By Dr. Malatesh Undi

Posted on : August 31, 2016

Karnataka, the eighth largest state in India in terms of total geographical area and ninth largest in terms of population has one agency for the collection of data related to health, morbidity, mortality and family welfare. The Directorate of Health and Family Welfare services collects major data on above mentioned subjects. Health Management Information System (HMIS) remains the major health related data collection system in Karnataka. Others include Integrated Child Development Services (ICDS) Scheme and Integrated Disease Surveillance Project (IDSP).

In Karnataka, there is a system in place to collect exhaustive data. There are around 370 major parameters collected. Also, functional web portals (HMIS, IDSP, etc.) with provision of computer, internet, data operator and other resources for digitalisation of data in all districts. There is availability of telemedicine facility at selected centres as well.

But the most commendable feature remains the real time monitoring, weekly reporting system in IDSP with inbuilt early warning system.

But when we talk about data in a country like India and specifically in a progressive state like Karnataka, we cannot leave the focus without highlighting the fact there is a lot of missing data, high degree of non-response and incompleteness in filling up the reporting formats further compounded by near total absence of data by the private sector which accounts for a considerable share (>40%) of the health services.

Another issue which adds to the problem is lack of authenticity, the compilation up to PHC level is manual and subsequently it is on web portal. The accuracy and reliability are affected by non-response, delayed response, manual transmission of data and absence of fast validation checks among other reasons. 

If examined in detail, there is a major problem of duplication of data collection by field workers. There may be a considerable overlap of data collection, lack of supportive supervision, overburdened grass root level workers, digital illiteracy of health workers, lack of stable technology and internet access adds more to the issue.

Shortage, high dropouts and turnover of frontline workers, shortage of specialists is leading to poor supervision of data collection. The strategic posts to ensure quality of data are vacant in many places or occupied by clinical specialists who are less interested in data management and do not realise the intricacies of public health data management and compromising with the quality and quantity of health data.

Also absence of single window system and non-disclosure of meta data of most of the programmes questions the reliability and usefulness of data obtained in the state except for utilisation for framing PIP and fund allocation. The other two important stakeholders of data viz., public and researcher/academicians are kept at bay.

Data is meaningless without transforming it into information and intelligence! The GIGO (garbage in garbage out) principle applies to health information too. Hence, the collected data before analysing and using, has to be scrutinised for its adequacy, completeness, timeliness, validity and reliability by designated qualified persons.

On average, the state is producing 90 MD Community Medicine specialists every year, which if utilised judiciously by creating public health cadre with decent compensation shall be a great asset and immensely improve health data utilisation. Thus, data capture in Karnataka has many strengths as well as flaws. The health department shall use the existing opportunities in the state keeping in mind the threats. 

The state is performing better in many health related indicators than the national values, however much needs to be done to overcome the weakness in the system by early establishment of a public health cadre and accelerate the progress in order to meet the sustainable development goals by 2030.

 Dr. Malatesh Undi is Karnataka State Surveillance Team member for  HIV Sentinel Surveillance(2015), Assistant Professor, Dept. of Community Medicine, SSIMS & RC, Davangere, Karnataka, India.