An in-depth assessment of India’s Mother and Child Tracking System (MCTS) in Rajasthan and Uttar Pradesh

Abstract

BackgroundIndia’s Mother and Child Tracking System (MCTS)1 is an information system for tracking maternal and child health beneficiaries in India’s public health system, and improving service delivery planning and outcomes. This ambitious project was launched in 2009 and currently covers all states in India, but no in-depth assessment of the system has been conducted. This study by the Public Health Foundation of India (PHFI) evaluated the performance of MCTS and identified implementation challenges in areas in Rajasthan and Uttar Pradesh (UP) in December 2012.MethodsTwo assessment methods were employed: a Data Quality Assessment (DQA) to evaluate data quality and an assessment survey to identify implementation challenges. The survey comprised semi-structured questionnaires for health staff in the sampled districts, observation checklists and survey investigator notes. Purposive sampling was used for selecting two districts in each state and two blocks in each district. For the DQA, 45 mothers who became pregnant and 84 children born within the stipulated timeframes were randomly sampled.ResultsDQA overall performance numbers were 34 % for pregnant women and 33 % for children in the Rajasthan study areas, while UP’s performance numbers were 18 % for pregnant women and 25 % for children. Weaknesses in the MCTS' data completeness accounted for much of this performance shortfall. The beneficiary profiles for Rajasthan were largely incomplete, and the MCTS in UP struggled to register beneficiaries. Shared challenges in both states were the absence of clear processes and guidelines governing data processes, and the lack of systematic monitoring and supervision frameworks for MCTS implementation. As a result, Front Line Health Workers (FHWs) were overburdened with data documentation work, and there were long delays in data capturing. FHWs and block level health officials were not adequately trained in using the MCTS. UP staff reported unreliable internet and electricity availability, lack of dedicated data entry personnel, and a shortage of consumables such as MCTS registers.ConclusionsThere is an urgent need to create data processes and supervision guidelines that complement existing workflows and service delivery priorities. Health staff should be trained to implement these guidelines. MCTS outputs, such as service delivery planning tools, should replace existing tools once data quality improves.

Sustainability of health information systems: a three-country qualitative study in southern Africa

“…A main objective of EHIS is to reduce burden on health workers. The additional burden of parallel paper- and computer-based systems can be, and has been, a key challenge to the introduction and implementation of these systems in these three countries, and has been cited elsewhere in the literature [24, 28]. Managers and policymakers in all three countries emphasized the systems’ potential for simplifying and accelerating data collection.…”

“…The study focuses on work in three sub-Saharan African countries supported by the Centers for Disease Control and Prevention (CDC) under PEPFAR. This article complements a broader emerging literature about the implementation, effectiveness and impact of EHIS in low-resource settings [18–20] including in Latin America [21–23], Asia [24–26] and sub-Saharan Africa [27, 28]. Few studies have emphasized the sustainability of EHIS, particularly with a multi-country comparison and in the context of declining donor support, as is presented here (with some noteworthy exceptions [21, 29]).…”

Prevalence in the utilization of text message services under the mother and child tracking system of India: a cross sectional study from Pune district, Maharashtra, India

“…This data automatically generates monthly work plans for auxiliary nurse midwife (ANM) which contains information on either ANC, Post Natal Care (PNC)) or immunization services to be delivered to the registered woman or child. 6 The MCTS system also generates an automatic text message (short message service (SMS)) to the registered beneficiary to alert them about their outstanding services. Other information delivered through SMS includes healthy practices during ANC, PNC, and the importance of immunization for children.…”

Data Mining Probabilistic Classifiers for Extracting Knowledge from Maternal Health Datasets

“…Monthly Village Health and Nutrition Day (VHND) is an Anganwadi activity for maternal and child care that includes nutrition also [7]. Mother Child Tracking System/Reproductive Child Health (MCTS/RCH) is a web based application to track all pregnant women and children to use full services [8,9]. Janani Shishu Suraksha Karyakaram (JSSK) provides number of free facilities to pregnant women and infants like free delivery including C-section, to-and-fro transport, free diet, diagnosis, drugs, and blood transfusion [10].…”