User guideline on User guideline on MIES reporting FormatMIES reporting Format

Statistics Division,Statistics Division,

MoHFW, New DelhiMoHFW, New Delhi

The objectives of user guideline

To ensure uniformity and consistency in understanding of the monitoring indicators across States and Districts;

To facilitate standardized compilation and calculation of the various indicators at various levels of health care system;

To facilitate the programme managers and other stake-holders in tracking monitoring indicators through use of standardized definition of indicators.

To facilitate peripheral staff who are engaged in the data collection to clearly fill the information without any ambiguity.

Contd..

The guideline will help in

compiling good and robust data

arriving at reasonable estimates of monitoring indicators and

comparisons between different points in time.

National and State programme Managers, Demographers, Mission Directors, CMOs etc .can also use these guidelines

for monitoring the performance,

making comparisons across states and districts and,

provide insight to taking recourse to mid term corrections in the health programmes.

CHAPTER - 1

CHAPTER – 2

CHAPTER – 3CHAPTER – 4CHAPTER – 5

Monthly reporting format from state to centreQuarterly reporting formatAnnual reporting formatGeneral concepts and definitionsIndicators for local level health planningList of referencesImportant links / websites

Organisation of the User Guideline

Chapter -1 monthly reporting format Chapter -1 monthly reporting format from state to centrefrom state to centre

The Monthly reporting format of the MIES contains data relating to :

The special information on CHC and PHC up-gradation, Reproductive and Child Health indicators and Inventory status.

These suggested indicators should be tracked on a monthly basis.

This Chapter has three main sections:

Section 1A covers “Special Information on NRHM agreed indicators” given in items M100 to M400 of the MIES monthly format.

Section 1B provides information on “Reproductive Health” related information covered in M1 to M16 and

Section 1C provides information on “Monthly Inventory Status” covered in items M17 to M19 of the MIES Monthly format.

1A. art A. Special Information1A. art A. Special Information Part A of the monthly format contains some special information with regard to the performance of the public facilities such as

CHC upgraded as FRUs

PHCs functioning as 24 hrs RCH services

Total number of FRUs, CHCs and 24 hrs PHCs that are conducting at least 10 Wet mount tests per month and stock certain critical items.

M-100 Performance of CHCs upgraded as FRUs

This section deals with capturing information on the performance of CHCs that have been upgraded as FRUs.

As this is a separate compilation, there would be a certain level of duplication on a few items like the no. of deliveries, C-Section etc. being captured in item no M2 (2.2) & M3 (3.1) which is for all the CHCs whether they are FRUs or not. This duplication is intentional.

First Referral Unit (FRU)First Referral Unit (FRU)An existing facility (district hospital, sub-divisional hospital, community health centre etc.) can be declared a fully operational First Referral Unit (FRU) only if it is equipped to provide round-the-clock services for Emergency Obstetric and New-born Care, in addition to all emergencies that any hospital is required to provide. Minimum services to be provided by a fully functional FRU 

24-hour delivery services including normal and assisted deliveriesEmergency Obstetric Care including surgical interventions like Caesarean Sections(*) and other medical interventionsNew-born Care(*)Emergency Care of sick childrenFull range of family planning services including Laproscopic ServicesSafe Abortion ServicesTreatment of STI / RTIBlood Storage Facility (*)Essential Laboratory ServicesReferral (transport) Services(*): Critical determinants of functionality

M-200M-200.Performance of PHCs .Performance of PHCs functioning as 24 hr RCH centresfunctioning as 24 hr RCH centres

This section deals with capturing information on the performance of PHCs that are functioning as 24 hr RCH Centre.

This is a separate compilation, there would be a certain level of duplication on a few items like the no. of deliveries, C-Section etc. being captured in item no M2 (2.2) & M3 (3.1) which is for all the PHCs whether they are functioning as 24 hr. RCH Centre or not.

24 x 7 PHC

NRHM envisages that all the Primary Health Centres should function as a 24x7 centre in a phased manner

to improve the availability of health care services and

also promotes the conduct of institutional deliveries at these centres.

Contd..

A 24 hour PHC :provides Basic Essential Obstetric Care and reproductive health services which includes (i)24 hour delivery services (assisted +normal), (ii)Essential new born care, (iii)Referral for emergency (iv)Routine ANC (v)PNC and (vi)Safe Abortion services (vii)Family planning (viii)Prevention and management of RTIs/STIs. (ix)Essential lab services.

The steps that may be needed are as follows: 

Conduct an institution specific facility survey and identify the gaps.

In order to make the PHC 24x7 delivery of services,

There should be at least 4 Staff Nurses (to perform rotation duties round the clock. )

To improve the institutional deliveries, appointment of at least three Staff Nurses may be recruited on contractual basis to fill the gaps.

A labour room with appropriate equipments and drugs with

Round the clock referral transport support either managed by the PHC or by the NGOs / CBOs for referring patients in case of emergency is essential.

Appointment of two Medical Officers (MBBS) preferably one lady MO), and one AYUSH practitioner, either by relocation or on contractual basis.

All effort should be made to see that all the PHCs have the Medical Officers.Contd..

PHC buildings should be made environment friendly, disabled friendly, with a good source of water supply, electricity / solar power / other alternative energy sources and telephone.

Utilization of untied fund for strengthening the functioning of PHCs.Utilization of Annual Maintenance Grant for strengthening the infrastructure and basic necessitiesEach PHC must have a Rogi Kalyan Samiti (RKS) and display of

the Citizens’ Charter that should spell out the details of the health services available at the centre. Once a specific PHC has achieved the 24x7 / IPHS status, the district authority / state authority should declare the institution as 24x7 / IPHS and continuously monitor that these standards are being maintained on a regular basis.

M -300.

M -300. Total number of FRUs, CHCs and 24 hrs PHCs that

conducted at least 10 wet mount test (Refer 4.21 Chapter 4) per month is to be recorded

(This is one of the agreed indicators that are to be monitored monthly.)

M-400.

This provides Monthly Stock of Critical items (viz. Injection Oxytoxin, Gloves, MVA Syringes, Tab. Fluconazole, Blood transfusion sets, Tubal rings, Gluteraldehyde 2%, Oral pills, Measles vaccine, Vitamin A Solution, Ad Syringes etc.).  

The Logistic Management Information System has

to be need-based and a mechanism of buffer stock management has to be in place at all levels of the health system.

Number of Districts having stock-outs(Refer 4.22 Chapter 4) for these critical items (400.1 to 400.11) at any time during the month to be recorded 

4.22 Stock-outs

Sufficient stock is defined as the quantity required meeting estimated consumption needs for the following period (month/quarter/year). No facility can afford to keep sufficient stock to meet every demand. Inability to meet a demand due to lack of inventory is called Stock-out.  Unit of measurement : Stock out percentage It is calculated as the % of number of orders which could not be satisfied to the total number of orders.

For items (400.1 to 400.11) take the monthly stock average of an item during last financial year. Thus if Stock available at the time of recording is less than one-third of the monthly average it should be considered as Stock-out.

1B. Part B: Reproductive Health

Disaggregated data by Disaggregated data by SC, ST and OthersSC, ST and Others to be to be recorded for the reporting month for item M1 to M16recorded for the reporting month for item M1 to M16

M1M1 ANTE NATAL CARE SERVICES ANTE NATAL CARE SERVICES

M2M2 DELIVERIESDELIVERIES

M3M3 NUMBER OF CAESAREAN (C-SECTION) DELIVERIES PERFORMEDNUMBER OF CAESAREAN (C-SECTION) DELIVERIES PERFORMED

M4 M4 PREGNANCY OUTCOMEPREGNANCY OUTCOME

M5 M5 NUMBER OF CASES OF PREGNANT WOMEN IDENTIFIED WITH NUMBER OF CASES OF PREGNANT WOMEN IDENTIFIED WITH OBSTETRIC COMPLICATIONS AND ATTENDEDOBSTETRIC COMPLICATIONS AND ATTENDED

M6M6 MATERNAL DEATHS / DEATHS OF WOMEN (NUMBERS)MATERNAL DEATHS / DEATHS OF WOMEN (NUMBERS)

M7M7 POST PARTUM CAREPOST PARTUM CARE

M8M8 MEDICAL TERMINATION OF PREGNANCY (MTP)MEDICAL TERMINATION OF PREGNANCY (MTP) Contd..

1B. Part B: Reproductive Health ......Contd..

M 9 RTI/STI CASESM 9 RTI/STI CASES

M 10 CONTRACEPTIONM 10 CONTRACEPTION

M11M11 NUMBER OF ELIGIBLE COUPLES ACCEPTING PERMANENT NUMBER OF ELIGIBLE COUPLES ACCEPTING PERMANENT METHODS FOR CONTRACEPTION METHODS FOR CONTRACEPTION

M12. JANANI SURAKSHA YOJANA (JSY)M12. JANANI SURAKSHA YOJANA (JSY)

M13 CHILD IMMUNIZATIONM13 CHILD IMMUNIZATION

M14 NUMBER OF VITAMIN A DOSES ADMINISTERED BETWEEN M14 NUMBER OF VITAMIN A DOSES ADMINISTERED BETWEEN 9 MONTHS AND 3 YEARS9 MONTHS AND 3 YEARS

M 15 M 15 NUMBER OF CHILD HOOD DISEASES REPORTED DURING NUMBER OF CHILD HOOD DISEASES REPORTED DURING THE MONTHTHE MONTH

M 16 M 16 NUMBER OF INFANT/CHILD DEATHS IDENTIFIEDNUMBER OF INFANT/CHILD DEATHS IDENTIFIED

1C. PART C : Monthly Inventory Status

Part C of the monthly format provides information on the inventory status of certain critical items.  

M17M17 This provides information on Vaccine Stock Position during the month. One of the objectives of the UIP multi year strategic plan is to ensure an efficient and vaccine and injection equipment and management logistics 17.1 17.1 to 17.6to 17.6 Record the stock position of DPT, OPV, TT, DT, BCG & Measles Record the stock position of DPT, OPV, TT, DT, BCG & Measles vaccine in the respective columnvaccine in the respective column  

M 18M 18 Stock position of other drugs such as Vitamin A solution, ORS Packets, Vaccine Carriers are to be provided in 18.1, 18.2 and 18.3.  

M 19M 19 Stock of AD syringes (0.1 ml, 0.5 ml and 5 ml) is to be recorded in 19.1, 19.2 and 19.3.

CHAPTER -2 QUARTERLY REPORTING FORMAT

The Quarterly format contains data relating to the status of

• health infrastructure, • manpower, • logistics and • institutional reforms under NRHM.

This format is basically for assessing the progress of various initiatives under NRHM.

Contd..

The strategy under NRHM involves wide ranging sectoral and systematic reforms in the health sector, like

Intersectoral convergence,

Pooling of funds /Societies of Health and Family Welfare programmes under National/State/District Mission,

Strengthening of public health infrastructure by involving the Panchayat Raj Institutions,

Increased accountability of doctors and paramedical staff at distrct/sub-distrct level,

Constitution of Hospital Committee empowered to levy user free, involvement of private sector in the health delivery ,

Strengthening of village health delivery by providing additional manpower etc.

Thus, it is paramount to track progress of NRHM for every quarter.

The quarterly format provides a brief summary of the progress achieved under NRHM during the four quarters.

Contd..

Part APart A of this format is related the status of health infrastructure such as Community Health Centers (CHC), Primary Health Centre (PHC), Sub-Centers (SC), District Hospitals, Medical Colleges etc. NRHM envisages bringing up the services of all health facilities to the Level of Indian Public Health Standards.

Part BPart B of this format deals with status of human resource availability- staffing status of some selected positions,

Part CPart C gives information on Training of Programme managers and various categories of staff members. Information on the type of training programme, the number of trainees identified and the number actually trained should be recorded.

This Chapter has Six main sections:

Part D provides information on Details of Camps Held.

Part E Indicate status of equipments.

Part F provides information on Additional NRHM Components viz. State/District Health Missions, Health Societies, Rogi Kalyan Samitis, ASHAs and Functioning of VHC etc.

Part G provides information on the National Health Programmes.

This data is already being collected by the respective nodal health officers and no fresh data collection is necessary.

These officers have already been instructed to share this information with the State/District mission Director for NRHM.

CHAPTER –3 ANNUAL REPORTING FORMAT

This annual reporting format is to be submitted every year by the state to This annual reporting format is to be submitted every year by the state to GOI and status of the data to be recorded is as on 1GOI and status of the data to be recorded is as on 1stst of April every year. of April every year.

This gives a This gives a summary of health profile of the statesummary of health profile of the state and has and has following Sections:following Sections:

3A. : DEMOGRAPHIC 3A. : DEMOGRAPHIC (A1 to A7)(A1 to A7)

3B. : FROM THE ELIGIBLE COUPLE REGISTER (ECR)(3B. : FROM THE ELIGIBLE COUPLE REGISTER (ECR)(A8 to A10)A8 to A10)

3C. : SELECTED INDICATORS 3C. : SELECTED INDICATORS (A11 to A15)(A11 to A15)

3D. : URBAN HEALTH 3D. : URBAN HEALTH (A16 )(A16 )

CHAPTER – 4 GENERAL CONCEPTS AND DEFINITIONS

This chapter provides brief discussion on general concepts and definitions applied throughout the Guidelines.

These definitions are given in bullets 4.1 to 4.28 of the user guideline.

A care has been taken to follow latest definitions as per MoHFW/NRHM

CHAPTER –5 INDICATORS FOR LOCAL LEVEL HEALTH PLANNING

This chapter provides discussion on various health and family planning indicators to enable readers and district level health programme managers to understand the concept that are used to monitor and evaluate health programmes and translate these concepts into local level health planning.

Methodology for Monthly Performance Report on FW Statistics

I. SterilizationI. Sterilization::

a. Total No. of Eligible Couples @ in the beginning of year: (EC = Projected population during the year X Rate*)

(* Rate = estimated eligible couples per 1000 population On the basis of 2001 census)

@ = Eligible couples are those couples whose wife is in the age group 15-45 years. Females are not eligible for sterilization after 45 years of age.

b. Unsterilized couples are calculated: (Total no. of estimated eligible couples minus Estimated Sterilized Couples $ as per NFHS II/III)

$ Estimated Sterilized Couples are Calculated:

(Estimated eligible couples multiplied by %age current users of Ster.)

(Page 62)

Contd..

Sterilization (Contd..)

c. Current Year performance : As per the monthly report received from States/UTs about the total number of operations done

d. Last year performance of corresponding month for which report is prepared.

e. % change in current month performance over corresponding month.

f. Estimated Unsterilized Couples exposed to higher order births 3 & 3+: (Estimated No. of EC Unsterilized multiplied by %age no. of Couples who have 3 or more children Source NFHS II/II)

g. Sterilization per 10,000 unsterilized couples exposed to higher order of birth 3 & 3+ = (Current Sterilization divided by Est. unsterilized couples exposed to higher order of birth multiplied by 10000)

Contd..

II. IUD InsertionsII. IUD Insertions::

a. Total No. of eligible couples unsterilized in the beginning of year as taken in Sterilization statement

b. Performance of particular month during current year

c. Performance of particular corresponding month during last year % Change

d. Current IUDs divided by Est. unsterilized couples exposed to higher order of births multiplied by 10,000)

Contd..

III. III. Eq. Condom Users:

a. Total No. of eligible couples unsterilized in the beginning of year as taken in Sterilization statement

b. Performance of particular month during current year. Condom users are calculated : (No. of Condom pieces (Net) / 72 ) X (12 / 1..2..3 for April, May, June)

c. Performance of particular corresponding month during last year……same methodology as above

d. % Change

e. Current Condom users divided by Est. unsterilized couples exposed to higher order of births multiplied by 10,000)

f. Note: Eq. Condom users are cumulative users as one beneficiary who uses 72 condoms pieces in a year is counted one user.

Contd..

IV. IV. Eq. Oral Pill Users:

a. Total No. of eligible couples unsterilized in the beginning of year as taken in Sterilization statement

b. Performance of particular month during current year. Oral Pill users are calculated : (No. of OP Cycles/ 13 ) X (12 / 1..2..3 for April, May, June)

c. Performance of particular corresponding month during last year……same methodology as above

d. % Change

e. Oral Pill Users per 10,000 unsterilized couples during current year

f. Note: Eq. Oral pill users are cumulative users as one beneficiary who uses 13 cycles in a year is counted one user.

Contd..

Methodology for Monthly Performance Report on Immunization Statistics

I. DPT Immunisation for children (0-1 Years) 3rd Dose:

a. Prop. Need Assessed during the current financial year : Prop. Need assessed are calculated:

i. Live Birth = (Projected mid-year population X Crude Birth Rate)ii. Children 0-1 years = (Live Births – (Live Birth X IMR)/1000

b. Cumulative performance upto the month during current yearc. Cumulative performance upto month of last yeard. % Change

II. POLIO (3rd Dose) 0-1 Years children: (same as per DPT above)

III. B.C.G. (One Dose) 0-1 year children: - do –

IV. Measles (One Dose) 9-12 months: - do –

Contd..

V. D.T. (Diptheria Tetanus) 5 Years Dose

a. Prop. Need Assessed during the current financial year : Prop. Need assessed are calculated:

i. Projected mid-year population X proportion of children in the age of 5 years as per SRS Bulletin)

b. Cumulative performance upto the month during current yearc. Cumulative performance upto month of last yeard. % Changee. % Achievement of prop. Need assessed

VI/VII. T.T. 10/16 Years Dose

a. Prop. Need Assessed during the current financial year : Prop. Need assessed are calculated:

i. Projected mid-year population X proportion of children in the age of 10/16 years as per SRS Bulletin)

b. Cumulative performance upto the month during current yearc. Cumulative performance upto month of last yeard. % Changee. % Achievement of prop. Need assessed

Contd..

VIII. Vitamin ‘A’ (Prophylaxis against blindness due to Vit ‘A’ deficiency) Ist dose and 2nd-5th dose

IST DOSE (0-1 YEARS)

a. Annual Need Assessed (Total No. of Infants during current year)b. Achievement Cumulative (Ist Dose) during current year)c. Achievement of the same period during last yeard. % Changee. % Achievement of Need assessed

2-5th DOSE (1-3 YEARS)

a. Annual Need Assessed (Total No. of Children aged 1-3 Years during current year)

b. Achievement Cumulative (2-5th Dose) during current year)c. Achievement of the same period during last yeard. % Changee. % Achievement of Need assessed of Vit ‘A’ (2-5 dose) worked out by taking (2

X 1.9 times) of Children (1-2 years)

* Earlier half of doses initiated, continuing and completed were taken to get the total no. of beneficiaries.