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Assessment of Management Information Systems in Health for Stillbirths in Pakistan (AIMS II)

This research titled, ‘Understanding and Assessing Information systems in Health in relation to Stillbirths,” focused on assessing the provisions, accuracy and utilization of existing information systems for stillbirth reporting, consolidation of information (number and causes of stillbirth), tracking, analysis and planning. Recording in DHIS and LHW-MIS was carried out. The study aimed to not just provide preliminary insights but to identify gaps and suggest recommendations for the improvement of stillbirth reporting, tracking and planning in Health Information Systems.

Study specific structured and semi-structured pre-tested tools were employed for data collection across the selected provinces and districts. The extensive study was completed with the support of provincial authorities which gave access to their districts health departments for in depth data collection.Detailed research report with technical oversight of renowned researcher Dr. Zulfiqar Bhutta was generated, designed and printed.

A national seminar took place in September 2014 where findings of the research and policy recommendations were shared with key stakeholders and health department personnel at district, provincial and national level, for policy change & DHIS improvement.

Objectives

  • Identify the provisions for recording stillbirths in information and management systems;
  • Assess the existing practices of the personnel responsible to collect information; are recording protocols/instructions for stillbirths being followed where provided for in the recording system?
  • Assess the health care provider's capacity and perspectives about stillbirths in relation to the information system & its utilization;
  • Assess the perspectives of community based informal service providers (Dai's and TBAs) on still births, importance of reporting and how information can be incorporated into the public information system?
  • Assess factors (social norms) supporting/ preventing identification of different types of still birth.
  • Describe the process of still birth reporting with reference to information flow, reporting and accuracy;
  • Describe the utilization of information on stillbirths at various levels of the health sector for decision making and incorporation into the health policy;
  • Compare the DHIS, and LHW-MIS with the Vital registration systems at the sub-district level for stillbirths recording and statistics
  • Explore women’s perspectives and opinions about reporting of stillbirth and its causes in existing public sector healthcare mechanisms.
  • Synthesize available information to understand the local terminology used for still birth by mothers and health providers
  • Evaluate the level of evidence of circumstances influencing/ contributing to still birth, elucidate the stigmas associated with still births

Outcomes

  • The primary outcome of this study was that an assessment of the provisions, accuracy and utilization of stillbirths’ reporting and recording in DHIS and LHW-MIS across four districts in two provinces of Pakistan was carried out.
  • The findings provided an understanding of healthcare providers’ participation and engagement in reporting stillbirths with the barriers faced in reporting such as adverse pregnancy outcomes; ability of the system to report, analyse and utilize stillbirth data; resultant generation of evidence.
  • Subsequent policy interventions were suggested to address the issue of stillbirths - reporting & information utilization in Pakistan.

Time frame: May 2013 – Sept 2014

Location: KPK: District Mardan & Nowshera - Sindh: District Tando Allah Yar & Thatta

Donor: Research and Advocacy Fund (RAF)

Budget: 25,062,835(PKR)

Cost: 24,615,043 (PKR)

Implementing Partner: None

Beneficiaries: 1000