Register HSIS- 5.4
20 TB Specimen Request Form HSIS- 5.5
21 Leprosy Examination/treatment Card HSIS- 5.6
22 Leprosy treatment register HSIS- 5.7
23 Malaria Kalazar Classification /Treatment register HSIS- 5.8
24 VCT Register for HIV/AIDS HSIS- 5.9
25 Disaster/ Epidemic Register HSIS- 5.10
HSIS – 6 Hospital related Tools
26 OPD Register for Hospital HSIS- 6.1
27 Hospital Admission Register HSIS- 6.2
28 Hospital Discharge Register HSIS- 6.3
29 Maternity Admission / Discharge Register HSIS- 6.4
30 Emergency Service Register HSIS- 6.5
31 Death/ Postmortem Register HSIS- 6.6
HSIS – 7 Community Level Tool
32 VHW/MCHW Daily Record Booklet HSIS- 7

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 HSIS Tools – Recording
SN
Tools … Name of the Tools
HSIS – 12 Monthly Reporting Tools by level
33 VHW/MCHW
Tools No

HSIS- 12.1
34 SHP HSIS- 12.2
35 HP HSIS- 12.3
36 PHCC HSIS- 12.4
37 District Hospital HSIS- 12.5
38 Zonal/ Sub-regional/ Regional/Central Reporting HSIS- 12.6
39 Centinal/Specialized Hospitals HSIS- 12.7
40 Private Hospital / Nurshing Home HSIS- 12.8
41 Private Clinics HSIS- 12.9
42 Ayurbedic Dispensory HSIS- 12.10
43 Ayurbedic Hospital HSIS- 12.11
44 NGO's monthly Report HSIS- 12.12
HSIS – 13 Annual Reporting Tools by level
45 SHP HSIS- 13.1
46 HP HSIS- 13.2
47 PHCC HSIS- 13.3
48 District Hospital HSIS- 13.4
49 Zonal / Sub-regional / Regional/Central HSIS- 13.5
50 Centinial /Specialized Hospitals HSIS- 13.6
51 Private hospital/Nurshing Home HSIS- 13.7
52 Ayurbedic Dispensory HSIS- 13.8
53 Ayurbedic Hospital HSIS- 13.9
54 NGO's Annual Report HSIS- 13.10

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 Current Status of
Information Systems
o Revised HMIS incorporated the
major strength of HSIS.

o Current state of different Information Systems

under MoHP
• HMIS and LMIS are functioning systems
• Other systems FMIS, HuRIS, DS, TIMS …. are
partially functioning or not functioning at all

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DHIS 2 Data Platform
 DHIS 2
• District Health Information Software 2 (DHIS2) is a free
and open source health management data platform
used by multiple organizations, including the European
Union (EU), and governments worldwide.
• A total of 54 countries are deploying DHIS2 on a
national scale, 30 of which are in the pilot stage or
early phase in their rollouts.
• Since DHIS2's release in 2006, NGOs and national
governments in 60 countries have deployed DHIS2 for
health-related projects, including patient health
monitoring, improving disease surveillance and
pinpointing outbreaks, and speeding up health data
access.
 DHIS 2
• DHIS2 is used to aggregate statistical data
collection, validation, analysis, management, and
presentation. This data analytics and management
platform is completely web-based and boasts great
visualization features and the ability to create
analysis from live data in seconds.
• In addition, DHIS2 can be used to monitor patient
health, improve disease surveillance, map disease
outbreaks, and speed up health data access for
health facilities and government organizations.
Use of DHIS 2 in Nepal
 Use of DHIS 2 in Nepal
• Nepal has officially started using DHIS 2 platform
in HMIS since 2016/17.
• The current HMIS software system (DHIS 2
software) almost is meet all the requirements of
the recently revised HMIS.
• The HMIS in DHIS2 platform has been updated to
incorporate the latest federal structure.
• Electronic reporting of service statistics from
health facilities has expanded to more than 600
facilities across the country in the FY 2016/17.
 Use of DHIS 2 in Nepal
• In FY 2018/19 the MoHP continued the expansion of electronic reporting of
service data from health facilities.

• A total of 1200 public health facilities now submit the HMIS monthly reports
electronically.

• As health posts and primary health care centres are now being managed by
the local government, the MoHP is focusing on enhancing their capacities
on health information management, including the use of the DHIS2
platform.

• This will allow for the continuous flow of data from the health facilities to
the national HMIS system.

• The HMIS e-learning modules for the orientation of health workers,

statisticians, computer operators and programme managers have been
developed and are available on the MoHP website.
 DHIS2 in Nepal

 Health Management Information System

(HMIS)
Customized and planned to be rolled out from
fiscal year 2073/74
 Early Warning and Reporting System
(EWARS)
Customized and Rolled out from Ashwin 2073
Currently a central system and will go to
sentinel site in next phase
 WHY DHIS-2
 Data quality - validation
 Interoperability - OpenMRS
 Free and open software platform
 Strong analytical tool and visualization option
 Group communication/interaction
 Easy upgradability
 Data validation rules/mechanisms are built-in
Ensuring data quality
 Can be immediately rolled-out to health facility level without
major modifications
 Legacy data can be imported to DHIS2 and multiple year
analysis is possible
 User experience sharing, messaging
Individual Record Mobile
Friendly
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 Key Features
1. Dashboard
2. Data visualizer
3. Pivot table
4. GIS
5. Data quality modules
6. Event Capture
7. Standard reports
8. Feedback and messaging
 Features
• A user-specific dashboard for quick access to the
relevant monitoring and evaluation tools including
indicator charts and links to favourite reports, maps and
other key resources in the system.
• Easy to use user-interfaces for metadata management
e.g. for adding/editing datasets or health facilities. No
programming needed to set up the system in a new
setting.
• Functionality to design and modify calculated indicator
formulas.
• User management module for passwords, security, and
fine-grained access control (user roles).
• Messages can be sent to system users for feedback and
notifications. Messages can also be delivered to email
and SMS.
 Features
• Users can share and discuss their data in charts and reports using
Interpretations, enabling an active information-driven user
community.
• Functionalities of export-import of data and metadata, supporting
synchronisation of offline installations as well as interoperability
with other applications.
• Using the DHIS2 Web-API , allow for integration with external
software and extension of the core platform through the use of
custom apps.
• Further modules can be developed and integrated as per user
needs, either as part of the DHIS2 portal user interface or a more
loosely-coupled external application interacting through the
DHIS2 Web-API. In summary, DHIS2 provides a comprehensive HIS
solution for the reporting and analysis needs of health information
users at any level.
Dimensions of DHIS2: 3Ws
• What
• Where
• When
BCG Immunized Children
BASANTAPU Shrawan
R PHCC 2073
 Indicators Type
• Total
• Ratio
• Percentage
• Per 1000
• Per 100000
 When Dimension-Period
• Daily • Financial April
• Weekly (Nepali Fiscal
• Monthly Year)
• Bi-Monthly • Financial July
• Quarterly • Financial Oct
• Six Monthly • Six-monthly April
• Yearly
Some snapshots

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DHIS2 Login

http://192.168.1.2:8080/hmisnep
al
Logging out of DHIS2
Thank You

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