The eMIS has come a long way since the beginning of 2015 when it was introduced in two upazilas of two districts of Bangladesh, namely Basail of Tangail and Madhabpur of Habiganj by the implementing partners (IPs) of USAID. The eMIS for Ministry of Health and Family Welfare (MOHFW) developed mHealth apps for community health and family planning workers, their supervisors and managers for use by community level workers or at first-line facilities. Based on the successful implementation, the tools were scaled up gradually in other districts and till May 2019, the system was operational in 24 districts.
The Directorate General of Family Planning (DGFP) under the MOHFW adopted a long-term view regarding digitization of the work of its field workforce. Scaling up eMIS tools in 2 divisions (Sylhet and Chattogram) consisting of 15 districts was included in the current sector program (4th HPNSP). There is provision for purchase of equipment and training in the budget. In June 2019, the DGFP, started implementation in two districts of Sylhet division – Sylhet and Sunamganj. Sylhet district is composed of 11, while Sunamganj of 4 upazilas (sub-districts). MaMoni MNCSP/Save the Children and MEASURE Evaluation/icddr,b had already covered or are going to cover some of the districts in these divisions. That would make it possible for the DGFP to select additional districts for expansion.
The users of eMIS
Key users of the community based systems are Family Welfare Assistants (FWA) and their supervisors – Family Welfare Inspectors (FPI). They need training before introduction and many users at different stages require some technical support for gaining proficiency in using the system.
Before implementation, training programs were conducted by managers, monitoring officers, developers of the IPs for community based systems (FWA eRegister and FPI eSupervision System). As national implementation would require, the DGFP personnel took over the responsibility of the training in Sylhet and Sunamganj.
During the pilot implementation, field supervisors employed by icddr,b assisted the field workforce in Tangail. Initially, one field supervisor in each upazila provided support to local level employees. However, their role was reduced as more districts were taken up for scale up. Later, the FPIs were trained on basic trouble shooting and they supported the FWAs well. They also gained through knowledge in the operation of all the apps, which helped to reduce the role of external support.
On way to create a resource pool
For managing implementation Sylhet and Sunamganj, a ToT was organized in Dhaka at icddr,b on 15 June 27, 2019 where Deputy Directors, Family Planning (district manager of DGFP), Assistant Director, Family planning (ADFP), UFPOs and FPIs participated. After the ToT, 8 out of 12 FPIs, who participated in the ToT were selected for conducting training in Sylhet and Sunamganj. These FPIs had first-hand knowledge of using or managing digital apps as they were selected from the districts where eMIS have been implemented. They support FWAs and the FWAs also consult them when required. This event also marked the beginning of the creation of a resource pool for the DGFP.
Conducting training in Sylhet and Sunamganj
Eventually, trainings for the FPIs and FWAs were organized in Sylhet and Sunamganj in the 2nd half of June. While the FPIs conducted the training, back up support was made available by managers and monitoring officers of the icddr,b. Training on FPI eSupervision System consisted of 2 days and that of FWA eRegister 5 days. Following training, the digital data continued to pour in the server.
Looking to the future
DGFP had taken many steps recently to internalize the eMIS and enhance their capacity. This experience would enable DGFP to manage the systems effectively in the long run. As such, this also clears the path for the sustainability of the eMIS.