Strengthening health management information systems in India: An assessment

Since 2005, National Rural Health Mission (NRHM) is strengthening ‘Health Management Information Systems (HMIS)' in India towards decentralized public health planning but validity of HMIS is not established. ‘District Level Household Survey (DLHS)' provides data similar to HMIS. Objective: To determine if HMIS strengthening yield data that are comparable to DLHS. Methodology: HMIS: 2009-10 and DLHS III: 2007-08 data on 14 indicators (antenatal care registration- trimester1, home deliveries, home deliveries-skilled birth attendant, iron folic acid during pregnancy, postnatal complications attended, sterilization (male-female), intrauterine device insertions, condoms, oral and emergency contraceptive pills, newborns breastfed within 1 hour of birth, reproductive/sexually transmitted infections treated, HIV test-female) were compared for 590 Districts. Districts of States that solicited NRHM's support since 2005 were categorized as ‘HMIS early', others as ‘HMIS late'. If HMIS data were less/more 10% than DLHS III data then they were defined ‘comparable'. Chi-square and logistic regression analyses were done to determine odds of ‘HMIS early' Districts yielding data ‘comparable' with DLHS than ‘HMIS late' Districts. Results: Data were ‘comparable' in more than 90% Districts for 5 contraceptive indicators. Greater proportion of ‘HMIS early' Districts had ‘comparable' data for: home deliveries-skilled birth attendant, oral contraceptive pills, sterilization-female, and HIV test-female, (p<0.05). ‘HMIS early' Districts were 3.39 (95% CI:1.61, 7.16, p<0.05) times and 2.67 (95% CI:1.81, 3.95, p<0.05) times more likely to have ‘comparable' data for oral contraceptive pills and home deliveries-skilled birth attendant, respectively than ‘HMIS late' Districts. Conclusions: HMIS and DLHS data are ‘comparable'; NRHM's support yields ‘comparable' data.