If you are looking for MDV-115 IGNOU Solved Assignment solution for the subject Health and Development, you have come to the right place. MDV-115 solution on this page applies to 2021-22 session students studying in MADVS, MACSR courses of IGNOU.
MDV-115 Solved Assignment Solution by Gyaniversity
Assignment Code: MDV-115/TMA/2021-22
Course Code: MDV-115
Assignment Name: Health and Development
Year: 2021-2022
Verification Status: Verified by Professor
Marks: 100
Q1) Explain the traditional Indian healing system of Ayurveda and its contemporary relevance
Ans) Since the dawn of civilisation, India's traditional medicine and health-care system has evolved through numerous periods, and even predates the birth of Christ. The Vedas, particularly Atharveda, are the foundations of Indian medicine. This health-care system has existed for the treatment of ailments as well as disease prevention. From ancient times, Ayurveda, Yoga, and Naturopathy evolved and were practised. During the mediaeval period, Muslim monarchs brought Unani health treatment to India, while European conquerors brought homoeopathy. We shall look at three alternative health systems that began and grew up in this subcontinent: Ayurveda, Naturopathy, and Siddha.
Ayurveda is a well-known traditional Indian medicinal system that is still practised today. Charak (physician), Sushrata (surgeon), Atreya, and Jivak are all well-known contributors to traditional Indian health knowledge. This Ayurveda system explains ancient notions about the human body, aetiology, symptomology, and treatments for a variety of illnesses. It also has sections on the importance of food, hygiene, prevention, medical education, and the physician-nurse-patient teamwork required for rehabilitation. All of this traditional medical knowledge was passed down and added to with each generation. These specialists wrote two monumental volumes, the Charaka Samhita and the Susrut Samhita. The Ayurvedic system is founded on the kapha, vaat, and pitta tri-dosh (three balancing signs). Any disruption in these three equilibriums resulted in disease and chaos in the health system.
Second, Yoga and Naturopathy are the most popular health-care systems in India, with roots dating back to ancient times. It is a health-care system that ties together physical, mental, and spiritual well-being. It encompasses both disease-curing and disease-prevention measures. Yama (abstentions), Niyama (observances), Asana (seating position), Pranayama (breath exercises), Pratyahara (abstraction), Dharana (concentration), Dhyana (meditation), and Samadhi are the eight components according to Patanjali (liberation). Each stage is a separate process that leads to liberty. People are becoming more interested in yoga and naturopathy as psychiatric illnesses, lifestyle diseases, and non-communicable diseases become more prevalent. The negative impacts of the allopathic system have also increased its popularity around the world, with the United Nations commemorating International Yoga Day on May 19th.
Siddha medicine is a historic alternative medical system that originated in Tamil culture (South India and Sri Lanka). This information was passed down to the next generation by Agastyar and siddhars, who practised this technique of medicine and served as spiritual teachers. Siddhar is endowed with ashta sidhis (eight supernatural abilities), which he uses to diagnose and treat health issues. Apart from these, external rulers/colonizers contributed knowledge of the health system from Arab culture, Central Asia, and Europe, which was assimilated into the Indian health care system. Yunani and Homeopathy are two well-known alternative health-care systems that are quite popular in India. Yunani is a Perso-Arabic medical system founded on the Greek physicians Hippocrates and Galen. Mughals and Muslims from south and central Asia primarily practised it. When compared to the tri-dosh of Ayurveda, this system follows four essential principles called four humours: phlegm (balgham), blood (dam), yellow bile (cafrâ), and black bile (saudâ'). Other influences of Chinese traditional health system are also present.
Homeopathy is another alternative medicine technique that originated outside of India and was imported to India during the British colonial period. Samuel Hahnemann developed this healing approach in 1796 based on the premise of 'like cures like.' He looked into the causes of disease in a phenomenon known as miasm. Apart from these, there are less well-known therapeutic methods such as 'Sowa-Rigpa,' which is Tibetan traditional medicine mostly practised in the Himalayan region. In India, Sikkim, Arunachal Pradesh, Darjeeling (West Bengal), Dharamsala, Lahaul and Spiti, and Ladakh use this system extensively. In India, the traditional alternative health system arose from the use of locally available natural resources to meet health requirements. Since 1995, these traditional health systems have been grouped under the department of AYUSH (Ayurveda, Yoga & Naturopathy, Unani, Siddha, and Homeopathy), which now has a ministry of AYUSH with increased budgetary allocation and a strong focus on education and research.
Q2) Analyse major determinants for health linkages with development.
Ans) On the one hand, health has an impact on development, while the level of sustainable development dictates the level of health in every society or region. It covers health-care facilities, infrastructure, and people's health-education levels. As previously stated, health is not solely a consequence of biological elements, but also encompasses a wide range of socio-cultural factors. As a result, there are numerous elements that are linked to individual and community health. Here, we'll look at six significant health determinants: economic, social, political, psychological, and environmental factors, all of which influence not only health but also the total growth of society.
Economic Factor
Income and wealth are the foundations of each household's and country's economic standing. The purchasing power of health care is determined by an individual's or a group's economic standing. Economic standing determines your ability to meet basic requirements such as food, shelter, housing, health care, and education. The last two were added later, but they are highly significant needs that are dependent on purchasing power potential. High-income countries, such as the United States, South Korea, and European countries, have higher purchasing power and better health facilities, but low-income countries, such as Sierra Leone, Kenya, and other underdeveloped regions, have poor health indices.
Poverty is a major contributor to and result of poor health. As Kofi Annan, Secretary General of the United Nations, puts it, "the main opponent of health care in the developing world is poverty." Poverty causes bad health due to a lack of clean water, inadequate sanitation, inadequate shelter, and environmental factors. The Millennium Development Goals place a strong emphasis on health.
Social Factor
The creation of health conditions and behaviour is influenced by society and culture. It has been found that in the absence of social considerations, health programmes and planning frequently fail. It is a well-known reality that each community has its own set of beliefs and behaviours when it comes to human health, both normal and ill. The distinction between illness and sickness is made clear by social variables; disease is determined by community conduct or social perceptions of health problems, whereas sickness is determined by community behaviour or social perceptions of health problems. Diseases as defined by biomedicine are not always validated and accepted by local culture and community. Some infectious diseases, such as Ascariasis in many parts of Africa and Schistosomiasis in Egypt, were once regarded typical health conditions by society and culture. The concept of health is also governed by these factors, which are considered as god's act of faith and magic in society, such as smallpox and chickenpox, which are visualised as god's curse.
Talcott Parsons (1948), an American sociologist, coined the term "sick role" to describe health-related social behaviour. These social behaviours indicate not only normal and abnormal health disorders, but also their symptoms, treatments, and socio-cultural circumstances of sick people. As a result, the sick person has been assigned a position and a status in the family, community, and society. It is not true that all cultures are the same; rather, they may differ from one community to the next. As a result, any society's culture, customs, and beliefs play a vital influence in shaping people's perceptions of health and illness. Gender is another essential aspect of health-related social behaviour. It is a sociological rather than a biological construct that determines a woman's function and status in society. Gender inequality is a widespread issue in many parts of the world. Gender hierarchy behaviour in society will reflect in people's health perceptions and treatment processes.
Psychological Factor
Depression, anxiety, and psychiatric illnesses were caused by the shifting social network and societal structure. The influence of industrialization and urbanisation changed the joint family system and loosened emotion support in agrarian-based societies, whereas the influence of industrialization and urbanisation changed the nuclear family system and loosened emotion support. Isolation resulted in a variety of mental and neuropsychiatric illnesses, including schizophrenia, epilepsy, substance misuse, multiple sclerosis, cerebral palsy, dementia, migraines, bipolar disorder, and other forms of mental impairment. It's remarkable that wealthy countries are more affected by this health problem than developing and poor countries. According to the WHO, America has a higher frequency of psychiatric diseases, with Japan having the highest prevalence of schizophrenia.
The World Health Organization is now conducting a global survey based on ICD and DSM criteria in 26 countries around the globe. Anxiety and mood disorders were found to be the most common in most countries, whereas substance abuse and impulse control disorders were generally less common but growing dangers. Furthermore, it was discovered that the United States, Colombia, the Netherlands, and Ukraine had greater prevalence estimates across most types of illness, whereas Nigeria, Shanghai, and Italy had consistently low prevalence, and Asian countries in general had lower prevalence. Obsessive-compulsive disorder is two to three times as common in Latin America, Africa, and Europe as it is in Asia and Oceania, according to the WHO, and bipolar disorder and panic disorder have similar prevalence all over the world. However, due to poor diagnosis (particularly in countries with limited access to mental health professionals) and low reporting rates (due to the prevalence of self-report data), these are widely thought to be underestimates. Due to psychological factors, all of the aforementioned health issues are leading to an increase in suicide, violence, and other problems.
Political Factor
Health inequity has been documented around the world and within countries as a result of political decisions, laws, and practises in health care. Here, health has become a commodity available on the open market based on an individual's purchasing capacity. The reasons of health disparity were considered as power imbalance and unequal economic distribution around the world. As a result, the political component deals with global / national governance and its impact on health disparity, which is a result of weak governance, rising illegal migration, and glaring socio-economic disparities. It also highlights a fundamental inconsistency between political commitment to universal health care and its inadequate role in public health care.
Government agencies, business agencies, civil society health institutions, and others now deliver diverse health services without effective inter-sectoral coordination under current global health governance. As a result, power and socioeconomic disparity perpetuated health care, policy, and other basic requirements. However, BRICS (Brazil, Russia, India, China, and South Africa) and MIKT (Mexico, Indonesia, South Korea, and Turkey) rising economies are asserting their involvement in UN agencies and other international venues for climate, trade, security, and health issues. This served as a pressure group for these global concerns, and international organisations should take an active part in addressing the problem.
According to the World Health Organization (WHO), a significant proportion of people in developing countries still do not have access to basic health care. Poor governance and poverty are two main bottlenecks in these developing countries. As previously stated, good income and wealth play a major role in purchasing health services, and developed countries spend a higher share of GDP on health, both individual and government, whereas less developed countries' health spending is very low, including India. It has also been observed that civil society and marginalised groups participate more actively in decision-making processes globally.
Transparency in governance, flexibility in health institutions, effective health policy, and international institutions for standards and recommendations can all help to safeguard and promote health. Health should be regarded as a universal requirement, regardless of economic disparities or political systems, as a worldwide responsibility by the global community.
Environmental Factor
Our ancient civilizations sprang up near rivers and had other favourable physical conditions. The understanding of the environment and its value for life and health can be found in early texts. The Vedas are a part of the Indus Valley culture. Hippocrates (about 400 BC), a Greek physician, highlighted environmental, nutritional, behavioural, and other elements of health. Even today, doctors take an oath known as the 'Hippocrates Oath.' It has been worshipped and regarded a god because of the importance of the environment.
The environment relates to the human and earth's surroundings, which includes animals, vegetation, air, water, and land. Apart from the physical components, social components are also regarded to be a part of the environment. Any alteration in these ecological components has a direct impact on the others. With the advancement of technology, these balances have interfered with or disrupted the ecosystem's equilibrium, resulting in a slew of health issues, particularly noncommunicable diseases. The changes in life have resulted in an increase in lifestyle diseases. The impact of humans on the environment and vice versa is recognised by modern environmental health experts. They also look at changes in air quality, water quality, food safety, solid waste management, radiation safety, noise safety, and housing, as well as their effects on organisms. Emerging changes in organisms and genetic modifications have been observed, and future implications must be understood and explored.
Cleanliness has always been emphasised by health scientists as crucial as religion. However, it has paid the least attention to health education, government programmes, and health policies. This is also an important factor in terms of health and the environment. Many places of the world are unable to overcome open defecation, clean drinkable water, solid waste management, liquid waste management, industrial pollution, and effective sewage. These are the fundamental requirements that can be met with the smallest amount of resources, competent governance, and citizen participation. We can easily overcome this initial lack of cleanliness and manage the ongoing threat of communicable diseases and seasonal viral infections such as dengue, chikungunya, and malaria.
Other Factors
Aside from the aforementioned issues, other factors such as shifting livelihood conditions, eating habits, and occupational changes have resulted in livelihood disease and occupational hazards. Technology advancements, industrialisation, migration, urbanisation, and the recent internet revolution have all aided these goals. All of these changes reduced human physical activity and altered lifestyles, resulting in the emergence of lifestyle diseases such as cardiovascular disease, sense organ dysfunction, and other health issues. Dietary habits shifted away from grains and toward processed foods, high-carbohydrate foods, and unsaturated fats, reducing fresh and traditional healthy food habits. According to studies, human grain consumption is declining due to an increase in processed food consumption. Drug addiction, smoking, and drinking are all habits that contribute to health problems in people's lives.
Similarly, occupational dangers are on the rise as a result of a lack of workplace safety measures and increased job pressure. Occupational disease was caused by changes in occupation, mobility, stress, and other variables.
Q3) What is a venereal disease? Describe its various forms and major health problem in reproductive health care in India.
Ans) The word venereal comes from the Latin word venereus, which means "to engage in sexual intercourse or desire," and is derived from Venus, the Roman goddess of love. In the past, sexually transmitted infections (STIs) have been referred to as "blood illnesses" and "social diseases."
Reproductive Tract Infection (RTI)
Infections of the reproductive tract, which is a portion of the reproductive system, are known as Reproductive Tract Infections (RTI). Reproductive tract infections in females can affect the upper reproductive system, which includes the fallopian tubes, ovary, and uterus, as well as the lower reproductive tract, which includes the vagina, cervix, and vulva. Severe menstrual cramping, also known as dysmenorrhoea, is the most frequent reproductive system condition that occurs during a woman's monthly menstrual period. Severe discomfort before or during the period can last anywhere from one to seven days, interrupting women's typical daily routines at school, work, and at home. Medications that prevent the effects of prostaglandins, such as ibuprofen and naproxen, are the best treatments.
By reducing blood flow, the birth control pill is also effective in treating dysmenorrhoea. A vaginal yeast infection, which is caused by a yeast fungus in the vagina, is another common female reproductive system condition. Such an infection can be caused by any disease contracted and transferred during or by sexual intercourse, caused by microorganisms that survive on the skin or mucus membranes, or transmitted by semen, vaginal secretions, or blood due to intercourse. The vaginal area, as medically understood, provides a safe, moist, warm environment that is highly conducive to the multiplication of bacteria, viruses, and yeast, among other things. This allows for the transmission of the most serious infections, such as AIDS and Chlamydia. Because of neglect and a lack of awareness, gonorrhoea and syphilis are the most frequent sexual diseases in India.
Venereal illnesses, which are often transmitted through sexual contact, can be controlled if antibiotics are administered promptly.
Common Venereal Diseases in India
Gonorrhoea: In India, this is a frequent bacterial infection. Gonorrhoea, sometimes known as 'the clap,' is a sexually transmitted infection spread by unprotected oral, anal, or vaginal sex. Neisseria Gonorrhoea is a gram-negative intracellular diplococcus that causes this disease.
Chlamydia: Chlamydia is a sexually transmitted disease (STD) that affects both the female cervix and the male penile urethra. When a person experiences pain during sexual activity, as well as discharge from the vaginal or penis, they are at risk. It is, however, an asymptomatic infection that can go undetected for weeks or even months. Latex condoms are recommended by some skilled personnel to avoid such diseases..
Syphilis:Â Syphilis has a reputation for being one of the most infamous STDs. It is caused by the spirochaete bacterium, which also causes syphilis, bejel, and yaws, and is exclusively transferred between people. If left untreated, this can lead to major consequences. Syphilis is spread through direct contact with syphilis sores, which can occur on the external genitals, the vaginal or rectum, and the mouth as a result of oral or vaginal sex. Because the sores are usually painless, it's difficult to discover and treat them early.
Mycoplasma Genitalium: The cervix, urethra, and rectum are all affected by this infection. Mycoplasma is transmitted during sex, whether your partner is of the same gender as you or not. The majority of those infected with mycoplasma show no signs or symptoms. This infection is becoming more widely recognised as a leading cause of cervicitis in women and non-gonococcal urethritis in males. This infection may also result in a long-term sickness of infertility due to pelvic inflammatory disease. In India, the disease is less common than in Western countries such as the United States.
Trichomoniasis:Â This condition is widely reported among women, however it is a treatable STD. Because of the typical symptoms, it is sometimes misdiagnosed as a yeast or bacterial infection.
Human Papilloma Virus (HPV): Before the HPV vaccination was developed and approved for use in June 2006, this disease was thought to be the most frequent infection. Although a few strains of HPV were found to cause the 'cervical cancer virus,' it was determined to be rare among sexually active partners. Vaccination is advised for men and women between the ages of 11 and 12. It protects against four different strains of the virus.
HIV/AIDS:Â The Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) is caused by a blood or body fluid infection that can only be transmitted by bodily fluids such as sperm, vaginal secretions, breast milk, and blood. As a result, it's linked to sexually transmitted infections (STIs) and reproductive health.
Crabs/Pubic Lice: The 'crabs,' which are a type of lice, live on the hair in the vaginal area as well as coarse-haired portions of the body (armpits, eyebrows). They can be transferred by infested linens and clothing, as well as sexual contact, although they are not the same as head lice.
Scabies is a parasitic disease produced by the sarcoptes scabie parasite, which causes itching and severe rashes. This is contagious and can be spread by skin-to-skin contact, sharing clothing, and other means. It is not always transmitted through sexual contact.
Herpes/HSV:Â It's a viral STD that causes cold sores and, in some cases, genital sores. Although there is no cure for this virus, antiviral medicines are used to lower the risk.
Hepatitis/HBV: Hepatitis viruses infect the liver in almost all cases; however hepatitis B and C can also be transferred sexually. Hepatitis B also causes cirrhosis of the liver and cancer of the liver.
Chancroid is a genital ulcer illness caused by the bacteria Haemophilus ducreyi, which is a major risk factor for HIV infection in underdeveloped nations. The ulcers caused by the chancroid are larger and more painful than those caused by syphilis.
Bacterial Vaginosis (BV): This is an ailment that occurs when beneficial bacteria in a woman's vaginal area are replaced by other species. This causes burning and itching around the vaginal area, as well as unwanted discharge. Infections like these can put a woman at risk for HIV, pelvic inflammatory disease, and premature birth. Antibiotics are the most effective therapy alternatives.
Non-gonococcal Urethritis (NGU): Any type of urethritis that is not caused by gonorrhoea is classified as NGU. Chlamydia and Mycoplasma Genitalium are the most prevalent culprits, both of which are linked to burning during urination and discharge in males. The majority of NGU cases, by the way, are asymptomatic.
Molluscum Contagiosum: A type of skin illness that affects young children and adults with weakened immune systems. Infections are spread by direct skin contact and even sexual interaction.
Lymphogranuloma Venereum (LGV): It's a sexually transmitted disease that usually affects guys who have intercourse with other men (MSM). It was just discovered in western Europe; however it does not affect the entire world's population. This infection can enhance the risk of HIV transmission and acquisition in people who are already infected.
Female Genital Mutilation (FGM)
The phrase "female genital mutilation" (FGM) is extensively used. Female genital circumcision (FGC) or female circumcision are other terms for it. FGM is the practise of removing a girl's or young woman's external genitalia for non-medical reasons. The external clitoral hod and clitoral glans, as well as the inner and outer labia and the closure of the vulva, are traditionally removed using a blade. This procedure is known medically as infibulations, and it involves keeping a tiny open for the flow of urine, menstrual fluid, and other reproductive functions.
Male Genital Disease (MGD)
Male reproductive systems include a number of sex organs located both outside and inside the pelvis. The penis, urethra, and scrotum are the external genitalia of a man, whereas the testis, epididymis, vas deferens, seminal vesicle, ejaculatory duct, bulbourethral gland, and prostate are the internal genitalia. A male genital disease is a disorder that affects the male reproductive system. Orchitis or testicular erosion are two examples. Blood in the sperm (hematospermia), blood in the urine (haematuria), acute discomfort, and enlargement of the testicles with visible nodes on afflicted areas/sides are the most typical symptoms.
Male Illnesses: There Are Several Types of Male Illnesses
Phimosis and paraphimosis are two different types of penile skin problems.
A common penile irritation is balanoposthitisis.
Hemospermia is a condition that occurs when blood enters the sperm.
Epididymitis occurs when the testis swells and aches as a result of everyday activities.
Another issue is hypospadias, which occurs when urine does not flow out of the exit organs.
The condition of cryptorchidism occurs when the testis does not descend to its appropriate location.
Male infertility is most commonly caused by varicocele.
Testicular Torsion is a life-threatening urological disease that requires immediate medical attention. When the spermatic cord twists and spins, blood flow to the testicles is increased. This causes excruciating pain and edoema.
The presence of fluid surrounding the testis is known as hydrocele.
Micropenis is a condition in which the penis is significantly smaller than it would be at that age.
The state of reproductive health is depicted in terms of many characteristics such as marriage, childbearing, childbirth, prenatal care, knowledge of reproductive tract infections, age at marriage, and so on.
Q4) Describe the important guidelines for successful Behavioural Change Communication (BCC).
Ans) A effective communication strategy is dependent on a number of elements that must be followed before the communication process can begin. The following are some of them:
Avoid Communication Under the Influence of Emotions: The efficiency of communication is influenced by one's emotional condition. Good communication will be difficult if either partner is in a heightened emotional state as a result of an occurrence. If someone is highly agitated, it is best not to try to interact with them since they need time to calm down before attempting to resolve the concerns. A few deep breaths with your eyes closed can help a lot. If someone is not in a good mood, postpone communication for the time being or avoid communication altogether.
Controlling Assumptions:Â Before talking, it's a good idea to double-check your assumptions. If one assumes that the other has good intentions, a conversation has a better chance of succeeding. Even if someone says something harmful to you, it's unlikely that it was their purpose to hurt you. Give the other person the benefit of the doubt and avoid making assumptions about their motives. People in general assume they know what others' goals are in the home and at work, and this biases them. By just using "I" messages, you may avoid making assumptions.
If we start by accusing, it's quite difficult to reconcile a conflict or soothe damaged sentiments. When we express our displeasure with something you did or said, we naturally put the other on the defensive. When allegations are flying, effective communication may be impossible. When you say "I," you're not referring to what the other person has done or said. You don't make any accusations or condemnations. You're only expressing your emotions. You're explaining how the other's words and/or actions affected you. You say things like, "I'm upset when..." or "I'm hurt when..." and so on. You're still letting them know you're hurt and unhappy, but this time you're talking about your feelings and how they've affected you rather than simply blaming or accusing.
Quality Listening/Listening with Full Concentration: One of the most powerful communication tools isn't really a communication instrument. It is paying attention. Many communication issues are exacerbated when we do not pay attention to what the other is saying. We are not truly listening to what they are saying if we are thinking about how we are going to respond to them while they are still speaking. We're merely attempting to respond appropriately.
Important information is lost due to a lack of quality listening. The communication link is skewed. Listening entails being psychologically present with the other individual. Listening intently is a sign of respect. Even though you are enraged with the other, you may show respect. Respectful listening can help both parties relax in a stressful circumstance. You are indicating that the connection is important to you and that you want to stay and work things out by being present. We must pay close attention. It's known as "active listening."
Interrupting someone during active listening can happen for two reasons. The first is to seek explanation. If you don't want to be misunderstood, you can politely request explanation. The purpose of the other reason for interrupting is the same. One can communicate with a brief note or by repeating anything back to the other to ensure that he understands completely. If you think you're bad at verbal communication when you're upset, you and the other person could agree to try to gather your thoughts and express your feelings about the situation in writing. It's possible that the other person will do the same. Then you meet together and read what each other has written, using it as a jumping off point for your continuous dialogue. The words have the ability to both harm and heal. Practicing using appropriate words in the right context might help you enhance your communication skills.
Use evidence-based communication: This guiding concept believes in truthful facts, numbers, and data to enhance communication. It never fosters conjecture or speculation. Individuals and other communication channels that provide factual facts and data and lucidly analyse the facts are trusted by people, particularly those with limited understanding in rural and urban slums.
Prioritising behaviours:Â Health and family welfare activists and communicators must prioritise communication themes based on their value when spreading health and family welfare messages.
Immunization of children and mothers, for example, takes precedence over components of family education. In other words, prioritising the supply of key services is more crucial.
Utilising technology for message dissemination: Today, a wide range of information technology platforms, including as the Internet, mobile apps, and social media, are being utilised to disseminate health and family welfare messages. Health communicators and educators must employ technology that is appropriate for the age group of their clients and the regions in which the messages are to be delivered. For example, rather than vaccines and family planning services, mobile apps and Facebook can be used to spread information about teen education.
Q5) Explain the concept and structure of Management Information System (MIS) for health.
Ans) This is a system for gathering, processing, analysing, and transmitting data that is needed for organising and operating health services, as well as for research and training. We'll go through four HMIS terms and what they mean. The term ‘system' refers to a group of components that operate together to achieve a common goal. 'Information System' refers to a system that supports decision-making at all levels of an organisation using data. The term "health information system" refers to a system that integrates data collecting, processing, reporting, and utilisation in order to improve health service efficacy and efficiency through better management at all levels of health care. As a result, a "health management information system" (HMIS) is an information system that is specifically designed to aid in the management and planning of health programmes rather than the delivery of care. All information systems, including HMIS, are based on the understanding of three fundamental concepts.
Data input, data management, and data output are the three categories. Data gathering and data verification are part of the data entry step. Data storage, data classification, data updating, and data computation are all part of the data management or processing phase. Finally, data retrieval and display are included in the data output step.
Structure of Management Information System for Health
The HMIS was launched in India in October 2008 to facilitate the entry of health data and its dissemination at various levels. For proper coordination and execution of information, the Indian management information system (MIS) for health is roughly categorised into three levels:
Central level: Three primary agencies deal with the health management information system at the federal level.
Central Bureau of Health Intelligence (CBHI):Â The Central Bureau of Health Intelligence is the health intelligence division of the Directorate General of Health Services (DGHS), which is part of the Ministry of Health and Family Planning (MoHFW) in New Delhi. The DGHS is a technical information repository for public health, medical education, and health care, and it coordinates health programme implementation with all states and UTs. It also addresses people's health concerns through its subordinate offices and institutes across the country.
Statistics Division in the Department of Health and Family Welfare: With a chief director and four joint directors, the division is well-staffed. It is divided into four sections: computer, demography, performance monitoring and assessment, and impact monitoring. Field evaluation unit and concurrent evaluation unit are two sub-units of the impact monitoring unit.
Sample Registration System (SRS):Â Every ten years, India undertakes census activities. In the interim, vital statistics estimates are based on a system known as the Sample Registration System. The SRS is a large-scale demographic survey carried out in India to provide credible annual estimates of the birth rate, death rate, and other fertility and mortality indicators at the national and sub-national levels. A local part-time enumerator, usually a teacher, conducts a continuous enumeration of births and deaths, which is followed by an independent survey every six months by an official. These actions result in data that is matched. In the field, unmatched and partially matched events are validated, and an unduplicated count of births and deaths is acquired.
State Level Organisation: Typically, every state has distinct organisations in the form of directorates for elementary, secondary, and medical education. The directorates of family welfare and RCH are frequently separated. Some states have training and IEC directorates. Statistics sections are overseen by Deputy Directors or Joint Directors in each of these directorates. They, in turn, have computational units to assist them in data processing. Because the states are executing numerous national programmes and infrastructure development projects, each project will have a statistician or equivalent. Aside from them, vital statistics are normally kept in a separate section, which is also led by a joint director or so. The civil registration system is the primary focus of vital statistics departments.
Organisation at the District Level: An average district health system is led by a district medical and health officer, sometimes known as a chief medical officer. He is in charge of the district's health and family welfare. In some states, such as Andhra Pradesh, two functionaries operate in the district, one responsible for hospitals (District Coordinator Hospital Services) and the other for the PHC system and family welfare (District Medical Officer). Assistant or supplementary DMOs assist the DMO for many national programmes, including the Family Welfare Program, which is now RCH. Two statistical officers assist him, one for health and the other for family welfare. These statistical officers are critical members of the HMIS chain. The HMIS's continuation and sustainability is heavily reliant on their dedication, support, and skills.
Sub-Systems under the HMIS
Routine Service Reporting System: Hospitals and health centres (PHC and CHC) report on the morbidity and mortality cases they see on a monthly basis.
Epidemiological Surveillance System: This is used to find diseases, risk factors, investigations, follow-ups, and control measures, among other things. This sub-system currently includes programmes such as the Integrated Disease Surveillance Programme (IDSP), Polio Surveillance, HIV Surveillance, and others.
Specific Programme Reporting: On a monthly basis, various divisions under the MOHFW at the federal and state levels compile and report their accomplishments. The Revised National Tuberculosis Programme (RNTCP), the National Vector Borne Disease Control Programme (NVBDCP), the National Leprosy Eradication Programme (NLEP), the National Programme for Control of Blindness (NPCB), and so on are examples of these divisions.
Administrative Support System: The MIS is used for a variety of activities in health care settings. It contains, for example, an accounting and finance system, a drug procurement system, a storage and distribution system, and a people management system. Finance Management System (FMG) under the NRHM at the MOHFW in the Government of India is an example of a similar system in use at the national level.
Vital Statistics System: The Registrar General of the Ministry of Home Affairs is responsible for the implementation of the Registration of Births and Deaths Act, the census, and the Sample Registration System.
National Sample Surveys: This category includes the national family health survey (NFHS), district level household surveys (DLHS), and annual health surveys (AHS), among others.
Other Aspects of HMIS
This involves several aspects of report preparation, such as data collecting, analysis, and finalisation. It also includes quality considerations such as timeliness, completeness, correctness, data quality, and good presentation. You'll also learn how to avoid data entry errors and poor data quality.
Components of HMIS
Data reporting and data entry:- monthly / quarterly / annual
Data aggregation (consolidation) :- block level / DPMU level / state level
Data authorisation (check and verification) :- all the above levels
Converting data elements into indicators: - specific as per requirement
Report preparation / Decision making process:- all levels / highest level
Parameters for quality data
Completeness
Timeliness
Accuracy
Data entry errors
Systematic errors
Data completeness is assessed for the following:
Number of facilities reported against total facilities.
Number of data elements reported against total data elements in a reporting form.
Timeliness
Data processing and reporting in a timely manner allows for rapid data availability for decision-making.
Accuracy
The validity of data obtained in terms of actual quantity of services delivered or health events organised is referred to as accuracy.
During analyses and interpretation, inaccurate data will lead to wrong results. Because data from many providers/facilities is combined, little errors at the facility level will compound into larger errors.
Data entry error
Data entry errors could be due to:
Typing errors: wrong numbers typed in computer
Wrong box entry: data entered in wrong box e.g., ‘ANC registration’ data entered in ‘Registration in first trimester’.
Calculation errors: Basic computation takes place during data entering. Errors can occur if formulae are incorrect.
Data inaccuracy can be caused by a variety of factors, including a lack of understanding of data definitions and collection procedures, data recording and data entry problems, and misreporting.
Systemic errors: Because of the logical faults ingrained in the system, these problems will persist in the system unless the underlying systemic issues are addressed.
As a result, data quality refers to the goal of the measurement. It is not enough to gather and publish data; it must also be reviewed for quality to reduce errors and allow for decision-making. When evaluating data or reporting completeness, keep in mind that zeros and blanks must be carefully reviewed. Because reports reflect service delivery and utilisation, an incomplete report will reflect partial service delivery and utilisation. As a result, data assessment, reporting, and completeness play an important role in health MIS.
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