Country presentation Myanmar MA4Health/Inter-country Measurement and Accountability Conference 26-28 April, 2016, Dhaka,Bangladesh
Country Profile • Nay Pyi Taw Council Territory and 14 States and Regions •74 Districts, 330 Townships, 398 Towns, 3065 Wards, 13,619 Village Tracts and 64,134 Villages •Great diversity of topography exists between the regions; Delta, hilly, coastal and the central plain •Area of 676,578 square kilometers •Area of 676,578 square kilometers •Total population – 51.42 Millions (76 persons per square kilometre) •Urban:Rural – 3:7 •135 national races speaking over 100 languages and dialects •Pluralistic mix of public and private system both in the financing and provision of Health Care •MoH remains the major provider of comprehensive health care
Background • No policy related to health information in current national health policy • Proposed to put policy related to health information in revised national health policy information in revised national health policy • No separate health information policy in written and plan to have in future
HIS Strategic Plan • HIS strategic Plan (2011-2015) – Present • Plan to develop next 5 years HIS strategic plan is in urgent matter
HIS Five Years Strategic Plan (2011-2015)
HIS Strategic plan (2011-2015) Vision A simple, effective and systematic health information system established at all levels of health care delivery for the strengthening of health system
General objective To improve the availability, accessibility and utilization of quality health information Strategic objectives To enhance the HIS commitment, coordination and HIS resources To improve the quality of the hospital data recording and reporting To improve the quality of the hospital data recording and reporting To improve the quality of the public health data recording and reporting To develop a reporting system for private health sector To improve the coverage and quality of vital registration system To improve surveillance system on disease and health To encourage population based survey To improve data management, and data sharing encompassing IT development To promote utilization of health information in decision making process
Investment in Health Data System • WHO regular budget support for capacity building of medical record technicians and medical doctors in ICD-10, Fellowship for ICD-10 and advanced data analysis, supervision visit to hospitals • Global fund support to give Training on DHIS2 in (9) Regions/States, workshop on integration with HIV,TB and Regions/States, workshop on integration with HIV,TB and Malaria and also training for vertical staff • 3 MDGs fund support training on DHIS2 in two batched covering 26 Townships • JSI and Pact Myanmar cover DHIS2 training in one township each and also provide laptops to RHC • Previously UNICEF and UNFPA provide for printing cost of HMIS data dictionary
Supporting Manuals Data Dictionary Data Dictionary (English (Myanmar Version) Version)) For all townships For all staffs
Training ******* Medical record technician
Training on ICD 10 to Medical Doctors
Data Quality Assessment • Quality assessment on Data Flow (reporting flow from sub-center to township) • Quality assessment on Data generation ( from Register to report) ( from Register to report) • Quality assessment on Registers and Record ( checking with home visit) • Service Quality
Data Quality assessment through the data flow Each Township Randomly selected Randomly selected at each steps at each steps RHC RHC RHC RHC MCH MCH RHC RHC SC SC SC At least 20
88% 84% 79.8% (2010) (2010) (2011) 82% 82.5% (2011) (2012)
Overall Data Quality in 2013 - 82.7% Data Consistency Data Data Consistency Data Total between Consistency between Consistency Quality Township between RHC Subcenter report between Percent report(n=40)and report(n=148) (n=159)and sample of RHC and Subcenter register(n=159) register report(n=148) report(n=159) (n=110)and Home Home visit(n=2329) AN 100.00% 100% 91.20% 95.50% 87.1% Delivery 100.00% 100% 90.00% 74.90% 67.4% DPT 98.00% 100% 100% 77.00% 75.5% TT 100.00% 100% 100% 88.90% 88.9% U5 100.00% 100% 91.40% 92.00% 84.1% Overall 98.40% 100% 93.30% 90.10% 82.7%
Training on DHIS2 customization Nay Pyi Taw (13-1-2014 to 15-1-2014)
DHIS2 Training • Patheingyi – 1.9.2014 – 5.9.2014 • Nyaunglaybin – 20.10.2014 – 24.10.2014 • Chaung U – 22.3.2015 – 26.3.2015 • Madaya – 1.6.2015 -5.6.2015 • Madaya – 1.6.2015 -5.6.2015 • (26) Townships – 7-11Dec 2015,14-18 Dec 2015
Data Entry Form for aggregate data
Dashboard
Problem/Issues • How to improve routine health service information system in Myanmar Three Main characteristics of the problem Three Main characteristics of the problem • lack of written health information policy • Insufficient manpower and capacity of those who are working in health information area • Inadequate facilities for advanced information technology
Three programmatic options to address the problem • Regulations, laws and policy • Education and professional support • Infrastructure for advanced technology Infrastructure for advanced technology
Three implementation considerations that will be need to be addressed Regulations • Expand organizational set up and assign vacant post • Enhance scope of service by medical record technicians technicians • Expand the coverage of health information to private sector • Compulsory service in health and hospital profile and statistics • Encourage evidence based decision making and actions
Education and professional support • Establish medical record technician training school as other paramedics • Curriculum that include health information management in every level of health staff including medical doctors • In-service training that reflect current implementation issues related to health information management issues related to health information management • Continuous professional development like CME as well as master and PhD course nationally and internationally • Career development • Public recognition measure • Favourable working environment • Supportive field supervision
Development of Infrastructure • Computer, laptop, smart phone, internet access, electricity and networking • Development of open MRS software for hospital • Prototyping software of DHIS2 for public health information • Mobile phone application especially in hard to reach area • Establishment of unique health identifier
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