Abstract
BackgroundAchievement of successful health outcomes depends on evidence-based programming and implementation of effective health interventions. Routine Health Management Information System is one of the most valuable data sets to support evidence-based programming, however, evidence on systemic use of routine monitoring data for problem-solving and improving health outcomes remain negligible. We attempt to understand the effects of systematic evidence-based review mechanism on improving health outcomes in Uttar Pradesh, India.MethodsData comes from decision-tracking system and routine health management information system for period Nov-2017 to Mar-2019 covering 6963 health facilities across 25 high-priority districts of the state. Decision-tracking data captured pattern of decisions taken, actions planned and completed, while the latter one provided information on service coverage outcomes over time. Three service coverage indicators, namely, pregnant women receiving 4 or more times ANC and haemoglobin testing during pregnancy, delivered at the health facility, and receive post-partum care within 48 h of delivery were used as outcomes. Univariate and bivariate analyses were conducted.ResultsTotal 412 decisions were taken during the study reference period and a majority were related to ante-natal care services (31%) followed by delivery (16%) and post-natal services (16%). About 21% decisions-taken were focused on improving data quality. By 1 year, 67% of actions planned based on these decisions were completed, 26% were in progress, and the remaining 7% were not completed. We found that, over a year, districts witnessing > 20 percentage-point increase in outcomes were also the districts with significantly higher action completion rates (> 80%) compared to the districts with < 10 percentage-point increase in outcomes having completion of action plans around 50–70%.ConclusionsFindings revealed a significantly higher improvement in coverage outcomes among the districts which used routine health management data to conduct monthly review meetings and had high actions completion rates. A data-based review-mechanisms could specifically identify programmatic gaps in service delivery leading to strategic decision making by district authorities to bridge the programmatic gaps. Going forward, establishing systematic evidence-based review platforms can be an important strategy to improve health outcomes and promote the use of routine health monitoring system data in any setting.
Highlights
Achievement of successful health outcomes depends on evidence-based programming and implementation of effective health interventions
Similar to other national and international contexts, the Government of Uttar Pradesh (GoUP) implemented routine Health Management Information System (HMIS) in 2009 [5] that enables effective decision making by providing health care data at different levels
Two data sets were used for analysis: i) the decisiontracking data collected from November 2017 to September 2018 and ii) health outcome/output data gathered between April 2018 to March 2019 reported on HMIS
Summary
Achievement of successful health outcomes depends on evidence-based programming and implementation of effective health interventions. The attainment of successful health outcomes in the state would largely depend on the effective implementation of health interventions supported by evidence-based programme planning and implementation. Similar to other national and international contexts, the Government of Uttar Pradesh (GoUP) implemented routine Health Management Information System (HMIS) in 2009 [5] that enables effective decision making by providing health care data at different levels. This provided a basis to analyse the multiple critical health system functions required for planning, coordination and implementation of health programs [6]. HMIS data largely comprises of output indicators while information on input and process indicators are almost missing
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
