The Health Management Information System (HMIS) was designed to facilitate the monitoring and evaluation of the National Rural Health Mission (NRHM), which aims to improve health care delivery in India, and identify shortcomings. A study of the HMIS in the Udham Singh Nagar district in Uttarakhand, a state in northern India, finds that the coverage of the private sector is inadequate, the quality of the data reported poor, and monitoring non-existent and that, therefore, the HMIS serves limited purpose in policy making. The main reasons for this sorry situation are inadequate training and lack of accountability. The Training of Trainers (TOT) model that is currently followed should be abandoned, and competent resource persons should train Auxiliary Nurse Midwives (ANM) and Lady Health Visitors (LHV).
Training modules for Block Programme Managers (BPM) should be redesigned to detect errors in data and the possible reasons for such errors and for eliminating such errors. All facilities must maintain a copy of the data they submit to facilitate checking. External agencies (such as Population Research Centres) should supplement current monitoring efforts. An abridged HMIS format might help in ensuring the co-operation of private sector units, and such forms could be linked to prenatal diagnostic test forms that registered private facilities must submit.
