The Technical Committee on eMIS implementation was constituted in the Directorate General of Family Planning (DGFP) on 20 February 2018 to oversee the scale up of eMIS all over the county. Before that, the DGFP headquarters reviewed the experience of eMIS pilot implementation in Tangail and Habiganj and received feedback from the field officials, users. DGFP has a long-term vision for digitizing the work of community and facility workers. They have included provisions for scaling of eMIS in 2 divisions namely Chattogram and Sylhet under the current sector program (4th Health, Population and Nutrition Sector Development Program or 4th HPNSP). In this background, the Technical Committee for eMIS Implementation (TC) was formed to oversee the scale up activities on 20 February 2018. Evidences following the formation of TC suggest that it was a well-conceived step of DGFP as the TC provided leadership, expanded the agenda for discussion and ensured smooth implementation. This also helped the implementing partners (IPs) to effectively coordinate with the headquarters as well as field officials.
Terms of Reference of the Committee
The terms of reference of the TC are set out as below:
- To oversee and monitor the eMIS implementation in the planned districts
- To provide directions to the local level officials for successful implementation of eMIS activities
- To take decisions to solve any issue related to eMIS implementation
- To coordinate with all stakeholders
The TC is required to keep the DG, DGFP informed about the progress of implementation. The TC includes program managers of different OPs/wings and also representatives of implementing partners of eMIS. The TC is required to hold meetings every three months, or if necessary, more frequently.
Frequencies of meetings
From April 2018 till January 2019, 3 meetings of the TC have been held. The 1st meeting took place on 17 April 2018. The Director (MIS), DGFP and Chairperson of the TC presided. Additionally, 2 implementation review meetings were also held with DG, DGFP in the chair, which provided guidance and directions on implementation issues.
Important Decisions by the TC
Some of the important decisions taken be the TC are elaborated below:
- Sustainability of eMIS: The implementing partners were requested to develop a strategy elaborating the implementation of eMIS in all the districts and identify the steps required to be taken for maintaining and sustaining the digital solutions from a longer term perspective. The IPs accordingly set out to prepare an Implementation Guideline based on their experience of implementing eMIS in different districts, which could be used by the DGFP in the new districts while scaling up.
- Capacity Development and HR Issues: With introduction of eMIS, the DGFP embarked on a transformation from manual to digital system. A key aspect of managing this transformation is to get the existing workforce ready to use the new systems based on information and communication technologies. Training is key input in such endeavor. The TC dwelt on HR issues and agreed to: (i) develop a small set up high level technical persons to manage its digital resources. (ii) to create master trainers at the central level based on which a Training of Trainers (ToT) was organized in October 2018; (iii) to create teams in the districts comprised of master trainers and trouble shooters, (iv) to establish HRIS- a ministry wide human resource information system (HRIS) early in the eMIS districts.
- Internet costs: At the pilot stage and later, the implementing partners provided internet connection to the users. The DGFP decided to provide for cost of internet expenses in the 1st TC meeting. Since January 2019, the DGFP is bearing the costs for internet.
- Selection of districts and UHFWCs: The TC discusses the implementation plan and approves the roll out in districts for community and facility systems.
- Data Center: Though the DGFP established a data center, there were limitations for using it for the eMIS. The eMIS partners suggested to utilize the data center of Bangladesh Computer Council (BCC), which is large government undertaking, to which the DGFP agreed. The eMIS facilitated on the technical aspects and a service level agreement has been signed between the DGFP and the BCC on use of BCC server for DGFP eMIS data.
- DHIS2 Implementation: The DGFP had committed itself to implement DHIS2 for aggregate reporting under the current sector program. The eMIS offered to assist the DHIS2 for transitioning to DHIS2 from existing Service Statistics – a web-based platform. Already, the system has been piloted Tangail and Cumilla. DHIS2 would be implemented countrywide. The eMIS partners facilitated the training. The UNFPA is also supporting the DGFP for training.
- Paperless transactions: The IPs proposed to DGFP to go entirely paperless in two upazilas in two districts where eRegisters have been introduced long ago in order to prepare for total elimination of paper registers eventually. Mirzapur and Habiganj were later selected and official order was issued.
- Software Modification: In January 2019 the DGFP introduced the 9th version of FWA Register with some changes. The FWA eRegister required modification to incorporate those changes. The 9th version of FWA Register was fully incorporated in the eRegister. Similarly, variables on autism were included following the requirements of the DGFP.
- Expansion on urban areas: The FP-FSD showed interest for using the eMIS tools in urban areas under NGOs. The tools, developed for rural areas and primarily for public sector workers, were modified. It is set to roll out soon in some areas of Sylhet City corporation.
- Tablet procurement and asset management policy: The quality of tablets matter, as those are used heavily by the users in the field. The eMIS suggested to ensure minimum quality while procuring tablets. An asset management policy for tablets was suggested for acquisition and replacement including creating a buffer stock.
Follow up mechanisms
The TC is required to inform the DG, DGFP on the progress of implementation. This was achieved through a follow up mechanism in the form of implementation review meetings chaired by the DG, DGFP. In the review meetings, the directors representing different wings remain present. Overall, the TC and the implementation review meeting had been very effective for a number of reasons:
- The DGFP assumed full control regarding the scale up and implementation through the TC.
- Secondly, some decisions of the TC required approval of DG, which were endorsed in the review meeting (otherwise additional steps would have been required).
- Thirdly, some of the decisions were contingent upon actions by other wings and presence of wing heads facilitated this process.
- Fourthly, awareness about the eMIS within DGFP increased due to larger group meetings and facilitated expansion of eMIS into urban areas as well as implementing DHIS2.
- Finally, it also manifested complete buy-in from the DGFP and expedited the process of carrying the eMIS forward.
The eMIS initiative was not considered as a one-off pilot implementation. It aimed to automate the business processes of community health and family planning workers. Developing a system wide digital solutions is not an easy task as it involves large number of workforce and remodeling of an entrenched bureaucratic system. The implementation of digital solutions was facilitated both by strong engagement and effective leadership of the DGFP at middle and senior management level and eagerness of the field workforce in using the digital solutions. The review mechanism also boosted compliance and ensured effective implementation.
DGFP notification regarding the formation of the committee can be accessed from here (in Bangla).
Minutes of the TC meetings can be accessed from here.
Please click here to access the minutes of the review meetings.