PESHAWAR, Jan 19: Shortage of funds and staff and widespread mismanagement have affected the performance of the Health Management Information System, officials told Dawn on Wednesday.

The system was launched in 1993 with the financial assistance of the USAID and Unicef to collect demographic data regarding 18 diseases, enabling the government to effectively cope with the situation.

Initially, the HMIS worked under the director-general health services and established branches in all 24 districts of the province. It had a smooth sailing, but suffered a setback in 1996 when both the donors stopped releasing funds and its activities came to a standstill.

It was, however, re-launched and funded by the Women Health Project (WHP) in 1999. Later, some funds were also arranged from the Social Action Programme during the same year.

During 2002, the Health Management Information System reported about 3.5 million cases of various diseases, including 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, the HMIS reported about 3.2million cases of 18 diseases in the year 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 and 80 per cent of the patients visit private care hospitals.

Furthermore, the Health Management Information System's report also 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.

He said owing to inadequate staff and lack of funds, it was impossible for the health personnel to prepare correct data. An official said the HMIS was provided with computers but they were not networked and plans to link them through internet were not materialised.

Another doctor told Dawn that the amount allocated by the Women Health Project (about Rs5.5 million) was too little to meet the 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 up a proforma at the end of every month and send it to the health department just because the director-general health pressured them to file these reports.

Another doctor contacted by Dawn said the HMIS conducted 80 workshops, imparting training to about 35,000 health professionals despite its being without any kind of printed material and investigative instruments since 1999.

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 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.