LHW Systems Review - Oxford Policy Management

Management information systemand the PPIU and the FPIU (albeit more on a biannual than a quarterly basis), theProgramme Review Committee did not meet during the period 2003–08.There is no audit of the MIS data provided to measure KPIs. Audit is purely financial, notsystem or performance oriented. The main performance indicator that is required to bereported on externally is the number of working LHWs. The quarterly review by the PlanningCommission, as a part of the Public Sector Development (PSDP) and the MoH quarterlyreview, reportedly, focuses on only a few indicators.Operational decision-makingFor Programme management at the district and provincial levels, managers appear morereliant on the reporting of exceptions from the field (by FPOs, LHSs, and their own staff)when facing management challenges. Given that the main purpose of the ImplementationUnits is operational, the main information that they find useful is information on operationalproblems. It is the day-to-day challenges that take up management attention.Accuracy, timeliness and relevance of informationThe lack of an external evaluation in 2005, and the mini-surveys, presented a drawback tothe MIS, which is dependent on external verification of indicators (see Annex C). Thisimpacted on the Programme having accurate, timely, and relevant information to supportstrategic planning and policy decisions.A substantial amount of information is collected by the Programme’s internal MIS. Thecollection of this information also demands considerable effort by the LHWs and theirsupervisors. However, there are still some gaps. The evaluation team had to calculate thenumber of LHWs recruited annually over this period indirectly. This was surprising, given thatthis is a key cost driver.Compliance with on submitting the regular monthly reports is monitored at the provincial andfederal levels at regular meetings (e.g. the provincial quarterly meetings with DCs, and themonthly meeting at the PPIU of the FPOs). The data for entry into the PSP begins with themonthly reports of the LHWs and LHSs. The Quantitative Survey results show that there hasbeen a significant increase in the percentage of LHWs and LHSs who could show theirmonthly work-plans and their monthly reports (Table 10.1).The health facility staff members are supposed to prepare the MIS report at the healthfacility. The survey shows that almost 60 percent of LHSs are now undertaking this task.This does not necessarily mean that facility management is not interested in LHW serviceprovision. However, there is a risk that this could indicate a lack of engagement.69