CHAPTER 5 Planning, Implementation and Monitoring

CHAPTER 5 

Planning, Implementation and Monitoring

Programme Implementation Plan 2011-12 

National Rural Health Mission 

Health and Family Welfare Department, West Bengal 

COMMUNITY MONITORING 

West Bengal has a well organised PRI network at all levels down to Villages. It has been decided 

that all health programmes should be monitored by the community in order to develop ownership 

amongst the community members. Then and only then can Health be truly of the people and for 

the people. 

Just as the villages have Gram Sansads, similarly, Blocks have Block Sansads which act as 

interface between Block Health & Family Welfare Samities and the community people. It has been 

decided that visioning workshops will be held at Block Sansads, in order to disseminate details of 

health activities. Any identified problems can be addressed by community representatives in these 

workshops. 

Similar visioning workshops will be held at district level by involving Zilla Sansad. 

Finally, a state level workshop cum symposium will be conducted based on the findings of Block 

and Zilla Sansad visioning workshops, to validate the future planning of health activities. 

Fund for the above activities are cited below. 

Cost for state level visioning workshop: ` 5.0 lakhs 

Cost for district level workshop: ` 1.00 lakhs per district for 18 districts aggregating to ` 18.00 lakh 

Cost for block level workshop: ` .20 lakhs per block for 341 blocks aggretating to ` 68.20 lakhs 

Total cost estimated for the activity is ` 91.20 lakhs 

MONITORING AND EVALUATION by HMIS and Mother & Child Tracking system 

Under the aegis of NRHM an e-health applications (An initiative of Government of India, Ministry 

of Health & Family Welfare) that includes routine Health Information Systems (i.e. HMIS- Health 

Management Information system and MCTS-Mother and child tracking system). This inititaive has 

been introduced in West Bengal under NRHM on January 2009. It has been implemented in 

phases upto block level. Emphasis will be given in this year to operationalize the HMIS and MCTS 

and to establish these as sole source of data for monitoring the health outcomes. With a view to 

operationalizing these two softwares as a tool for overall Monitoring and Evaluation, plans for 

establishing ICT infrastructure including Hardware, connectivity and Human Resources have been




chalked out. Apart from the existing Human Resources engaged under NRHM on contract basis, 

plans have been made for outsourcing the data entry to external agencies . Possibility of engaging 

the Common Service Centres have also been explored. The foregoing paragraphs try to describe 

in brief the detailed plans towards accomplishing these activities. 

(i) HMIS- Health Management Information system 

Health Management Information system in West Bengal (Under NRHM) includes following 

activities– 

a. National Reporting i.e. reporting to Ministry of Health & Family Welfare, GOI, through 

NRHM-HMIS Web Portal 

At Present the district MIES reports are directly uploaded to the HMIS web Portal by the districts 

themselves on regular basis. 

b. Internal/ Reporting within the State- 

For HMIS reporting within the State, West Bengal has adopted free and open source District 

Health Information Software Version 2 (DHIS 2) which is developed by NHSRC (National Health 

system Resource Centre), which is a technical arm under NRHM, New Delhi. Online HMIS 

reporting up to Block level in 16 out of 19 districts have been successfully in practice through 

DHIS2. HIMS data is entered online in DHIS2 by the reporting unit (Blocks, Distict Hospitals, 

SDH/SGH, RH & Private set up). District reports generated by DHIS2 are uploaded to HMIS Web 

Portal. The following chart shows the system of data flow through HMIS portal. 

Uploading in HMIS Web Portal 

Report generation 

Online data capturing in DHIS2 software from block level 

Data reporting from Subcenter and PHC to Block (Offline)




c. Existing Infrastucture 

Table 1: Infrastructural Scenario 

Type of 

Organization 

unit 

No. of 

Organization 

Unit 

HR Personnel (Related 

to HMIS) 

State 1 HMIS Consultant 

*Data Entry Operator-1 (* 

But not dedicated for 

HMIS) 

Districts 19 District Statistical 

Deployment of 

computers 

 

Internet 

Connectivity 

 

 

Manager (No dedicated 

computer 

available 

is 

for 

HMIS) 

Blocks 341 *Block Data entry 

(No 

dedicated 

** 

operators-2 ( *Not 

dedicated for HMIS ) 

computer 

available 

HMIS) 

is 

for 

Sub – centre 10356 ANMs & ASHA 

Note **: 

Out of 341 Blocks, broadband connectiobs are available only in 270 locations. Even in places 

where there is broad band connection, the speed of the same are very poor. Hence, there is 

further requirement of other source of internet connection, such as Dial Up connection, data card 

connection etc. 

d. Status of Server and other Hardwares 

 

Server- At present, the data in the HMIS portal is uploaded through DHIS-2 software, which 

is hosted in the server located with NHSRC. But NHSRC is emphasising on procuring 

separate server for hosting of the DHIS-2 software. So it is imperative to procure a serverspace 

either on hiring basis or to procure a server. It is also important that the same be 

placed at the State Data Centre or at the Data Centre of NIC .




 

Deployment of dedicated Computers: There are two computers in each Block and all 

works relating to regular accounting and programme reporting is done in thee two 

computers. Presently, work on HMIS and MCTS also is shared on these computers. Due to 

increase in work load on HMIS and MCTS, it is required to have at least one dedicated 

computer with relevant software in each Block. Estimated cost of procuring the those PCs 

will be about Rs.40,000.00 per block including UPS and a printer. 

 

Level of internet connectivity: Out of 341 Blocks, 267 Blocks have broad band 

connectivity. In order to have assured internet connectivity in all blocks, it has been decided 

that data card may be provided for operating the on-line software. On an average, Rs.750.00 

per month may be earmarked as cost of connectivity. 

Broad activities covered under HMIS from April 2009 to November 2010. 

1. Capacity building- Both State level Personnel and District level had been given training on 

HMIS functionality and DHIS 2 application. Special training on Reporting HMIS Formats 

were given to all reporting units beginning from sub center. 

2. Standardization of formats- The HMIS formats were integrated with the RCH reporting 

formats of the State and accordingly Software (DHIS2) had been customized as per the 

State requirement. At present the DHIS2 is catering both State reporting and Reporting to 

GOI, Ministry of Health & Family welfare. 

3. Online data entry from district / block level- In the first phase (1 st six months) the level of 

entry was District and in the second phase (2 nd six months) the level of entry was shifted to 

Block level in DHIS2. Currently, 16 out of 19 districts are reporting online in DHIS2 from 

block level. Besides District Hospitals, Sub divisional hospitals, State General Hospital, 

Rural Hospitals, PP Units and private health facilities (Nursing homes, NGOs) are also 

reporting in DHIS2. 

4. Data analysis & Feedback- Feedback to the districts for notifying probable outlier and data 

quality issues had been done periodically. 

Planned activities for the year 2011-2012 

i) Web Based facility wise reporting- Reporting of facility-wise HMIS data and 

Infrastructure information would be operationalized from April 2011. Mapping of the health




facilities has already been done and incorporated in the HMIS web Portal. Capacity 

building activities have already been initiated with the training of State & district level 

officials on facility level data reporting in the month of January 2011. A similar training is 

required for the block teams which would be conducted at the district & block levels. 

Health data from private health facilities also flows in the present reporting system. The 

efforts will be to include them as reporting entity in the HMIS web Portal. The state specific 

data items need to be reported from facility level onwards and the system needs to be 

prepared to incorporate the same.These would be useful for evaluating indicator based 

performance of the health facilities through HMIS web Portal for West Bengal. 

The primary registers need to be operationalized for uniformity and effective recording of 

data for the purpose of reporting of Mother & child tracking and HMIS data elements. This 

requires reviewing, printing and distribution of primary registers for data capturing & data 

reporting. 

Extensive training of ANMs/ASHAs will be taken as an important activity this year. The 

training will include data recording and reporting on MCTS and HMIS data formats. 

The infrastructure and manpower needs to be identified and computer hardware along with 

internet connectivity is to be provided in all blocks. At present the internet facility is not 

available in all the blocks but it is required that all the blocks are connected so that the 

MCH tracking system and HMIS can be made functional at the block level with facility 

based reporting. 

The manpower is required for Necessary support for monitoring, analysis and support to 

the HMIS Cell for facility based data reporting at block level. So a need for Program 

(HMIS) associate is envisaged at the State HMIS Cell. The person recruited would support 

and assist the State HMIS officer for operationalization of HMIS & MCTS in the State. 

ii) 

Reporting for National Disease Control Programmes- In the year 2011-2012 the efforts 

will be done to start reporting for National Disease Control Programmes from district level. 

Necessary system will be established to get the data flow from facility level. 

iii) 

The FMRs, infrastructure details, facility survey reports- 

In the HMIS web Portal till date there is no option for uploading the HMIS FMR to the HMIS




web Portal, but the available option is that it can be entered online directly in the HMIS we 

portal’s FMR format. Accordingly the State has planned to train the DAM (District Account 

Manager) and build their skill on FMR reporting. The real flow of data can be expected 

from the beginning of the financial year 2011-2012. For the infrastructure reporting a State 

level training is already organized on format understating, will be followed by further 

meetings on deciding flow of infrastructure data and deciding reporting persons. So we 

can expect infrastructure data of the reporting health facilities by 30 th of April 2011. 

Besides , facility survey activities for the PHC and CHC (RH and BPHC) will also be 

carried out. 

iv) 

Data quality checks 

• Training of the district officials on improving data quality on HMIS portal 

• Field visits of State and district personnel for checking the data on the field 

• Training of ANMs/ASHA/Facility data entry personnel on concept & terminology of data , 

recording in primary registers & reporting on HMIS, MCTS formats. 

• Review meeting for data verification and data quality 

• Building up a regular feedback mechanism from the state level onwards by conducting 

regular review meetings and data analysis for District and block level. 

• Regular Performance monitoring of physical & financial indicators at various levels. 

• Involvement of other program deprtments and agencies for improving data quality. 

(ii) MCH Tracking system (MCTS) 

For MCTS tracking system the facility mapping is already be done and Master been 

incorporated in the server . The customization of MCTS software according to the Satte 

requirement is yet to be finalized so that it can be made functional and data entery can be 

initiated.Training of the district personnel is in process and two districts are already 

covered. Remaining districts would be covered by end of March 2011. 

Data is being captured for all pregnant women and children from 1st April 2009 onwards in 

registers. The data entry in the software would effectively take place as soon as the 

software is ready with the changes.The legacy data for the year would be entered by hiring 

of agency for the same. 

Broad activities undertaken for HMIS from April 2009 to November 2010 

Data Recording at Facilities- Data capturing and data reporting registers (formats) both have




been distributed to sub centres. Reports in hard copy have been reported to Blocks and 

compilation of block data have been done in excel sheet. Both State level Personnel and District 

level had been given training on format orientation for Name based mother and child tracking. 

Data Reporting -Training has been arranged for two districts up to the period November 2010 for 

entering data in online MCTS application. 

(iii) checking the validity and reliability of data.- 

As state do not have PRCs, therefore the core team for checking validaity and reliability of data 

would comprise the Regional Director (MoHFW) and SIHFW would be constituted at state and 

district level for institutionaling a mechanism for reviewing the HMIS data in regular review 

meetings. 

(a) Integration of Monitoring & Evaluation activities across programmes: 

It is a concern to adopt a uniform Monitoring and Evaluation strategy across the Programmes. 

Different vertical programmes use different sources of data and take necessary strategic and 

implementation decision. Different sources of data also causes of different data element. Now 

MCTS and HMIS have emerged as a major source of data. It is planned that MCTS and HMIS 

data will be the primary source for monitoring. But these two data sources do not cover at least 

two major broad areas viz. Data related to Public Health Programme and Data related to 

performance of the facilities, particularly performance of hospitals. Besides, in peri urban areas 

there are number of private service providers. However, to minimize the gaps regular meeting of 

core committee constituted for verification and validation of data have been planned to be 

conducted. Meeting the Third Saturday is a vibrant forum for collecting information from the 

community level. It will be effective if data collected from the Third Saturday may be compiled and 

may be cross verified with the macro level HMIS data. It has also been planned to share the major 

findings and the outliers with the key personnel of every vertical programmes. Presently, one 

meeting on MIS is conducted every month at district level where key stakeholders of every vertical 

programme remains to review and analyse data generated and compiled at district level. Similarly, 

it is also planned to conduct such meeting at state level also for making corrective decision. The 

state has now completed GIS based facility mapping. Census data, facility level meta data are 

also superimposed on the GIS platform . It is also a strategy to use this tool for monitoring all the 

programmes at macro as well as at macro level.




(b) M&E Action Plan: 

HMIS and MCTS will take an important part in overall Monitoring and Evaluation of the overall 

outcomes NRHM Goals. To make effective utilization of the inputs from the HMIS and MCTS, the 

plan for Monitoring and Evaluation have been framed in form of regular watch to the data ported in 

the HMIS/MCTS portal from the facility level. Timely reporting is crucial for effectiveness of an M 

&E System. The HMIS portal is mostly updated with respect of all the Districts in West Bengal. To 

ensure timely porting of data, plan has been framed for periodical persuasion of the District Level 

functionaries through monthly meetings of the District Statistical Managers, who are key persons 

for updating of data. Quarterly meeting with the Nodal Persons of the districts as stated in the 

table below has also been planned to be held. In every month, MIS meetings are held at district 

level during the 3 rd Week to ensure quality of the data ported in the HMIS portal. To ensure quality 

of data, triangulations of data available with the HMIS portal are done with other data available at 

the State Level with the Programme Officers of different vertical programmes. As a strategy for 

strengthening HMIS, it has been decided that from 2011-12 onwards, data available only through 

HMIS portal will be only recognized source of data for taking decision at the State Level. 

(c) M & E Officer 

Table 2: Notification of Nodal M&E Officers for HMIS and MCH tracking 

Level Nos. Nos. Present Remarks 

State 2 2 One State Statistical Service Officer in the rank of Deputy 

Director has been notified as Nodal officer for HMIS. 

Separate Nodal Officer for MCTs have also been notified 

Districts 19 19 Deputy CMOH-III and District Maternal and Child Health 

Officers have been entrusted as Nodal Officer at this issue. 

Besides, the District Statistical Managers will assist them in 

the matters related to imputing data related to both HMIS 

Blocks 341 341 BPHNs act as nodal person for HMIS and MCTS under the 

overall guidance of the BMOHs. There are two Data Entry 

Operators for necessary computational support 

(d) Strengthening IT Infrastructure




The efforts will be done to establish a single MIS system for reporting. Our basis strategy will be to 

integrate the existing reporting formats of the State MIS with the available HMIS formats and 

accordingly establishing the software / hardware for its proper compatibility with reporting to 

MoHFW, GOI along with server management and domain creation. Necessary steps will be taken 

to collaborate with NIC for proper software implications. A need assessment for the hardware 

needs has been done at various levels and accordingly computer will be provided to reporting 

units earmarked only for HMIS works. Ensuring internet connectivity throughout the network will 

be our area of emphasis. Besides this year we would try hard to mainstream at least 9 District 

Hospitals of West Bengal with the HMIS reporting system. For that our strategy will be to establish 

a strong LAN Network within the hospital and ensuring internet connectivity. 

(e) Training strategy for M & E 

For the capacity building of the M & E team, a training calendar will be prepared and will be 

implemented in accordingly. The MoHFW Resource persons will train the State M & E team 

periodically, who in turn will train the District M & E team. District M & E officer with his/her team 

will train the concerned block Officials. The respective Block BPHN in supervision of Block 

Medical Officer will monitor the HMIS activities implementation at the Subcenter and PHC level. 

(f) Strengthening of MCTS 

MCTS application will be taken as important tool for monitoring progress of health services 

provided to target beneficiaries. Same time it will explore the area for intervention in providing 

support to service providing health facilities. The implementation of decentralized training sessions 

has already been initiated and will be completed by the 2 nd quarter of year 2011. For creating the 

database for backlog data, it is planned to be done by an outsourced agency. Block HQ will be 

made as a hub for online data entry and internet connectivity will be ensured. Regular data checks 

will be done to check the data quality as per the MCTS guideline - 

Table 3: Extent of supervision in different levels 

S.No. Level % of cases for 

monthly checks 

1. State 1% 

2. District 2% 

3. Block 5%




Table 4: Details Budget for Monitorisng and Evaluation during 2011-12 

Major Head Minor Head Budget 

in Rs. 

In lakh 

Details 

(including 

cost per 

unit) 

Remarks 

1.Strengthen 

ing of 

M&E/HMIS/ 

MCH 

Tracking 

2. 

Procurement 

of 

HW/SW and 

other 

equipment 

Salaries of M&E, MIS & 1.1 12.00 1 

Data entry Consultants 

Mobility for M & E Officers 1.2 20.00 20 Lump Sum 

Workshops/Training on M 

& E 

1.3 6.00 0.5 12 

workshops 

M & E studies 1.4 0.50 

Others (specify)- 

Review Meeting (HMIS) 

1.5 5.00 4 meetings 

each in one 

quarter 

Hardware/Software 2.1 0.00 

Procurement 

Server 2.1.1 1.50 Lump sumthe 

server 

may be 

hired also 

in a running 

data centre 

Personal Computer 2.1.2 144.80 0.40 362 PCs 

(Budgeted in Chapter 8: 

one for 

Additional Part of NRHM 

each Block, 

Flexipool) 

one for 

District unit 

and 2 for 

State Unit 

Internet connectivity 2.2 30.69 750 x 12 x 

341 

LAN connectivity at District 

Hospital 

2.2.1 27.00 3.00 9 DH / SDH




Annual Maintenance 2.3 34.1 0.10 Rs. 10,000 

per year for 

each block 

Operational Costs 2.4 5.00 

3.Operationa Review of existing registers 3.1 1.00 

lising 

HMIS at Sub 

District level 

to make them compatible 

with National HMIS 

Printing of new registers & 3.2 146.00 

forms 

Training of staff 3.3 34.10 5000 x 341 

x 2 

4.Operationa Printing and reproducing 4.1 5.00 

lising 

MCH 

tracking 

Registers/ Forms 

Capacity building of teams 4.2 34.10 At a rate of 

Rs.10,000 

per block 

for 2 

persons 

On-going review of MCH 4.3 5.00 

tracking activities 

Monitoring data collection 4.4 2.00 

and data quality 

Others (specify)- 4.5 0.00 

1. Back log data entry 4.5.1 139.20 Through 

outsource 

agency for 

116 blocks 

where CSC 

are 

available. 

Total 652.99

CHAPTER 5 Planning, Implementation and Monitoring

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