LHW Systems Review - Oxford Policy Management

LHWP – Systems ReviewThe Strategic Plan outlined new or improved MIS tools that were to be developed. Theseincluded new instruments, such as: mini-surveys for operation at the district level; a fleetmanagement database; a procurement management database; and a review of thepersonnel database; further development of the MIS administrative records; and a review ofthe LHW/LHS reporting system, which would take into account management capabilities atusing the information collected.In addition to new MIS instruments, the PC-1 (p. 51) referred to the need for an efficientcomputerised system that would support decision-making, improving accuracy, andtimeliness of data. All PIUs were to be equipped with computers and printers for propercompilation and analysis of reports on a monthly, quarterly, and annual basis. All PIUs wereto be linked through WAN or email for timely and efficient transfer of data.10.6 System performance10.6.1 Performance indicatorsMIS reports on KPIsThe analysis of whether the MIS gathers information to measure the KPIs is provided inAnnex C.Information from the MIS is used to inform strategic and management decisionsManagement information that can be used for decision-making is provided throughsummaries of the PSP to show results against some of the Programme’s main targets (e.g.the number of LHWs employed, the ratio of LHS to LHWs, the number of vehicles, andpopulation coverage. However, this information does not provide for measures of a broadrange of KPIs. 83Information for strategic decision-making and policy development is primarily generated byexternal evaluations. There is a clear progression from the findings of the 3rd Evaluation topolicies in the Strategic Plan and budgeted activities in the PC-1.However, a mid-term evaluation planned for 2005 did not take place, and the planned minisurveysto be derived from the 3rd Evaluation were not developed. In the absence of thisinformation, the Programme had to rely on the results from the evaluation conducted in 2000and the information collected by its internal management information system.The Programme did not implement Phase 2: Development of a Sustainable Programme(outlined in the PC-1) that had been planned for July 2005. If it had done so, then theremight have been more demand for the evaluation undertaken in 2005 in order to informoptions.There also appears to be a lack of demand from the Ministry of Health and the PlanningCommission as a part of a performance monitoring process. Annual planning and reviewwould provide an obvious need for high quality data. The Programme produced a NationalPlan of Action in 2003, 2004, and 2005 but failed to do so after that date.While annual reviews are published, they do not place a high demand on the MIS. 84 WhileProvincial Review meetings have been held between the PPIU and District Coordinators,83The MIS is described in detail in the ‘Module on Use of Information at District Level: LHW MIS’. This manual guides the DPIUstaff through the analysis and use of data collected from the LHWs and the LHSs. It was produced in 2005, and trainingcourses were held throughout the Programme. In the introduction, Dr Zahid Larik (the then National Coordinator) said:‘Providing adequate and accurate information for the management of health care services is still a big challenge for the MISsections’ of the Implementation Units, ‘[w]hile some data are unreliable, most are often not processed or analysed formanagement use84The Programme does produce annual Cash Plans/Work Plans, for the Ministry of Finance; however, these do not requirereporting against the range of KPIs.68