Health System

The TBI project is being implemented with the Central TB Division and the State Tuberculosis Offices. It is managed by William J Clinton Foundation (WJCF) along with FIND and the UNION across the country. The project Joint Effort for Elimination of Tuberculosis (JEET) aims to build efficacious, efficient and sustainable structures that will help strengthen the existing systems, extending quality care to people with tuberculosis.

JEET works closely with the NTEP team to support records of notifications (private sector), specimen collection, and care and treatment adherence support for TB patients. This intervention has the potential to guide the NTEP on TBI management for TB prevention and control in the country.

SDRC is working with WJCF in building a comprehensive Management Information System (MIS) to ensure systematic recording and extraction of project information by the key partners for informed decision making. The MIS will be used to register Index patients and their contacts, in both Public and Private sector under the program. The system should have the capability to generate a unique patient ID which would help track details such as diagnostic tests and results, drug prescription details (for confirmed cases), counselling status, drug dispensation, and adherence to prescribed regimen. The MIS will have capability for linkages to various testing and health facility.The MIS shall produce necessary structured reports for project management in the form of dashboards and should allow key decision makers to extract raw data.

Apart from data management, the MIS shall generate task lists with reminders to manage daily operations of the field staff.

Issues

DFY along with UNICEF is working closely with the Department of Health and Family Welfare in areas related to system strengthening, capacity development, facility assessment, etc for improving the impact of health service delivery system. It wanted to conduct a comprehensive gap analysis to identify the gaps/bottlenecks towards strengthening the health delivery systems in Urban PHCs.

Intervention

The comprehensive gap analysis of health facilities was initiated to contribute in identifying gaps and bottlenecks as well as developing facility improvement plans. The main project features are -

• Development of digital forms for data collection - UPHC, Maternity Homes , Dispensary, Helath Posts
• Dashboard to present the findings of the gap assessment exercise
• Data tree module
• Facility improvement programme module
• Reporting module

Outcome

First round of data collection is completed in 4 districts of Maharshtra.

Issue

School Health and Wellness Programme is one of the three pillars under Ayushman Bharat designed to increase knowledge, inculcate positive attitudes and enhance life skills to promote informed, responsible and healthy behaviors among school going children and adolescents capacitating them as “Health and Wellness Messengers” within their communities. The training has eleven modules and a baseline assessment of these has been done in eight states (four states each in two phases) that required data analysis and presentation of the key findings.

Intervention

SDRC was responsible for the following tasks:

• Cleaning of the raw data received from the client for four states in phase 1 (Andhra Pradesh, Gujarat, Maharashtra and Telengana)
• Tabulation and analysis of the data
• Powerpoint presentation presenting the key findings across states on the different components of the programme.
• Two pager factsheet for each state.

Outcome

• Powerpoint presenation
• Two pager factsheets for each state.

With its majority population living in rural areas, the Independent state of Papua New Guinea (PNG) has a population of over 7 million residing over a challenging geography. With 6000 babies dying within first month of birth every year, PNG has an alarmingly high rate of newborn deaths. With about 17 newborns dying per day, this situation has not increased in last 20 years. Hypothermia among newborn only accounts for 42 percent of these deaths which can be prevented with correct hypothermia management. Similarly, post-partum haemorrhage is one of the major reasons of maternal deaths in PNG.

In order to prevent and manage post-partum haemorrhage among recently delivered mothers and neonatal hypothermia, UNICEF had launched a project named “Spreading lives and spreading smiles” in 2018. The project aims to curb maternal and newborn deaths by focusing on post-partum haemorrhage among recently delivered mothers and hypothermia among newborn babies.

The project also aims to strengthen local capacity in hospitals and facilities delivering health care services, assess and remove bottlenecks in health services deliveries related to maternal and newborn health.

The proposed technology-based solution will not only digitize monitoring and supervision of health facilities, but will also collate data collected from various national, provincial, district and LLG level users and will present data in user friendly manner on real time basis for effective decision making.

Issue

• Sexual & Reproductive Health (SRH) needs of adolescent girls are ignored or less talked due to the culture of silence around it.
• Young girls confront with challenges in accessing the basic health services in day to day life and practice unhygienic methods to address their RH needs.
• Socio-cultural restrictions imposed on girls during menstruation has negative implications on their development

Intervention

To monitor the project in 3 blocks of Ganjam District Aaina needed to do a baseline study and develop an M & E frame work. SDRC partnered with Aaina in designing and leading the baseline study--methodology, development of digital tools, capacity building of Aaina team on mobile based data collection, data cleansing, analysis and report writing. After baseline, an excel based monitoring template will also be developed for Aaina to monitor the progress against the targets set for different indicators.

Outcome

419 adolescent girls and boys (and their families/care-givers of girls with disability) identified from three blocks of Ganjam district. Awareness generation and sensitization of family, community and other institutions would be undertaken in a focussed manner under the project titled, "Flying Wings"

The Health Statistics Information Portal facilitates the flow of physical performance from the District level to the State HQ and the Centre using a web-based Health Management Information System (HMIS) interface. The portal provides periodic reports on the status of the health sector. While the HMIS provided the raw data with respect to the blocks and district, such data needs further analysis to measure to understand the status and measure performance. At present the Nutrition Performance Review Tool (NPRT) is being used by the different cells at state level like Maternal Health, Child Health, Adolescent health, data cell and by development partners. The Nutrition Performance Review Tool provides products like factsheet, report, graphical presentation of data, etc. Some of the key features of this NPRT is that it automatically fetches data from HMIS on weekly basis, query builder function is in built, which helps the user to identify better performing and poor performing districts and blocks, apart from this the state level officials can provide feedback to the districts directly through this review tool.

Issue

To be able to address the district specific health and nutrition specific needs, JSW CSR departments needed to identify the health and nutrition need in the intervention districts in seven states of India.

Intervention

Two pager district level factsheets with descriptive and predictive statistics on maternal and child health and nutrition indicators were developed. These districts were primarily the JSW plant districts. The presentation of the factsheets was made to include analysis over time series with disaggregation by level of geography and sex. The districts covered were:

• 1. Kinnaur, Himachal Pradesh
• 2. West Medinipore, West Bengal
• 3. Sundargarh, Odisha
• 4. Jajpur, Odisha
• 5. Nagpur, Maharashtra
• 6. Thane, Maharashtra
• 7. Raigad, Maharashtra
• 8. Ratnagiri, Maharashtra
• 9. Bellary, Karnataka
• 10. Barmer, Rajasthan
• 11. Salem, Tamil Nadu
• 12. Factsheet comparing performance of all these districts.

Expected Outcome

Need-based programme planning of the CSR programme of JSW.G12

This project aims to reduce anaemia by promoting iron folic supplement consumption among women of reproductive age. IPE Global in collaboration with Odisha Livelihood Mission, George Washington University and DCOR consulting is conducting a randomized trial in Athmallik and Kishorenagar blocks of Angul district, Odisha. IPE global through its fields staffs, will engage with community through group meetings and audio visual demonstrations to create awareness about anaemia and generate demand of iron folic consumption. It requires provision of techno-functional support for monitoring and evaluation of the program at national, state and district level to support evidence based decision making.

Issue

Shakti Varta Plus programme aims to reduce maternal and newborn mortality and malnutrition by using a participatory learning approach. Before launching it in 314 blocks of Odisha, APPI wanted to evaluate the pilot phase and understand its implementation challenges and the assumptions that may have been invalid.

Intervention

As the evaluation consultant, SDRC used a mix of both qualitative and quantitative research tools to evaluate the programme on three out of five OECD DAC criteria - Relevance, Effectiveness, Efficiency, Impact and Sustainability). The programme implemented by three different implementation partners in three different districts was covered in the evaluation.

Outcome

An evaluation report highlighting the learnings from the pilot phase and recommendations for improvement of the final roll out of the programme at a large scale.

The WeCan platform envisages:
• To develop a convergence mechanism, to map the various schemes addressing malnutrition.
• To identify the presence of partners across various districts of India.
• To enable collaboration between the various stakeholders of the Mission viz Ministry of Health and Family Welfare (National Health Mission), Ministry of Rural development (National Rural Livelihood Mission), development partners and donors who will envision and implement the intervention programmes
• To develop a digital monitoring system for effective review and planning of the interventions.

Globally, there is a paucity of data outlining how human milk and breastfeeding is supported in the NICU. In particular it is unclear how many mothers of NICU babies are supported to build an adequate milk supply to allow long term exclusive breastfeeding and subsequently whether NICU infants receive an optimal ‘dose’ of their own mother's milk. This initiative also enables identification of “Vulnerable Babies” based on an algorithm.

The Reproductive Maternal New born Child and Adolescent Health (RMNCH+A) program is an important indicator of overall functioning of health care delivery system in country. The program is an amalgamation of multiple interventions and a multitude of data is generated from various sources to track program implementation and progress. Due to the elaborate of the RMNCH+A program and the volume of the data being generated, it often is difficult to collate and compile critical RMNCHA+A indicator. The current toolkit offers one stop solution to assess RMNCH+A related statistics from different sources though a combination of approaches. Designed by Ministry of Health and Family Welfare with support from USAID - VRIDDHI (Scaling up RMNCH+A interventions) Project, e-MITRA provides customised snapshots of important indicators pertaining to overall RMNCH+A Program and its respective theme.

It contains data for 201 indicators with 4,71,831 data values from various secondary sources like Census, SRS, NFHS, DLHS, AHS, HMIS, SS. These data can be accessed by geographical locations (National, State and District levels), by themes and by sources.

SDRC is supporting John Snow India for Supportive Supervision Software for RMNCH+A Checklist to track health sector initiatives. The system shall enable real time visual and quantitative data about various RMNCH+A initiatives up to the facility level. The tools shall enable immediate feedback to the frontline workers as well as to program managers, implementers and policy makers. Besides, it shall offer multi-tenant, role based functionality to enable quick scalability and thus reduce the cost of deployment, implementation and capacity building. The system offers a "one stop" dashboard to be available online, offline as well as on mobile platform. The portal shall collate data from multiple sources and enable decision makers to identify hotspots and trends at an aggregate level as well as facility level.

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Safe Care Saving Lives The project focuses on process improvement in the labour rooms and special care newborn units in the public health facilities and neonatal intensive care units in public and private hospitals. SDRC developed a comprehensive technology solution for electronic data capture, data analysis and visualisation. The various modules under this are:

• Data entry
• Date capture from 3rd party applications
• Data migration
• Data analysis
• Content Management System
• Alerts and notification system
• Web and mobile dashboard for data dissemination/data reporting & visualization
• Planning module/program monitoring dashboard

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Issue

Lack of standard process for monitoring and evaluation of labor rooms. Paper based data collection resulted in delay of analysis and the quality improvement process.

Intervention

Digitizing the checklists for data collection using handheld devices and desktops. An interactive dashboard visualized for monitoring of sectors like infrastructure, human resources, equipment and supplies.Track progress of the labor rooms using visual evidence in the dashboard. System generated summary/raw/aggregated report for informed decision making.

Outcome

State: Telangana District: 31 Health Facilities: 118

Issue

UNICEF in Chhattisgarh works closely with the Department of Health and Family Welfare in areas related to system strengthening, capacity development, facility assessment, etc for improving the impact of health service delivery system. It wanted to conduct a comprehensive gap analysis to identify the gaps/bottlenecks towards strengthening the health delivery systems.

Intervention

The comprehensive gap analysis of health facilities was initiated to contribute in identifying gaps and bottlenecks as well as developing facility improvement plans. The main project features are -

• Development of digital forms for data collection and application for labour room data
• Dashboard to present the findings of the gap assessment exercise
• Data tree module
• Facility improvement programme module
• Reporting module

Outcome

Three rounds of district gap analysis have been completed and improvements visible for different time periods. The health system is being monitored through the active dashboard developed under the project.

Issue

This project focused on creating awareness among legislators by presenting evidence based data on various health issues, so that they would raise more health-related questions in the Assembly.

Intervention

As the knowledge partner of the project, SDRC's role was to provide data based support to the implementing partners in their advocacy initiatives. SDRC developed factsheets and scorecards based on latest published government statistics on health, and policy briefs on the status of health in the state of Chhattisgarh. These scorecards and factsheets were also translated in Hindi.

Outcome

Three factsheets; three scorecards and one policy brief per year (two years).

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Issue

This project focused on creating awareness among legislators by presenting evidence based data on various health issues, so that they would raise more health-related questions in the Assembly.

Intervention

As the knowledge partner of the project, SDRC's role was to provide data based support to the implementing partners in their advocacy initiatives. SDRC developed factsheets and scorecards based on latest published government statistics on health, and policy briefs on the status of health in the state of Odisha.

Outcome

Three factsheets; three scorecards and one policy brief per year (first two years). In the final year, two comprehensive infographic publications were developed:

• Health story of Odisha
• Health in Legislative Assembly

This program is aimed to enhance institutional capacity and preparedness of health facilities/outreach for prompt and effective management of childhood diarrhoea and pneumonia, improved access, coverage and utilization of Vitamin A, Zinc, ORS, and Antibiotics, strengthened referral linkages, developing a viable roadmap for state-wide rollout of IAPPD. Major activities include orientation and capacity building of key stakeholders, integrated SBCC campaign, mobilization of community level institutions, advocacy with private providers, knowledge management for better planning etc. As a part of this current assignment, the state data assistant will serve as IAPs representative at the state-level and work closely with the SHSB, ICDS, PHED, RD, Private practitioners, NGOs, programme officers and managers at various levels to achieve the objectives of IAP. S/he will also carry out state level operations (finance/administrative) and supervisory functions as assigned.

The specific tasks of Data Assistant will be to:

• Maintain State database related to IAPPD implementation.
• Maintain database of pool of Physicians and other clinical partners.
• Compile plans for Supportive Supervisory visits, track the progress and provide feedback.
• Data compilation and analysis.
• Assist IAP and state consultant in documenting findings, presentations for review meetings, maintaining office records and office equipment.
• Support in organization of events like reviews, trainings and workshops.
• Data upkeep to maintain data for trend analysis.
• Documenting case studies, success stories etc.
• Execute any other work assigned by the Supervisors or project consultant.

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The ULMAS system captures data pertaining to the various initiatives carried out by UNICEF's partners for the improvement of the lives of the children affected by EVD. It shall help organize information across several indicators and multiple sectors to help in understanding the results of the partner's initiative in an easy to consume manner. The application shall allow partners to upload data related to their engagement on the PCA's in a pre-approved XLS format. The application shall have a computation engine which would then compute all the key process indicators, outcome indicators and output indicators to produce the final aggregated results. The results shall then be displayed on an interactive dashboard for easy consumption by all the relevant stakeholders of the initiative.

The key deliverables include:

• Collection, collation, compilation of all three checklists from State/District/Block monitors during Mission Indradhanush.
• Analysis of data and sharing of data on daily basis during the campaign.
• Development of State/District and Block Factsheets and Dissemination of results at the end of each round of Mission Indradhanush.
• Submission of filled up MS Excel sheet as per the GOI suggested template as well as MS Power Point Presentation depicting relevant tables, graphs, and maps as per the approved layout.
• Provide ad hoc data analysis and report generation support as requested by UNICEF supervisors.

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PPE section intended to develop an updated database on specific indicators pertaining to demographic composition of children and population at large, maternal mortality, child mortality, child mortality profiles, nutrition status of children, education and literacy level, child health and morbidity, maternal health and water and sanitation etc. Multiple data points on each indicator would be compiled (based on available and consistent information) from various sources, mainly from governments large scale surveys and census, SOWC, Regional Data packets and other publications. The database would be on excel/csv platform so that the integration of data as well as its periodic updating can be done with ease. The dashboard would also have the facility of converting indicators into absolute numbers.

Provided technical support to NHRM GOJ for review of medical mobile units (MMU) with a monitoring framework and Standard Operating Protocols (SOP) for review. The overall objectives were:

• To review the existing recording formats/registers and data base and recommend a mechanism and framework for review of the implementation of the MMU program.
• To provide support for the roll out of a reporting process and utilize the DevInfo software to monitor the access (through the GPS markers) and create a dashboard for key monitoring indicators at the state and district level.

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Issue

UNICEF Chhattisgarh wanted to develop visually rich yet succinct factsheets on the issue of maternal and child health based on Annual Health Surveys reports. These reports were published for selected nine states for three consecutive years from 2010-11 to 2012-13.

Intervention

Factsheets were designed and developed for each district of Chhattisgarh as well as a consolidated factsheet at the state level. This involved:

• Compilation of data sets from three rounds of AHS into a DevInfo database
• Preparing a list of key indicators to be analysed and designing it in the form of factsheet
• Finally developing print-ready Factsheets to present the AHS data for the 16 districts of Chhattisgarh and one consolidate state level factsheet presenting the overall status in comparison to the country

Outcome

17 factsheets based on Annual Health Survey datasets- 16 district factsheets and one state factsheet for Chhattisgarh.

The EVM initiative provides materials and tools needed to monitor and assess vaccine supply chains and help countries to improve their supply chain performance. WHO-UNICEF have designed the Global Effective Vaccine Management (EVM) initiative to help countries to improve the quality of their vaccine and cold chain management from the time the vaccine arrives in their country down to the service delivery point.

It is based on nine basic indicators listed below:

• Vaccine arrival procedures
• Vaccine storage temperatures
• Cold storage capacity
• Buildings, cold chain equipment and transport
• Maintenance of cold chain equipment and transport
• Stock management
• Effective vaccine delivery
• Vaccine Management practices
• SOPs and Supportive Management Systems

It consists of a series of focused questions, which are numerically scored based on the observed practices and records of the past 12 months, against recommended standards.

Based on facts collected from the field and recommendations developed by assessment team members, improvements plans are prepared, to address gaps in the system. In addition, the data is presented as an online dashboard, which facilitates the visualization of criteria and category scores of health facilities as maps and charts.

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Issues

Annual Health Surveys were conducted for nine selected states for three years. Unicef Bihar office wanted to understand the situation of Maternal and Child Health in the State as well as the districts of Bihar, using data from Annual Health Survey reports for the three time periods for their own programme planning and development.

Intervention

SDRC supported Unicef Bihar office in compiling all the AHS data related to maternal and child health into a DevInfo database and design factsheets for the State as well as districts of Bihar using data from Annual Health Survey. These profiles were created using DevInfo.

Outcome

One state level factsheet and 37 district level factsheets on the Maternal and Child Health indicators were available for sharing with UNICEF and Govt. stakeholders for more strengthening a more focused programme planning and implementation.