PESHAWAR, Jan 8: Health officials have said that an information system developed for health management in the province has been hampered by fund and staff shortages as well as widespread mismanagement. Launched in 1993 by the provincial health department with the financial assistance of USAID and Unicef, the information system was designed to collect demographic data about 18 diseases and help the government to effectively deal with the health challenges.
Last year the Health Management Information System reported that some 3 million people were afflicted with such diseases, according to an official.
However, the official said, it had now become practically impossible for health workers to collect accurate data due to inadequate staff and lack of funds.
He said that although the HMIS was provided with computers, networking was still not possible and plans to link the computers with the World Wide Web had not materialised yet.
Another doctor told Dawn that the amount allocated by the women’s health project (about Rs5.5 million) was too meagre even for day-to-day expenses. Most of its staff working in different areas of the province do not maintain a register and lack a basic monitoring system for conducting surveys.
They just fill out a pro forma at the end of every month and send it to the health department just because the director-general of health pressured them to file these reports.
A doctor contacted by Dawn said that the HMIS had conducted 80 workshops and imparted training to about 35,000 health professionals even though it had neither printed material nor investigative instruments for the past six years.
Criticising the lack of proper data regarding the prevalence of various diseases, doctors said the data presented in this regard by the health department and the NGOs was not authentic.
The Health Management Information System is now looked after by an assistant director, who is allegedly preoccupied with other responsibilities and has little time for its affairs.
There are only two clerks who are supposed to receive data from various regions and prepare a report. Both of them are also required to look after other matters at the directorate of health.
A health official said the HMIS had played an important role in devising strategies for tackling public health issues, but the government was preoccupied with other matters and this important section has been put at the back-burner.
Initially, the system worked under the director-general health services and established branches in all 24 districts of the province. It worked fairly smoothly until 1996 when both the donors stopped releasing funds and its activities came to a standstill.
“This often happens with a donor-funded project. The donor provides funding for a few years and then suddenly stops financial assistance that results in the closure of project,” said a health official.
It was, however, relaunched and funded by the women’s health project (WHP) in 1999. Later, some funds were also arranged from the social action programme during the same year.
In 2002, the HMIS report said that there were about 3.5 million cases of diarrhoea, dysentery, acute respiratory infection, malaria, cough, suspected cholera, measles, diphtheria, whooping cough, goitre and suspected HIV/AIDS, in areas which included Malakand, Dera Ismail Khan, Peshawar, Mardan, Kohat and Hazara divisions.
Likewise, it reported about 3.2million cases in 2003. These cases were reported only from the rural heath centres and basic health units, where, according to Unicef, only 20 per cent people go for treatment. Eighty per cent of patients still visit private hospitals.
Furthermore, the HMIS report does not include the number of patients, treated at the DHQs and tertiary care hospitals. “The HMIS is important for collecting authentic data regarding the prevalence of diseases and to devise ways and means to save people from them,” said a doctor.
