Adbul Kalam Azad.“Use of ICT to Monitor and Improve Women’s and Children’s Health in Bangladesh." (English) Presentations to the Second Stakeholders Meeting on Implementing the Recommendations of the Commission on Information and Accountability for Women's and Children's Health Ottawa. Session 1 - General Perspectives Plenary Panel 21-22 November 2011

1. Prof. Dr A. K. Azad
Additional Director General &
Director, Management Information System
Directorate General of Health Services
Ministry of Health & Family Welfare
21 November 2011

2. India
India
Myanmar
A small country Bay of Bengal
South-
in South-East Asia
•Land Area:
147,570 Indian Ocean
sq. km.
•Population:
~150
million
•Population
density:
964/sq.
km.

3. Achievement
•MDG4 – Well on track; UN
MDG4
MDG4 Award 2010
•MDG5 – On track; 2/3rds
MDG5
MMR Reduction from 1990
•eHealth - UN Digital Health
eHealth
for Digital Development
Award 2011 for contributing
to MDGs

4. We believed - ICT could help improve HIS for
measurement of health sector progress
But, we had resource constraints
So, we undertook a model of ICT deployment, that is:
◦ Simple
◦ Low cost
◦ Innovative &
◦ Locally appropriate
This presentation captures some of the glimpses

5. Super-specialized Hospitals
Tertiary Hospital /
Medical College Hospital
Internet
District Hospital / connected
Medical College Hospital April 2009
Sub-district Hospital
About 600
hospitals
About 19,000 Union Health Center (Day care) To be
day-care connected
facilities from this
Community Clinic (Day care)
About 100,000 Community Health Workers fiscal
health
workforce
Device: Wireless Internet – Edge Modem

6. We are using DHIS 2.0 - Open Source SW
Data entered at source
• Same platform for public & private;
• End users need no software ; Inherent interoperability;
• Data gathered quickly; Better quality; No need for compilation at any level

7. We can check
who sent data, who not

8. We can produce automatic report
Dash board

9. We can produce GIS map

10. By DHIS 2.0, currently we collect only aggregate data
But, we are moving to case by case data collection

11. Ambitious Program
Household Information
•House code: Division-District-
Unique ID Upazila-Union-Ward-Household
•Drinking water source
•Latrine
•Economic situation
•Important mobile phone numbers
(3)
Household Member(s) Information
•Serial No. & Name
•National ID
•Date of birth
Basic data set
•Sex
•Marital status 85% data
•Education collection
•Occupation completed
•Religion
Verbal
•Chronic disease
Autopsy •Date of death
•Cause of death

12. FY2011-2016
Population CIDA is a
data partner Health service
information
Cloud
National
Health worker
District
Community
Population data: new birth (live
or still), birth weight, maternal Clinic
death, other death, pregnancy,
ANC, NCD, Economic condition,
water source, latrine Union
Community health service:
domiciliary visits, medication,
Health
Sub-district immunization, Vit A cap, Facility
albendazole, ANC, PNC,
Newborn care

13. Supported by WHO & Health Metrics Network
A partnership of public-private-NGO-local organizations
Field implementation: March 2011

14. MOVE-
MOVE-IT: to capture data at point of contact or care
Data entry by
health personnel
at the facilities
Data maintained by MOH
Web-Based
Electronic System
Data entry by
health worker at
Bangladesh Bureau
the community
of Statistics
MOVE-IT
Electronic Health
Record

15. Our routine HIS is already providing lot of current
data
We adopted HMN Framework for HIS
We hope that our efforts will:
◦ minimize needs for health surveys
◦ provide information on all core elements almost real time
to support evidence based planning & decision
making

16. 1. An attempt of Prime Minister’s Office
2. Aims to harmonize & inter-operate data use &
services
3. One common Govt. authority will provide
o Unique ID
o Citizen’s Core Data Structure (13 fields textual)
o Biometrics (photo, finger prints (10), iris, face)
4. Service ministries will feed & use service data

17. e-
Conceptual framework of National e-Health Architecture
National Population
National Statistics Register
B Pregnant
B Director, Health MIS
S Mothers,
Ba Newborn
ng M
la d 0 Deaths
es M
hN H O
ati V
Op on E
Other
MoX en al e- IT
-
e-S Go Health
erv ver Systems
ice nan
NGOs s B ce
us Arc
hit
ec
Other Countries tur
e
Global Health IS
Standards by
Government

19. Mobile Phone Health Service Example-
Example-1
Easier for women to seek health care
for herself & children from home
Mobile phone given to
every district & sub-district
hospital
Total 482 hospitals
Women & people can call
24h/7days & get free
medical advice from on-
duty doctor
Watch video at
www.dghs.gov.bd>Video gallery

20. More doctors in work place: better health for women & children
The system uses:
Example-
Example-2
Watch video at www.dghs.gov.bd>Video gallery

21. Example-
Example-3 Tele-medicine
Telemedicine for rural people, women &
children (in 18,000 Community Clinics)

22. Pregnancy Care Advice by SMS
First Trimester
Send <LMP: ddmmyyyy>
<Mobile No.> <Name>
>
Instant
PPP
Voice
≥60 to ≤90
days
IVR
Second Trimester
Third Trimester
180
days
240
days
255 days
Example-
Example-4

23. Mobile phone in Bangladesh
Empowered women
Scaled up Internet
connectivity
We leveraged this opportunity
for improving health of
citizens.