KEY PERFORMANCE INDICATORS for District Health … · Summary of Key Performance Indicators for District Health Services ... Details of Key Performance Indicators for District

KEY PERFORMANCE INDICATORS for

District Health Services

prepared by:

Dr Sohail Iqbal Information System Expert

TRF+, Khyber Pakhtunkhwa

January 10, 2017

Contents 1. Introduction…………………………………………………………………………………………………………………………………………………………………………………………… 1

2. Objectives……………………………………………………………………………………………………………………………………………………………………………………………… 2

3. System Design……………………………………………………………………………………………………………………………………………………………………………………….. 3

3.1. Management Levels ....................................................................................................................................................................................... 3

3.2. Performance domains .................................................................................................................................................................................... 4

3.3. Performance measures (KPIs) ........................................................................................................................................................................ 6

3.4. Data sources ................................................................................................................................................................................................... 7

3.5. Configuring Scorecards .................................................................................................................................................................................. 8

3.5.1. Benchmarks and Performance Standards .............................................................................................................................................. 9

3.5.3. Weightage / Formula / Scoring Engine .................................................................................................................................................. 9

3.5.4. Cascading Measures ............................................................................................................................................................................. 11

3.6. Processes and tools ...................................................................................................................................................................................... 11

3.6.1. Data collection process ........................................................................................................................................................................ 12

3.6.2. Data capture tools ................................................................................................................................................................................ 12

3.6.3. Web-based data management and reporting system ......................................................................................................................... 12

4. Summary of Key Performance Indicators for District Health Services………………………………………………………………………………………………..... 19

4. Details of Key Performance Indicators for District Health Services………………………………………………………………………………………………………. 21

Annex : Targets, Criteria and Formulas of Composite Index KPI’s…………………………………………………………………………………………………………………….. 53

Annex-1.2.1 Filled Post Index : Percentage of essential posts filled against sanctioned posts ........................................................................... 53

Annex - 1.2.3 Staff Presence Index : Percentage of staff present ....................................................................................................................... 56

Annex - 1.4.1 : Drug Availability Index (IMU) Primary ......................................................................................................................................... 58

Annex - 1.4.2 : Drug Availability Index (DHIS) Secondary Level ........................................................................................................................... 59

Annex - 1.4.3 : Equipment Availability /Functionality (IMU) Primary .................................................................................................................. 60

Annex - 2.3.1 Percentage MIS Reporting Regularity ............................................................................................................................................ 61

Annex – 4.2.1 Health Facility Utilization (Daily OPD) : Percentage of Health facilities meeting their targets of Daily OPD ............................ 62

Annex – 4.2.2 Bed Occupancy Rate : Average bed occupancy rate of HF/hospitals providing inpatient care (RHC, THQ, DHQ) ..................... 63

Annex – 4.3.1 Antenatal Care Coverage: Percentage of Health Facilities meeting their targets of first antenatal visits (ANC-1) .................... 64

Annex – 4.3.2 Total Institutional Deliveries: Percentage of Health facilities meeting their monthly targets of Deliveries .............................. 65

List of Abbreviations

CMW Community Midwife

DFID Department for International Development

DGHS Director General of Health Services

DHDC District Healthcare Development Center

DHIS District Health Information System

DoH Department of Health

DHO District Health Officer

DDOH Deputy District Health Officer

EPI Expanded Programme on Immunization

FP Family Planning

IMR Infant Mortality Rate

KPI Key Performance Indicator

LHW Lady Health Worker

M&E Monitoring and Evaluation

MDG Millennium Development Goals

MIS Management Information System

MMR Maternal Mortality Ratio

MNCH Maternal, Newborn and Child Health

NP National Programme

PHS Public Health Specialist

HSRP Health Sector Reform Project

RHIS Routine Health Information System

TA Technical Assistance

TBC TB Control

TOT Training of Trainers

TRF Technical Resource Facility

WFP World Food Programme

WHO World Health Organization

Revised KPIs for District Health Services 2016 – 2017

1. Introduction

The Government of the Khyber Pakhtunkhwa is committed to provide better health services to its people and took significant initiatives

in this direction. The prime focus is on the health service delivery, i.e. reduction of IMR, MMR and the improvement in mother and

child healthcare services through improving the access, quality and equity of the services.

The overall performance of the Department of Health (DoH) depends on the performance of its managers and health delivery

institutions. The performance can be measured through systematic collection of information (data) and the analysis of outcomes and

its impacts on the society.

Many MIS are functioning within the department, that collect data of the different vertical programees. However, in the context of

devolving and restructuring of the of health programmes, a comprehensive and integrated M&E system is deployed that would provide

basis for performance evaluation at various levels. For this purpose, the DoH took initiative and conceptualized an M&E system that

includes comprehensive system for data collection, reporting and validation. The system comprises of a set of agreed Key Performance

Indicators (KPIs) for monitoring of district health services and measure the performance of managerial / supervisory tiers including

Directorate General of Health Services Khyber Pakhtunkhwa (provincial level) and District Health Officers (District Heath

Management). The system measures the performance and direct corrective actions for the improvement of the health services.

Figure 1.1: Core Functions of Health System

Planning and Management

Monitoring and Supervision

Service DeliveryProgramme

Management

Goals


The team of consultants held a series of consultative meetings in year 2016-2017 with the key stakeholders of Health Department

Khyber Pakhtunkhwa Including DGHS Khyber Pakhtunkhwa, Provincial coordinator DHIS, Deputy Coordinator DHIS, Project Director

IMU, Deputy Director EPI, representative from HSRU, Project Director Integrated Health Program, Program manager of Provincial TB

Program, M&E officer of MNCH program, Program manager of Hepatitis program, Manager Provincial Malaria Control (PoMC),

Database Administrator DHIS, DHO Swabi, MS of DHQs and THQs and provincial Team Lead TRF+. After a series of meetings and

exhaustive deliberations a final set of KPIs was agreed.

To collect data, a number of existing online and offline data sources have been identified and agreed with the key stakeholders for the

data collection of KPIs. The online data sources include: District Health Information System (DHIS), EPI MIS, LHW MIS, MNCH MIS and

IMU database. The sources regularly collect curative and preventive care indicators from health facilities and vertical / special health

programmes. Moreover, data for KPIs has also been collect from some offline data sources such as Provincial TB Programe (PTP),

Provincial Malaria Control (PoMC) and DGHS and DHO offices.

The M&E system has various management levels that include Directorate General Health Services, District Health Officers (DHO),

Deputy District Officers Health (DDOH) and Medical Superintendents (MS) of secondary care hospitals (DHQ and THQ). The evaluation

is based on Key Performance Indicators (KPI) from existing online and offline data sources as well as additional sources such as

supervisory checklists.

A mechanism for data validation is also been adopted to ensure reporting accuracy. The M&E system is of web-based software which

will be fed by various data sources including DHIS, MISs of vertical programmes. The software processes the data from all the sources

and calculate key performance indicators with balance scorecard methodologies.

2. Objectives

The main objective of the KPI system is to enable the Health Department for unbiased monitoring and performance analysis of various

offices and institutions of the department. The system will improve health service delivery and other services by measuring and

reporting key performance indicators in various domains. The emphasis is on result-based performance and monitoring instead of

process or activities based performance.


The aim of the assignment is to design and develop a web-based performance monitoring and evaluation system for higher

management through online dashboards by using state of the art technologies. This document therefore presents outline of the

structural design of web-based M&E system as per assigned TORs, Inception Report and discussion with various stakeholders. As

already mentioned, the assignment will also build local capacity of the health department for improvement of the health systems on

sustainable basis.

The proposed structural design will pave a path towards detail designing, development and operations of the M&E system to achieve

overall objectives. On the basis of structural design, a web-based software system is developed and implemented in all districts of

Khyber Pakhtunkhwa for performance monitoring and evaluations.

3. System Design

This section presents structural design of the performance monitoring system, processes, data flows for measuring/capturing and

presentations of calculated KPIs scorecard on the dashboards. The detailed design specifications, particularly related to software

system is prepared during the system development and together with the document, shall form the overall set of technical

documentations to be used as reference material in future for system maintenance and its up-gradation.

3.1. Management Levels

As per assigned Terms of Reference (ToR) and agreed during the technical committee meetings, the following three management

levels of Khyber Pakhtunkhwa Health System have been directed for performance monitoring and evaluation:

1. Office of the Director General of Health Services (provincial level)

2. District Health Officers (25 districts)

3. Medical Superintendents of hospitals (THQs/DHQs)


Figure 3.1: Management Levels of KPI System

3.2. Performance domains

Performance domains and sub-domains for each of these management units/levels have been defined separately. These domains and

sub-domains relate to the major functions of the specific management unit/level. A list of these performance domain and sub-domains

is given as under:

Management unit/level Domain Sub-domain

DHO Planning and Management

Operational Planning

Human Resources

Financial Management

Medicines/supplies

Emergency transport




Supervisory/monitoring visits

Feedback

MIS

Coordination Coordination

Service Delivery

EPI

Curative Care

Mother and Child Health

Programme management

National TB Control Programme

National Programme for FP&PHC

MNCH Programme

Malaria Control Programme

Polio Eradication

MS (Hospital) Planning and Management

Human Resource

Financial Management

Medicines/Supplies



Emergency Transport

Monitoring and Supervision MIS

Hospital Management &

Services

Service Quality

Service Delivery

Table 3.1: Management Levels / Domains / Subdomains

3.3. Performance measures (KPIs)

A detailed list of quantitative performance measures, or key performance indicators (KPIs), their definition and formula for

computing scores are given in Annexes. A summary is given as under:

Management Level Number of KPIs

District (DHO) 32

Hospital (MS) 18

Table 3.2: No of KPIs of each Management Level

Similarly, for DHO level, 32 unique indicators have been selected of which most indicators are quantifiable measures such as coverage

percentages and proportions while five KPIs are in fact composite indices calculated from other indicators.

For hospitals or MS level, 18 unique indicators have been selected within three major performance domains. Most of these are

quantifiable measures including percentages and proportions while four KPIs are in fact composite indices calculated from other

indicators.


Software Interface: The system administration module of the software allows adding and changing individual KPIs and their

performance domains.

3.4. Data sources

A range of sources have been identified for data on key performance indicators. These include routine management information

system (DHIS, IMU, MNCH-MIS, EPI MIS and LHW-MIS) as well as third-party monitoring system (TPM/HRSP), special programmes,

office records, and hospital records. A list of data sources including in this system is given as under:

S.No. Data Source Type

1. DHIS Cell DHIS 2. Independent Monitoring Unit IMU Database 3. MNCH Program MNCH MIS 4. EPI Programme EPI MIS 5. LHW Programme LHW MIS 6. TBC Programme MIS 7. Malaria Programme MIS 8. LQAS Monitoring System 9. Director Budget Office Record

10. DHO Office Record 11. Minutes of meeting Office Record 12. MS Office Office Record 13. Minutes of meeting Office record 14. Hospital registers / record Hospital MIS/record

Table 3.3: Data Sources of KPI System


3.5. Configuring Scorecards

An administrative module, accessible through secure login is used for configuring the scorecard, for adding or changing key

performance indicators, for assigning or changing weights of scorecard and for defining or altering formula of computation.

The scoring/weightage engine is dynamic in the sense that every time formula or weight for a particular KPI is changed, it will re-

calculate performance indices of all management units and time periods according to new configuration.

Figure 3.4: Configuration of KPI System

• Weights

• Scoring formula

• Benchmarks

• Define KPIs

• Linked to domains

• Performance domains and sub-domains

• Defines mgmt levels

• Linked to admin units

• CascadingManagement

LevelsDomains

Scoring Engine

KPIs


3.5.1. Benchmarks and Performance Standards

For measuring performance according to set of standards, the following benchmarks have been developed after consultation with the

concerned officials of Health Department, Khyber Pakhtunkhwa:

a) For a qualitative indicator having dichotomous values such as yes/no, the scores will be assigned based on full (100% in case of

positive or ‘yes’) or NIL (0% in case of negative or ‘no’).

b) For quantitative indicators having scale variables (percentage or absolute number values), the ceiling/floor cut points is used as

the baseline or benchmark. Individual performance is measured in terms of variance between the KPI value and the benchmark

and scores is assigned based on their relative weightage.

3.5.2. Software Interface:

The system administration module of the software allows changes of benchmarks for individual KPIs and their relative scores. The

system is flexible to accommodate any change in KPIs.

3.5.3. Weightage / Formula / Scoring Engine

Weights to the performance scores is assigned at top management level based on subjective assessment of how important a

performance domain and its measures. The weights are expected to change from time to time as priorities concerning health system

management are changed. The scoring engine of the software is catered for this flexibility requirement through proper authentication

procedure. The rights to change weights is assigned to an authorized user at the provincial level.

The formula for computing performance scores based on KPI value and its relevant weightage is employed on the following methods.

Ceiling and Floor method

Ceiling and Floor are two performance extreme cut point assigned as benchmark. Ceiling is desired level and Floor is undesirable level

for KPI performance value.


Figure 3.5: Scorecard Process

Scorecard is calculated based on KPIs, performance standards/benchmarks and weightage system and converts utilization and service

statistics into scores. The balanced scorecard gives aggregate performance in all performance domains. The scorecard is completely

customizable and can be adapted to any performance management framework.

Figure 3.6: Performance Standards and Scorecard

Validation

Weights

KPI Values

Standards / Benchmarks

Scores


The Scoring engine of the software is accessible to an authorized user at the provincial level only, who will be able to configure it by

assigning weights, changing scoring methods and formulas.

3.5.4. Cascading Measures

Since the three management units (DGHS, DHO and MS) work in a management hierarchy and the combined performance of a lower

unit reflects the performance of the higher management unit, therefore, overall aggregate performance score of a management unit

is assigned to its next higher unit. For instance, a district performance score will be computed by adding aggregate score of all hospitals

within that district to the performance of the district. Similarly, aggregate district scores will also reflect the performance of the

provincial level management unit (DGHS).

Figure 3.7: Cascading measures

3.6. Processes and tools

This section describes processes and tools involved in the performance monitoring system for Khyber Pakhtunkhwa Health

Department.

MS

• Hospitals' aggregate score

DHO

• District's aggregate score

DGHS

• Province's aggregate score


3.6.1. Data collection process

At each district, the DHIS Computer staff is designated as focal person for collecting M&E data from the sources indicated on KPI sheet.

The data is collected on prescribed forms and then input in the online web-based system either through a web-browser using a

PC/Notebook connected to internet, or in cases where internet connectivity is not readily available, or facing electricity load-shedding

issues, then an Android tablet shall be used to input data through GPRS communication system. The designated DHIS computer staff

of the district will also collect data from the THQ and DHQ hospitals in the district.

Once data will be captured on the form, it will be checked for completeness, consistency and accuracy before entering into the system.

A signed hardcopy shall be filed for record and future reference.

3.6.2. Data capture tools

The following data collection forms are used for capturing data from the sources.

1. Annual KPI sheet

2. Quarterly KPI sheet

3. Monthly KPI sheet

4. Composite indices worksheet

For composite indices such as staff presence index or drugs availability index, separate forms shall be used to input specific data and

calculate composite index value.

3.6.3. Web-based data management and reporting system

Important Design Considerations:

• Flexibility: The software system is designed keeping the “extensibility” as key design element. The software is flexible to allow

changes in performance domains, measures (KPIs), their benchmarks, scoring methods and relative weightage.

• Integration: The structural design and technology platform is taken into consideration for future integration with other systems.

This is particularly important if move towards comprehensive and integrated HIS is made in the future. The performance

management system has easy interfaces with the new online data collection/reporting systems without requiring any significant

changes in its programming code or underlying database.


• Compliance to standards: Standards for data exchange such as XML is ensured for compatibility of the system across various

platforms.

• Layered approach:

Main modules of Online Software:

a. Data capture/entry module

b. Configuration module

c. Executive dashboard

d. WebGIS for spatial presentation of performance data

e. System administration

Web application:

It facilitates online extraction of data from various sources including DHIS, as well as other data systems. An admin control panel

enables the system administrator to configure the scoreboard and control access, whereas a data management user interface

allows sub-offices to upload their KPI data.


Figure 3.8: Web Application System Architecture


WEB-BASED PERFORMANCE MONITORING SYSTEM FOR KHYBER PAKHTUNKHWA HEALTH DEPARTMENT

SYSTEM ARCHITECTURE DIAGRAM

Figure 3.9: Cascading Measures of KPIs


KPI dashboard:

KPI dashboard is an online highly interactive user interface that allows managers to view and analyze performance from different

viewpoints. Depending upon the level of management hierarchy, the dashboard provides relevant view to its end-users.

Currently available on web-browsers, this can be extended to mobile gadgets such as tablets and smartphones.

The dashboards are built for using latest GIS and charting tools that provide ranking, comparison and drill-down facilities to end-

users.

Technology Platform

The following technology options have been selected for various components of this online system:

1. Web-based forms PHP

2. Web database Postgres

3. Dashboard Graphs Fusion Charts

Figure 3.10: Provincial Level KPI Dashboard


Figure 3.11: District Level KPI Dashboard


Figure 3.12: Source Level Drill down of a KPI


4. Summary of Key Performance Indicators for District Health Services

Domain Subdomain KPIs Weight Value Type

Performance Range Interval Data Source

Planning and Management

(70)

Planning (5) Annual Operational Plan 5 Y/N [0 - 1] Y

DHO/DGHS Office

Human Resource (30)

Filled Posts Index (HR MIS) 10 % [70 - 40] M

HR MIS (Disabled till HR MIS ready)

Filled Posts Index (IMU) 10 % [70 - 40] M IMU

Staff Presence Index (IMU) 10 % [70 - 40] M IMU

Financial Management (5) Budget Consumption 5 % [70 - 40] Y DHO Office and DGHS

Medicine/Supplies (30)

Drug Availability (IMU) 10 % [90 - 50] M IMU

Drug Availability (DHIS) 10 % [90 - 50] M DHIS

Equipment Availability / Functionality (IMU)

10 % [80 - 50] M IMU


(25)

Monitoring/Supervision (5) Supervisory Visits by district health department

5 % [80 - 50] M IMU/DHIS

Feedback (5) Feedback Provided 5 Y/N [1 - 0] Q DGHS Office/DHIS

MIS (15) MIS Reporting Regularity 15 % [90 - 70] M DHIS / MNCH-MIS / LHW-MIS/EPI-MIS

Coordination (5) Coordination (5) Review Meetings using KPIs and DHP 5 % [80 - 50] Q DHO Office (Meeting

Minutes)

Service Delivery (40)

EPI (10)

% of Fully Immunized Children (12-23

months) 5 % [80 - 50] M

EPI MIS

TT2 Coverage 5 % [90 - 50] M EPI MIS

Curative Care (15)

Health Facility Utilization (Daily OPD) 5 % [80 – 40] M DHIS

Bed Occupancy Rate (Secondary Hospitals)

5 % [70 - 40] M DHIS


OT Services at Secondary hospitals 5 % [80 - 50] M DHIS

Maternal & Child Health Services (Facility Based)

(15)

Antenatal Care Coverage (ANC-1) 5 % [70 - 40] M DHIS

Total Institutional Deliveries 5 % [70 - 40] M DHIS

Cesarean Section Services at Secondary Hospitals

5 % [100 - 0] M DHIS

Programme Management – 40

TB Control Programme (8)

TB Case Detection Rate 3 % [90 - 60] Q TBC Programme

TB Treatment Success Rate 3 % [80 - 50] Q TBC Programme

TB Default Rate 2 % [2 - 0] Q TBC Programme

LHW Program & Family Planning (12)

Newly Registered Pregnant Ladies by LHWs

3 % [100 – 90] M LHW MIS

Deliveries by Skilled Birth Attendant in LHW Covered Area 4 % [50 - 30] M LHW MIS

FP Users of Modern Methods in LHW Covered Area

5 % [60 - 40] M LHW MIS

MNCH Program (7) Percentage of CMWs Performing Two or More Deliveries

7 % [80 - 40] M MNCH MIS

Nutrition Program (5) Percentage of Identified SAM Children being Treated (Disabled: Because Currently Nutrition Program is working only in two districts)

5 % [80 - 50] M Nutrition MIS

Malaria Programme (3) Percentage of P. Falciparum + Cases of Malaria

3 % [10 - 40] {Inverse}

M Malaria Control

Programme

Polio Eradication (5) Polio Zero Reporting 5 % [90 -70] M Polio (PEI MIS)

Hospital Performance(10)

Hospital Performance(10) Consolidated Index of Secondary Hospitals Performance

10 % [0 - 100] M KPI System


4. Details of Key Performance Indicators for District Health Services

1. Domain: Planning & Management Weight 70

1.1 Sub-domain: Planning Weight 5

1.1.1 KPI: Annual Operational Plan Definition

Annual operational Plan/ budget planned prepared and approved based on DHIS evidence

Data Capture Point DHO with active participation of accounts section

Interval Yearly

Data Type Y/N

Criteria / Formula Yes = 1, No=0

Data Entry Method Automatic

Performance Range Upper Limit = 1, Lower Limit = 0

Scoring formula Performance = 1 Score = 5

Performance = 0 Score = 0

Weight 5

Discussion

This is to be included in the checklist of DMO. Since this is to be collected annually it may not be included in the android application. The DMOs should also be trained on the validation method

This indicator will ensure that the annual operational plan developed by district is based on evidence by using data generated from DHIS

May change this to District Health Plan – which is also mentioned in the Khyber Pakhtunkhwa District Government Rules of Business, 2015 as follows:

Formulate evidence-based district health plans for district health care delivery system based on real time data



1.2 Sub-domain: Human Resource Weight 30

1.2.1. KPI: Filled Posts Index (HR MIS) Definition

Essential posts filled against sanctioned posts for primary and secondary facilities

Data Capture Point HR-MIS (Data will be automatically retrieved from online HR-MIS)

Interval Monthly

Data Type Percentage Value

Criteria / Formula

Composite index calculated from sanctioned filled and vacant posts by type of facilities (See in Annex 1.2.1 for detailed calculation method) Categories extracted from MHSDP



Scoring formula

Performance >= Upper Limit Score = 10 Performance <= Lower Limit Score = 0 Otherwise Score = (Performance – Lower Limit)/(Upper Limit – Lower Limit) x 10

Weight 10

Discussion

This will be extracted from HR-MIS when finalized.

The staffing categories taken from MHSDP. This will be extracted from HR-MIS when finalized.

Indicator accepted, however it will be disabled until HR-MIS is finalized




1.2.2 KPI: Filled Posts Index (IMU) Definition

Essential posts filled against sanctioned posts for primary and secondary facilities

Data Capture Point IMU (Data will be automatically retrieved from online IMU)

Interval Monthly


Criteria / Formula Composite index calculated from sanctioned filled and vacant posts by type of facilities (See in Annex 1.2.1 for detailed calculation method)



Scoring formula


Weight 10

Discussion

This indicator will provide data on staffing situation with regards to filled and vacant posts.

This will be captured from data collected by IMU




1.2.3 Staff Presence Index (IMU) Definition Staff absent from duty at the time of monitoring visit

Data Capture Point IMU

Interval Percentage Value

Data Type Monthly

Criteria / Formula Composite index calculated from staff absent at the time of monitoring visit against filled posts by type of facilities (See in Annex 1.2.3 for detailed calculation method)



Scoring formula


Weight 10

Discussion This will be for key HR positions collected by IMU



1.3 Subdomain: Financial Management Weight 5

1.3.1. KPI: Budget Consumption

Definition % variation in budget released versus actual expenditure on selected budget items Salary and non-Salary (medicines, POL, utilities M&R,)

Data Capture Point DHO with active participation of accounts section

Interval Annually


Criteria / Formula Numerator: Expenditure on selected Budget items

Denominator: Allocated Budget

Data Entry Method Manual (by DHIS Cell)


Scoring Formula


Weight 5

Discussion

Data capturing point for the KPI is DHIS

It should be captured form District as well as Provincial account offices

To be done by FMC when established



1.4 Subdomain: Medicines/Supplies Weight 30

1.4.1 KPI: Drug Availability (IMU) Definition

Essential Drug Availability index (Essential Medicines/Vaccine in stock during month (DHQ, THQ, RHC, BHU))


Interval Monthly

Data Type Percentage value

Criteria / Formula Composite index calculated as defined by IMU (See in Annex 1.4.1 for detailed calculation method)



Scoring Formula


Weight 10

Discussion




1.4.2 KPI: Drug Availability (DHIS) Definition

Essential medicines/supplies in stock at secondary level hospitals

Data Capture Point DHIS

Interval Monthly


Criteria / Formula Composite index calculated from drugs availability status by type of facilities (See in Annex 1.4.2 for detailed calculation method)



Scoring Formula


Weight 10

Discussion

This is based on the existing DHIS tool.

However when the DHIS tools will be revised the list of medicines will correspond with the MHSDP list




1.4.3 KPI: Equipment Availability / Functionality Definition Composite index of essential equipment functional


Interval Monthly


Criteria / Formula Composite Index (See in Annex 1.4.3)



Scoring Formula


Weight 10

Discussion

This will be disabled temporarily – however when the DHIS tools are revised the essential equipment will be based on MHSDP-Primary and Secondary level

Draft Essential equipment list is provided in Composite Indicator Annex 1.4.3


2. Domain: Monitoring and Supervision Weight 25

2.1. Subdomain: Monitoring/Supervision Weight 5

2.1.1. KPI: Supervisory Visits by District Health Department Definition

% of HF visits by district administrators (DHO, coordinators, DSMs and implementing partners).


Interval Monthly


Criteria / Formula Numerator: Number of health facilities visited by district staff

Denominator: Total number of facilities visited by IMU



Scoring Formula


Weight 5

Discussions The visits by district administration is currently being collected by IMU



2.2. Subdomain: Feedback Weight 5

2.2.1 KPI: Feedback Provided Definition

Feedback provided by Provincial DHIS and DGHS office to districts

Data Capture Point Provincials office reports & letters written (Data will be manually entered) by DHIS Provincial Office

Interval Quarterly

Data Type Yes / No

Criteria / Formula Yes=1, No=0



Scoring formula Performance = 1 Score = 5 Performance = 0 Score = 0

Weight 5

Discussions



2.3 Subdomain: MIS Weight 15

2.3.1 KPI: MIS Reporting Regularity Definition

% of monthly reports submitted out of due reports of DHIS, CMWs, LHWs, EPI MIS

Data Capture Point Online DHIS, MNCH-MIS, LHW-MIS, EPI-MIS,

Interval Monthly


Criteria / Formula

Composite percentage value is calculated from MIS submitted report vs due report with weightage of importance of MIS

(See in Annex 2.3.1 for detailed weights, criteria and calculation formula)



Scoring Formula

Performance >= Upper Limit Score = 10

Performance <= Lower Limit Score = 0

Otherwise Score = (Performance – Lower Limit)/(Upper Limit – Lower Limit) x 10

Weight 10

Discussion



2.3. Subdomain: MIS Weight 15

2.3.2. KPI: Data Quality Definition

Percentage Monthly reports with consistency in reported vs actual data of DHIS

Data Capture Point LQAS

Interval Yearly


Criteria / Formula Numerator: Number of monthly reports with LQAS completed

Denominator: Total number of monthly reports submitted



Scoring Formula


Weight 5

Discussions

This is an important indicator to assess the quality of data collected and reported.

The committee recommended that resources must be allocated in DHIS from PC-1 on permanent basis for mobility and HR

IMU is also collecting data on visit by DHIS coordinator for LQAS. LQAS reports and visits by district coordinator can be validated


3. Domain: Coordination Weight 5

3.1.1 Subdomain: Coordination Weight 5

3.1.1 KPI: Review Meetings using KPIs and DHP Definition

Review meetings on KPIs and DHP Implementation % of action items addressed

Data Capture Point DHO Office – Minutes of Meeting

Interval Quarterly


Criteria / Formula

Numerator: # of action points addressed from previous quarter

Denominator: Total number of action points to be addressed

Data Entry Method Manual (by DHIS Cell) – After reviewing minutes of the meeting


Scoring formula


Weight 5

Discussions


4. Domain: Service Delivery Weight 40

4.1. Subdomain: EPI Weight 10

4.1.1. KPI: Fully Immunized Children (12-23 months)

Definition Percentage of children (12-23 months) fully immunized

Data Capture Point Online EPI MIS

Interval Monthly

Data Type Percentage

Criteria / Formula

Numerator: Number of Children fully immunized

Denominator: Expected Children of 12-23 months (dist. Population x 3.26%)/12



Scoring Formula



Otherwise Score = (Performance – Lower Limit)/ (Upper Limit – Lower Limit) x 5

Weight 5

Discussions This has been confirmed that fully immunized are children 12-23



4.1. Subdomain: EPI Weight 10

4.1.2. KPI: TT2 Coverage Definition Percentage of pregnant Women received TT2 vaccination

Data Capture Point Online EPI MIS

Interval Monthly


Criteria / Formula

Numerator: Number of pregnant women who received TT2 vaccination

Denominator: Total expected pregnancies (district pop x 3.5% / 12)



Scoring Formula




Weight 5

Discussions



4.2 Subdomain: Curative Care Weight 15

4.2.1 KPI: Health Facility Utilization Rate (Daily OPD)

Definition Percentage of Health facilities meeting their monthly targets of daily OPD (BHU, MCH, RHC, CH, THQ, DHQ)

Data Capture Point Online DHIS

Interval Monthly


Criteria / Formula Numerator: Number of Facilities meeting targets of Daily OPD with weighted index (Dispensaries, MCH, BHU, RHC, THQ, DHQ)

Denominator: Total No of Health facilities (Dispensaries, MCH, BHU, RHC, THQ, DHQ) (See Annex – 4.2.1 for criteria, weights, targets and calculation formula)



Scoring Formula Performance >= Upper Limit Score = 5



Weight 5

Discussion




4.2.2. KPI: Bed Occupancy Rate (Secondary Hospitals) Definition

Percentage of Average Daily Bed Occupancy Rate of HF/hospitals providing inpatient care (RHC/THQ/DHQ)


Interval Monthly


Criteria / Formula

Numerator: Total daily occupied beds (RHC, THQ, DHQ) {Weighted index)

Denominator: Number of Hospital Beds (from RHC/THQ/DHQ report) x No of days in month (See Annex – 4.2.2 for facility type wise weighted index criteria and calculation formula)


Performance Range Upper Limit = 70 , Lower Limit = 40

Scoring Formula




Weight 5

Discussion




4.2.3. KPI: OT Services at Secondary hospital Definition

Percentage of Secondary Hospital provided sufficient OT services


Interval Monthly


Criteria / Formula

Numerator: Number of Secondary Hospitals with one or more OT Cases with GA and SA

Denominator: Total Number of Secondary Hospitals



Scoring Formula




Weight 5

Discussion



4.3 Subdomain: MCH Weight 15

4.3.1. KPI: Antenatal Care Coverage (ANC-1) Definition

Percentage of Health Facilities meeting their targets of first antenatal visits (ANC-1)


Interval Monthly


Criteria / Formula

Numerator: Number of Facilities meeting targets of ANC_1 (MCH, BHU, RHC, THQ, DHQ)

Denominator: Total Facilities (MCH, BHU, RHC, THQ, DHQ)

(See Annex – 4.3.1 for facility type wise targets and calculation formula)



Scoring formula




Weight 5

Discussion




4.3.2 KPI: Total Institutional Deliveries Definition

Percentage of Health Facilities meeting their targets of deliveries (MCH, BHU, RHC, THQ, RHC)


Interval Monthly


Criteria / Formula

Numerator: Number of Facilities meeting targets of Deliveries (MCH, BHU, RHC, THQ, DHQ)

Denominator: Total Number of facilities (MCH, BHU, RHC, THQ, DHQ) (See Annex – 4.3.2 for criteria, weights, targets and calculation formula)



Scoring formula




Weight 5

Discussion




4.3.3 KPI: Cesarean Section Services at Secondary Hospitals Definition

Percentage of Secondary Hospitals providing services of Cesarean Section


Interval Monthly

Data Type %

Criteria / Formula

Numerator: No of Hospitals (CH, THQ, DHQ) with at least 1 or more cesarean cases during the month

Denominator: No of Secondary Hospitals (CH, THQ, DHQ)



Scoring formula Score = (Secondary Hospital providing Cesarean Services) / (Total No. of Secondary Hospitals) x 5

Weight 5

Discussion


5. Domain: Programme Management Weight 40

5.1. Subdomain: TB Control Program Weight 8

5.1.1 KPI: TB Case Detection Rate Definition TB Case Detected by TB Control Programme

Data Capture Point TB Control Programme

Interval Quarterly

Data Type Rate

Criteria / Formula

Numerator: Number of reported cases per 100,000 persons per quarter

Denominator: the estimated incidence rate per 100,000 per quarter


Performance Range Upper Limit = 90, Lower Limit = 60 (Inverse)

Scoring Formula


Weight 3

Discussion



5.1. Subdomain: TB Control Program Weight 8

5.1.2 KPI: TB Treatment Success Rate Definition

The proportion of new Smear-positive TB cases registered under DOTS that successfully completed treatment


Interval Quarterly


Criteria / Formula Numerator: No of Cases Successfully Completed Treatment

Denominator: No of Confirmed Cases (6 months ago)



Scoring Formula




Weight 3

Discussion



5.1. Subdomain: TB Control Programme Weight 8

5.1.3 KPI: TB Default Rate Definition TB Defaulter Rate


Interval Quarterly


Criteria / Formula Numerator: Number of Default Cases Denominator: Total Number of Registered Cases



Scoring Formula


Weight 2

Discussion



5.2 Subdomain: LHW Program & Family Planning Weight 12

5.2.1 KPI: Newly Registered Pregnant Ladies by LHWs Definition

Percentage of newly registered pregnant ladies by LHW in her Covered Area

Data Capture Point Online LHW MIS

Interval Monthly


Criteria / Formula

Numerator: Number of newly registered pregnant Ladies

Denominator: Expected Pregnancies in LHW Covered Area (total LHW CA pop x 3.0% / 12)



Scoring Formula

Performance >= Upper Limit Score =3 Performance <= Lower Limit Score = 0 Otherwise Score = (Performance – Lower Limit)/(Upper Limit – Lower Limit) x 3

Weight 3

Discussion



5.2 Subdomain: LHW Program & Family Planning Weight 12

5.2.2 KPI: FP Users of Modern Methods in LHW Covered Area Definition

Percentage of Family Planning clients of modern methods in LHW Covered Area


Interval Monthly


Criteria / Formula

Numerator: Family Planning Users of Modern Method in LHW Covered Area

Denominator: No of Eligible Couples



Scoring Formula


Weight 5



5.2. Subdomain: LHW Program & Family Planning Weight 12

5.2.3 KPI: Deliveries by Skill Birth Attendant in LHW Covered Areas Definition

Percentage of Deliveries by Skill Birth Attendant(SBA) reported in LHW Covered Area


Interval Monthly


Criteria / Formula

Numerator: Deliveries by SBA in LHW Covered Area

Denominator: Expected Live Births in LHW Covered Area (Total LHW Covered Area Population x 2.9% / 12)



Scoring Formula


Weight 4

Discussions



5.3 Subdomain: MNCH Program Weight 7

5.3.1 KPI: Percentage of CMWs Performing Two or More Deliveries Definition

Percentage of Reporting CMWs performing two or more deliveries per month in her area

Data Capture Point Online MNCH-MIS

Interval Monthly


Criteria / Formula

Numerator: Number of Reporting CMWs with Two or more deliveries

Denominator: Total number of deployed CMWs in the district



Scoring Formula




Weight 7

Discussion



5.4 Subdomain: Nutrition Programme Weight 5

5.4.1 KPI: Percentage of Identified SAM Children being Treated

(Note: Nutrition program is currently working in two districts only)

Definition Percentage of Identified Children with Severe Acute Malnutrition (SAM) being Treated

Data Capture Point Online Nutrition – MIS

Interval Monthly


Criteria / Formula

Numerator: Number of identified SAM children being treated

Denominator: Total number of children screened in targeted districts



Scoring Formula


Weight 5



5.5 Subdomain: Malaria Control Programme Weight 3

5.5.1 KPI : Percentage of P. Falciparum +ve Cases of Malaria

Definition Percentage of P. Falciparum +ve Cases of Malaria

Data Capture Point DHIS

Interval Monthly


Criteria / Formula Numerator: Number of P. Falciparum +ve cases Denominator: Total Slides Taken


Performance Range Upper Limit = 40, Lower Limit = 10 (Inverse)

Scoring Formula


Weight 3

Discussions



5.6 Subdomain: Polio Eradication Weight 5

5.6.1 KPI: Polio Zero Reporting Definition

Polio Zero Reporting (Average weekly compliance in a month of Zero Reports)

Data Capture Point EOC

Interval Monthly


Criteria / Formula

Numerator: Number of average weekly Reports Submitted in a month

Denominator: No of Due Weekly Reports



Scoring formula


Weight 5

Discussion


6. Domain: Hospital Performance Weight 10

6.1. Subdomain: Hospital Performance Weight 10

6.1.1. KPI: Consolidated index of Secondary Hospitals performance

Definition Average performance score of hospitals.

Data Capture Point M&E KPI System

Interval Monthly


Criteria / Formula Numerator: Average Score of MS THQ/DHQ in district Denominator: Total MS Score


Performance Range [0 - 100]

Scoring formula Score = ( (Average Score of MS THQ/DHQ in district) / (Total MS Score))x10

Weight 10

Discussion


Annex : Targets, Criteria and Formulas of Composite Index KPI’s

Annex-1.2.1 Filled Post Index : Percentage of essential posts filled against sanctioned posts

Facility Type

BHU RHC THQ DHQ

Criteria

Essential Staff

Sanctioned Weight Essential Staff

Sanctioned Weight Essential Staff

Sanctioned Weight Sanctioned Staff

Sanctioned Weight

WMO/MO 1 50 SMO 1 15 Specialists Doctors

4 20 Specialists Doctors

8 20

LHV 1 20 MO 2 15 MO (Male) 2 15 MO (Male) 3 15

Medical Technician

1 20 WMO 1 10 MO (Female)

1 15 MO (Female) 1 15

Cleaner 1 10 Dental Surgeon

1 10 Dental Surgeon

1 5 Dental Surgeon

1 5

Medical Technician

3 10 Nurses 3 10 Nurses 10 10

EPI Technician

2 10 Medical Technician

2 10 Medical Technician

3 10

LHV 3 10 EPI Technician

1 5 EPI Technician

1 5

Cleaners 1 10 LHV 2 10 LHV 5 10

Ambulance Drivers

1 10 Cleaners 3 5 Cleaners 4 5

Ambulance Drivers

1 5 Ambulance Drivers

2 5

4 100 15 100 20 100 38 100

Overall Weight (Facility type wise)

25 25 25 25

Formula

Case 1: When District have at-least 1 DHQ and 1 THQ

Filled Post Index = 25 % of Filled posts index of BHU +

25 % of Filled posts index of RHC +


25 % of Filled posts index of THQ +

25 % of Filled posts index of DHQ

Case 2: When District have 0 DHQ and at-least 1 THQ

Filled Post Index = 33.3 % of Filled posts index of BHU +

33.3 % of Filled posts index of RHC +

33.3 % of Filled posts index of THQ


Filled Post Index = 33.3 % of Filled posts index of BHU +

33.3 % of Filled posts index of RHC +

33.3 % of Filled posts index of DHQ

Case 4: When District have 0 DHQ and 0 THQ

Filled Post Index = 50 % of Filled posts index of BHU +

50 % of Filled posts index of RHC

Case 5: When District have 0 DHQ and 0 THQ and 0 RHC

Filled Post Index = 100 % of Filled posts index of BHU

Filled Post index of BHU = (No of BHU with at-least 1 WMO/MO post filled / Total No of BHU Visited) * 50 +

(No of BHU with at-least 1 LHV post filled / Total No of BHU Visited) * 20 +

(No of BHU with at-least 1 Medical Technician post filled / Total No of BHU Visited) * 20 +

(No of BHU with at-least 1 cleaner posts filled / Total No of BHU Visited) * 10

Filled Post index of RHC = (No of RHC with at-least 1 SMO post filled / Total No of RHC Visited) * 15 +

(No of RHC with at-least 2 MO post filled / Total No of RHC Visited) * 15 +

(No of RHC with at-least 1 WMO post filled / Total No of RHC Visited) * 10 +

(No of RHC with at-least 1 Dental Surgeon post filled / Total No of RHC Visited) * 10 +

(No of RHC with at-least 3 Medical Technician post filled / Total No of RHC Visited) * 10 +

(No of RHC with at-least 2 EPI Technician posts filled / Total No of RHC Visited) * 10 +

(No of RHC with at-least 3 LHV posts filled / Total No of RHC Visited) * 10 +

(No of RHC with at-least 1 Cleaner posts filled / Total No of RHC Visited) * 10 +


(No of RHC with at-least 1 Ambulance Driver posts filled / Total No of RHC Visited) * 10

Filled Post index of THQ = (No of THQ with at-least 4 Specialist post filled / Total No of THQ Visited) * 20 +

(No of THQ with at-least 2 MO (Male) post filled / Total No of THQ Visited) * 15 +

(No of THQ with at-least 1 2 MO (Female) post filled / Total No of THQ Visited) * 15 +

(No of THQ with at-least 1 Dental Surgeon post filled / Total No of THQ Visited) * 5 +

(No of THQ with at-least 3 Nurses post filled / Total No of THQ Visited) * 10 +

(No of THQ with at-least 2 Medical Technician post filled / Total No of THQ Visited) * 10 +

(No of THQ with at-least 1 EPI Technician post filled / Total No of THQ Visited) * 5 +

(No of THQ with at-least 2 LHV post filled / Total No of THQ Visited) * 10 +

(No of THQ with at-least 3 Cleaner post filled / Total No of THQ Visited) * 5 +

(No of THQ with at-least 1 Ambulance Driver post filled / Total No of THQ Visited) * 5

Filled Post index of DHQ = (No of THQ with at-least 8 Specialist post filled / Total No of THQ Visited) * 20 +

(No of THQ with at-least 3 MO (Male) post filled / Total No of THQ Visited) * 15 +

(No of THQ with at-least 1 2 MO (Female) post filled / Total No of THQ Visited) * 15 +

(No of THQ with at-least 1 Dental Surgeon post filled / Total No of THQ Visited) * 5 +

(No of THQ with at-least 10 Nurses post filled / Total No of THQ Visited) * 10 +

(No of THQ with at-least 3 Medical Technician post filled / Total No of THQ Visited) * 10 +

(No of THQ with at-least 1 EPI Technician post filled / Total No of THQ Visited) * 5 +

(No of THQ with at-least 5 LHV post filled / Total No of THQ Visited) * 10 +

(No of THQ with at-least 4 Cleaner post filled / Total No of THQ Visited) * 5 +

(No of THQ with at-least 2 Ambulance Driver post filled / Total No of THQ Visited) * 5


Annex - 1.2.3 Staff Presence Index : Percentage of staff present

Facility Type BHU RHC THQ DHQ

Criteria

Essential Staff Weight Essential Staff Weight Essential Staff Weight Sanctioned Staff Weight

WMO/MO 50 SMO 15 Specialists Doctors 20 Specialists Doctors 20

LHV 20 MO 15 MO (Male) 15 MO (Male) 15

Medical Technician 20 WMO 10 MO (Female) 15 MO (Female) 15

Cleaner 10 Dental Surgeon 10 Dental Surgeon 5 Dental Surgeon 5

Medical Technician 10 Nurses 10 Nurses 10

EPI Technician 10 Medical Technician 10 Medical Technician 10

LHV 10 EPI Technician 5 EPI Technician 5

Cleaners 10 LHV 10 LHV 10

Ambulance Drivers 10 Cleaners 5 Cleaners 5

Ambulance Drivers 5 Ambulance Drivers 5

100 100 100 100

Overall Weight (Facility type wise)

25 25 25 25

Formula


Staff Presence Index = 25 % of Staff Presence index of BHU +

25 % of Staff Presence index of RHC +

25 % of Staff Presence index of THQ +

25 % of Staff Presence index of DHQ



Staff Presence Index = 33.33 % of Staff Presence index of BHU +

33.33 % of Staff Presence index of RHC +

33.33 % of Staff Presence index of THQ


Staff Presence Index = 33.33 % of Staff Presence index of BHU +

33.33 % of Staff Presence index of RHC +

33.33 % of Staff Presence index of DHQ


Staff Presence Index = 50 % of Staff Presence index of BHU +

50 % of Staff Presence index of RHC

Case 5: When District have 0 DHQ and 0 THQ and 0 RHC

Staff Presence Index = 100 % of Staff Presence index of BHU


Annex - 1.4.1 : Drug Availability Index (IMU) Primary

Criteria

Essential Medicine List (From IMU)

High Consumption Medicine Low Consumption Medicine Required Level of Stock

Cap. Amoxicillin/Ampicillin Syp. Amoxicillin/Ampicillin/Cephradine Tab.Cotrimoxazole/Ofloxacin/Ciprofloxacin/Erythromycin/Levofloxacin Tab. Metronidazole Tab.Diclofenac/Paracetamol/Ibuprofen/Mefenemic acid Syp. Paracetamol/Ibuprofen/Mefenemic acid Syp. Albendazole/Mebendazole Tab/Caps. Iron/Folic acidI ORS (Packets) Tab Glibenclamide/Metformin/Glimipride Tab.Nifedipine/Nephidipine/Atenolol/Amlodipine Contraceptive injections Condoms Oral Contraceptive pills

Syp.Cotrimoxazole/Erythromycin/Clarythromycin Syp. Metronidazole Inj.Ampicillin/Amoxicillin/Gentamycin/Ceftriaxone Inj. Diclofenac/Paracetamol Tab.Chloroquine/Artemether+Lumefentrine Syp. Salbutamol I/V Infusions Inj. Dexamethasone/Hydrocortisone Inj Adrenaline Inj. Misoprostol/Oxytocin Inj. Magnesium Sulphate IUD

10 10 15 15 30 15 5

10 3 5 3 2


Annex - 1.4.2 : Drug Availability Index (DHIS) Secondary Level

Drug List: (18 Essential Medicines and 9 Vaccine for all HF type included in DHIS)

Criteria

Essential Medicine List (From DHIS) Vaccine List (From DHIS)

Cap. Amoxicillin Syp. Amoxicillin Tab. Contrimoxazole Syp. Cotrimoxazole Tab. Metronidazole Syp. Metronidazole Inj. Ampicillin Tab. Diclofenac Syp. Paracetamol Inj. Diclofenac Tab. Chloroquin Syp. Salbutamol Syp. Antihelminthic I/V infusions Inj. Dexamethasone Tab. Iron / Folic Acid ORS Oral pills (COC)

BCG vaccine Pentavalent vaccine Polio vaccine Heptatitis-B vaccine Measles vaccine Tetanus Toxiod Anti Rabies Vaccine Anti Snake Venom Vaccine Syringes


Annex - 1.4.3 : Equipment Availability /Functionality (IMU) Primary

Criteria

Equipment List (From IMU)

BHU RHC

Ambu Bag Ambu Bag

Bulb Sucker Bulb Sucker

Delivery Set Delivery Set

Delivery Table Delivery Table

Oxygen Cylinder Oxygen Cylinder

X-Ray

Ultrasound

Lab

50% 50%

% of Functional Equipment=(Sum(# of functional equipment in BHU)/(5*No of BHU) )*50 + (Sum(# of functional equipment in RHC)/(8*No of RHC) )* 50


Annex - 2.3.1 Percentage MIS Reporting Regularity

MIS DHIS MNCH-MIS LHW-MIS EPI MIS

Overall Weight % 40 20 20 20

Criteria / Formula

Case 1: When District has all Four MIS

Percentage MIS Reporting Regularity = 1/4 * ( % of DHIS Regularity) +

1/4 * ( % of MNCH MIS Regularity) +

1/4 * ( % of LHW MIS Regularity) +

1/4 * ( % of EPI MIS Regularity) +

Case 2: When District has Not LHW MIS

Percentage MIS Reporting Regularity = 1/3* ( % of DHIS Regularity) +

1/3 * (% of MNCH MIS Regularity) +

1/3 *( % of EPI MIS Regularity)

DHIS Reporting Compliance = (Number of Health Facilities Reports Submitted / No of Functional and Reporting Health Facilities during

month ) * 100

MNCH-MIS Reporting Compliance = (Number of CMW reports submitted / No of Deployed CMW during month) * 100

LHW-MIS Reporting Compliance = (Number of Reports Submitted / No of Due Reports) * 100

EPI-MIS Reporting Compliance = (Number of Reports Submitted / No of Due Reports) * 100

% of MIS Reporting Regularity = DHIS Reporting Compliance * 40 + MNCH-MIS Reporting Compliance * 20 + LHW-MIS Reporting

Compliance * 20 + EPI-MIS Reporting Compliance * 20


Annex – 4.2.1 Health Facility Utilization (Daily OPD) : Percentage of Health facilities meeting their targets of Daily OPD

Facility Type BHU MCH RHC CH THQ DHQ

Targets 10 5 25 30 100 150

Weights 30 25 25 20

Formula Case 1: When District have at-least 1 DHQ and 1 THQ

Health Facility Utilization (Daily OPD) Index = 30 % of ((No of BHU/MCH meeting their targets of Daily OPD) / (Total No of Dispensaries/BHU/MCH in district)) + 25 % of ((No of RHC/CH meeting their targets of Daily OPD) / (Total No of RHC in district)) + 25 % of ((No of THQ meeting their targets of Daily OPD) / (Total No of THQ in district)) + 20 % of ((No of DHQ meeting their targets of Daily OPD) / (Total No of DHQ in district))


Health Facility Utilization (Daily OPD) Index = (30 % of ((No of BHU/MCH meeting their targets of Daily OPD) / (Total No of Dispensaries/BHU/MCH in district)) + 25 % of ((No of RHC/CH meeting their targets of Daily OPD) / (Total No of RHC in district)) + 25 % of ((No of THQ meeting their targets of Daily OPD) / (Total No of THQ in district)) ) * 100 / 80


Health Facility Utilization (Daily OPD) Index = (30 % of ((No of BHU/MCH meeting their targets of Daily OPD) / (Total No of Dispensaries/BHU/MCH in district)) + 25 % of ((No of RHC/CH meeting their targets of Daily OPD) / (Total No of RHC in district)) + 20 % of ((No of DHQ meeting their targets of Daily OPD) / (Total No of DHQ in district)) ) * 100 / 75


Health Facility Utilization (Daily OPD) Index = (30 % of ((No of BHU/MCH meeting their targets of Daily OPD) / (Total No of Dispensaries/BHU/MCH in district)) + 25 % of ((No of RHC/CH meeting their targets of Daily OPD) / (Total No of RHC in district)) ) * 100 / 55

Case 5: When District have 0 DHQ and 0 THQ 0 RHC/CH

Health Facility Utilization (Daily OPD) Index =

(100 % of ((No of RHC/CH meeting their targets of Daily OPD) / (Total No of RHC in district))


Annex – 4.2.2 Bed Occupancy Rate : Average bed occupancy rate of HF/hospitals providing inpatient care (RHC, THQ, DHQ)

Facility Type RHC THQ DHQ

Weights 10 30 60

Formula Case 1: When District have at-least 1 DHQ and 1 THQ

Bed Occupancy Rate = 10 % of BOR of RHCs + 30 % BOR of THQs + 60 % of BOR of DHQ


Bed Occupancy Rate = (10 % of BOR of RHCs + 30 % of BOR of THQs) * 100 / 40


Bed Occupancy Rate = (10 % of BOR of RHCs + 60 % of BOR of DHQ) * 100 / 70


Bed Occupancy Rate = BOR of RHCs

BOR of RHCs = ((Sum of Daily patients count in RHCs) / (Sum of Allocated Beds * Month days)) * 100

BOR of THQs = ((Sum of Daily patients count in THQs) / (Sum of Allocated Beds * Month days)) * 100

BOR of DHQ = ((Sum of Daily patients count in DHQ) / (Sum of Allocated Beds * Month days)) * 100


Annex – 4.3.1 Antenatal Care Coverage: Percentage of Health Facilities meeting their targets of first antenatal visits (ANC-1)


Targets 15 20 25 30 50 100

Formula

Antenatal Care Coverage =

((No of Health facilities (BHU, MCH, RHC, CH, THQ, DHQ) meeting their monthly target of ANC1) / (Total No of Health

Facilities (BHU, MCH, RHC, CH, THQ, DHQ)) ) * 100


Annex – 4.3.2 Total Institutional Deliveries: Percentage of Health facilities meeting their monthly targets of Deliveries


Targets 5 8 10 15 30 75

Weights 25 25 25 25

Formula


Institutional Deliveries (All) =

25 % of ((No of BHU/MCH meeting their targets of Deliveries) / (Total No of BHU/MCH in district))

+ 25 % of ((No of RHC/CH meeting their targets of Deliveries) / (Total No of RHC/CH in district))

+ 25 % of ((No of THQ meeting their targets of Deliveries) / (Total No of THQ in district))

+ 25 % of ((No of DHQ meeting their targets of Deliveries) / (Total No of DHQ in district))



(25 % of ((No of BHU/MCH meeting their targets of Deliveries) / (Total No of BHU/MCH in district))

+ 25 % of ((No of RHC/CH meeting their targets of Deliveries) / (Total No of RHCs in district))

+ 25 % of ((No of THQ meeting their targets of Deliveries) / (Total No of THQ in district)) ) * 100/75



(25 % of ((No of BHU/MCH meeting their targets of Deliveries) / (Total No of BHU/MCH in district))

+ 25 % of ((No of RHC/CH meeting their targets of Deliveries) / (Total No of RHC/CH in district))

+ 25 % of ((No of DHQ meeting their targets of Deliveries) / (Total No of DHQ in district)) ) * 100/75




+ 25 % of ((No of RHC/CH meeting their targets of Deliveries) / (Total No of RHC in district)) * 100/50


Case 4: When District have 0 DHQ and 0 THQ and 0 RHC/CH



Documents

KEY PERFORMANCE INDICATORS for District Health … · Summary of Key Performance Indicators for District Health Services ... Details of Key Performance Indicators for District