Rajasthans Health Info System tracks all pregnant women and children upto 16 years

To minimize maternal and infant mortality rate in the state, the Rajasthan
government has initiated a monitoring and evaluation cell in the Department of
Health and Family Welfare. The idea is to offer maternal and child health
services and establish and maintain management information system (MIS) about
children and pregnant mothers. The state government has also been encouraging
institutional deliveries to minimize maternal mortality rate and develop a
system for maternal mortality auditing to assess the causes of death within the
risk period of delivery. All these promotions and initiatives have led to the
development of this unique Pregnancy and Child Tracking and Health Services
Management System.

In terms of monitoring child health, the state government aims to reduce the
infant mortality rate to at least 32/1,000 live births by the end of 2012. It
also aims at ensuring that all infants receive appropriate vaccines available in
the public health system and ensure essential and qualitative post natal care.
Considered as one of the largest e-goverment projects of the country, this
online application incorporates the directory of government health institutions
within the state, multiple health information systems as well as online listing
of pregnant woman and infants. As a part of Health Information System for
Government (HEALING), this system makes it possible for the department to track
every single pregnant women in the state and provide subsequent health services
till the delivery and subsequently the immunization of every child till the age
of sixteen. Currently, the system encompasses thirty-four district hospitals,
thirty-two hospitals attached to medical colleges, about 200 city dispensaries,
more than 360 community health centers, around 1,500 primary health centers and
more than 10,900 health sub-centers.

Developed by National Informatics Center, Rajasthan, this online system is
accessible through intranet and does not require installation of any new
gadgets. This system runs on the infrastructure that has been developed for the
National Rural Health Mission. There has been value addition in terms of
additional manpower, says Indu Gupta, state informatics officer and senior
technical director, NIC. The website offers role based user authentication,
hence it cannot be accessed by anyone who is not a part of the system. This
system has brought about revolutionary changes in terms of collection and
compilation of the humongous data within a stipulated time. Moreover, this web
portal can generate graphical as well analytical reports based on different
parameters.

Reaping Benefits

Maternal care, new born care, population control and better health services
have always been the concern areas for governments. Lack of timely health
check-up and lack of vaccination results in thousands of maternal deaths every
year in our country. The system is path-breaking in minimizing maternal
mortality, infant mortality and in tracing areas with decreasing sex ratio at
birth.

A network of auxiliary nurse midwives (ANMs) operates at the block levels and
captures data on the number of pregnant women and new born babies in a
particular area. A woman gets registered into the system from the first day of
her pre-natal check-up and is issued an unique ID for future tracking. The
system also tracks every single new born baby and prepares an immunization
plan/chart for each child. The monthly requirement of vaccine dosages is
automatically prepared by the system for each health institution. This helps the
ANMs at the sub-center to adequately plan for vaccine stocks and immunization
sessions. The ANMs can also use the information to follow-up the cases. This in
turn ensures better immunization coverage resulting in reduction of child
mortality and improving child health. This helps minimize the maternal mortality
rate along with the infant mortality rate. The effectiveness of the system can
be measured by the fact that currently 10 lakh pregnant women have been
registered with the system, says JP Jat, state demographer, Government of
Rajasthan.

It is not unknown that checking the population growth of our country is an
extremely important task. MIS for sub-center management serves as a good tool in
providing information about all such couples who can be potential cases for
sterilization. The system provides information about all pregnant women who
already have one or more children and are registered for ANC check-up.
Counseling sessions can be taken up with all such women. A useful feature of
the system is that it also filters all such cases who have registered for
pregnancy but have not reported delivery even after the expected date of
delivery has passed. This information can be used in tracing abortions and
female foeticides as well, says Tarun Toshniwal, senior technical director, NIC,
Rajasthan.

The system is also used by all health institutions to report their
performance periodically. Thus, it is also an effective tool for monitoring
service delivery by every health institution. In addition, hospital activity
indicators provide information on IPD, OPD, investigations which are useful in
assessing service delivery. In addition, this system also tracks the cold chain
equipment so that the health centers can plan their resources.

The Process

Once the base information on pregnant women and immunization of children by
the ANM is captured, it is registered with the block primary healthcare centers
(PHCs). Reports are provided to the concerned citizens on the services being
delivered to the pregnant women and children based on the stipulated dates as
per the ANC schedule and immunization schedule each month. Each pregnant
mother/child record results in the generation of a unique ID with which the
pregnant mother/child can be tracked subsequently.

This system not only penetrates to the grassroots, thus making it one of the
best e-governance practices, but also creates a lot of awareness on family
planning and opting for proper medical care. The system allows everyone in the
hierarchy to view reports and monitor particular case studies on a priority
basis.

Atreyee Datta

atreyeed@cybermedia.co.in