Evolution and Challenges of Public Health Data Systems for Family Planning Service Delivery in Punjab Province, Pakistan

An effective and responsive health system is based on timely decision making based on accurate and real time data. Strong health information systems are a pre-requisite for effective health system especially in the context of family planning service delivery. This opinion piece provides an overview of health data system fragmentation in Punjab specifically the ones related to family planning, including the District Health Information System (DHIS), Lady Health Workers-Management Information System (LHW–MIS), Contraceptive Logistic Management Information System (cLMIS), Electronic Medical Records (EMR), and the Hospital Management Information System (HMIS). While each system is well intended to serve a particular purpose, however, their lack of compatibility and integration has created data silos and redundancies, which presents a major challenge for effective decision making. The main hurdles for a seamless health information system start from ambiguous and fragmented policies, human resource shortages, limited digital infrastructure and staff technical capacity to manual data-entry and insufficient and irregular data validation. These obstacles affect real-time monitoring of contraceptive availability and utilization and effectiveness of service delivery. The restructuring of health department in Punjab - merger of Health and Population Welfare departments and outsourcing of Basic Health Units (BHUs) and Rural Health Centers (RHCs) to private medical practitioners, without standard guidelines for data reporting, recording and management have further aggravated the issues. This opinion piece recommends that the data systems be integrated into a unified health information platform for data-entry and reporting.