Health Bulletin 2009

What are the types of data the health facilities produce? They produce the hospital utilization
data (number of outpatient and emergency visits, number of admissions, bed occupancy rate,
average length of stay and in-patient death rate), disease profile (age and sex disaggregated
morbidity data both for out-patient and inpatient based on common diseases and diagnoses
translated in ICD-10 codes). Each hospital needs to send mortality data for each in-patient
death on case by case basis. Compliance of monthly reporting is reasonably good for district
levels and below; but for medical college hospitals, and for tertiary care and private hospitals
are unsatisfactory. However, things are improving. How reliable the data are? In a rural subcenter,
a medical assistant sees patients without any investigation support.
S/he can provide symptomatic treatment. How much reliable his/her diagnosis can be? In an
out-patient department (OPD) of any hospital, a doctor may have to see on average 100 to 300
patients in OPD hours per day. S/he is not in a position to completely recording all information in
the register. The health facilities also have to prepare other health service statistics, viz.
emergency obstetric care statistics and IMCI statistics.
Type of health facility statistics received by MIS (health), DGHS
Who really does the data handling job? In each sub-district, there is a class III staff called
statistician, who is responsible for all the data gathering, compilation and transmission jobs. In
some districts there are two posts of statistical staff, one class I post of Statistician and one
class II post of Statistical assistant. In other districts, there is only one post of Statistician. But,
most of the class I posts are vacant. In the divisional health offices, there are 2 to 4 posts, one
class I (Assistant Chief) and one to three class III (Statistical assistant). Sylhet divisional health
office does not have any statistical staff. Follwing table shows the detail. Experience shows that
workloads are more in sub-district and district than in divisional health offices. But, number of
staff in sub-district and district health offices is less than in divisional health offices. The data
generated from the hospitals are huge in volume. But, there is no post of statistical staff in any
hospital beginning from district hospital as high as up to top level tertiary or specialty hospital.
This ambiguity creates situation for irregularity, inadequacy and poor quality in data flow.
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