Global EDS information support for local MCHC activity with emphasis on immunisation and evaluation

Abstract: This research, in the field of Medical Informatics within a defined sector of Primary Health Care services, namely, Maternal and Child Health Care (MCHC) is a realisation, implementation and evaluation of the WHO motto "Think globally, act locally". It has been conducted in three distinct phases. The first phase involved the design and development of an application software in the MCHC domain, The applicable Essential Data Set (EDS) was established after an analysis of the literature and Indian and the Swedish Maternal Health records (I), which also showed deficiencies in the existing documentation, pointing at a general need in both external audit and internal quality improvement for the MCHC application software (II). The MCHC software was developed and tested for microcomputer implementation, suitable for peripheral use in developing countries (Ill). The second phase comprised of the pilot implementation of the system at a number of sites in India and in particular at Bhorugram, a village in the Thar desert of Rajas than State of India (IV), where the application software was permanently installed and tested for clinical use (V). Cost-effectiveness of the information system is demonstrated through an economic evaluation of the project using a local quality indicator comprised by the immunisation subprogram, in particular the Fully Immunised Child (FIC) (VI). The third phase of the study was the performance evaluation of the information system after four years of constant use (VII). This had been successful in all operational terms, and the F1C index could be used as a local cardinal index to monitor and evaluate the quality of care, cost-effectiveness and community participation of the Information system, MCHS. Health Systems and Health Economy Research alike have long searched for apt quality and performance markers that in themselves could embrace and express a number of aspects and factors. The FIC index isshown to well meet the criteria of such a cardinal measure in the MCHC services, and the inferences to the value of the information system are comparatively straightforward. Participation and compliance improved asreflected in a markedly decreased drop-out frequency. These results could be extrapolated to the larger, even the global, scale.