End-of-month (EOM) reports, prepared by the field workers of Directorate General of Family Planning (DGFP), are an important source of national routine data. The reports summarize all the activities carried out by field workers in the previous month and bring out the overall health and family planning situation in their catchment areas.
The DGFP has been implementing the eMIS since 2015 which is now available in 32 districts. eMIS is an ecosystem of mobile apps and web-based applications linked to a cloud-based environment. Within eMIS, FWA eRegister has been developed for Family Welfare Assistants (FWA) and FPI eSupervision System for Family Planning Inspectors (FPI), who supervise FWAs. These are mHealth apps that run both online and offline and allow the users to conduct all their activities digitally using handheld Tablets. These tools are linked or fully integrated with each other.
The FWA eRegister is a digital innovation that is fully based on the FWA Register (paper-based) and other approved documents of DGFP (such as monthly MIS reports and monthly advance workplan) that the FWAs use. The FPI eSupervision System similarly is based on the workflow of FPIs. Both type of users uses these apps for submission of EOM reports. Currently, 6,251 FWAs are using FWA eRegister and 1,557 FPIs FPI eSupervision System. They are generating monthly MIS reports, known as MIS1 and MIS2, using their apps. The FPIs review MIS1 and afterwards combine all the MIS1 reports to prepare their MIS2 reports specific to the union. We reviewed the submission status of the reports and also tried to find out the level of acceptance of the apps together with the reasons from users at different levels.
The digital copy (accessed via webpage) of MIS1 is an exact replica of paper form, which the users could easily understand and identify.
The following image shows the submission status of MIS 1 in Mirzapur upazila of Tangail (August 2020):
The following image shows the submission status of MIS 2 in Mirzapur upazila of Tangail (August 2020):
The following image show the submission status of MIS 1 all over the district of Tangail (August 2020). The managers and supervisors can use this web-based tool (with access control) to identify the status of submission. They are able to drill down to the individual users as personal details with phone numbers are given in the list (personal details, such as names and phone numbers have been erased in the image).
Observation by an FWA
For the FWAs, compared to paper-based systems, there are obvious benefits in preparing MIS1 through eRegister.
How the FPIs see it
An FPIs also testified about the benefits and observed that additionally, accountability mechanisms are a built-in feature of the app.
Views of sub-district managers
The upazila (sub-district) managers explained benefits in multiple ways. For example, one saw improvement in timely and effortless submission.
Another explained how the need for prior preparatory meetings were eliminated:
Managerial and logistics angles were highlighted by one respondent.
The eMIS apps are brining many types of benefits to the end-users, managers and decision-makers. The quality of EOM reports increased on every count. Reports could be submitted in time, those are free of errors and generated effortlessly. It has eliminated some processes used for preparing reports. Overall benefits in terms of saving time and money have also been reported. The managers now have additional tools to supervise and monitor their field workforce. Report data are stored in databases chronologically and have potential for further analysis beyond current use.
Kazi Md. Obaydul Haq, Health Systems Manager, icddr,b conducted the interviews.