Public Health Foundation of India, Gurgaon, Haryana 122002, India.
London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK.
Int J Environ Res Public Health. 2020 Nov 9;17(21):8283. doi: 10.3390/ijerph17218283.
Effective coordination among multiple departments, including data-sharing, is needed for sound decision-making for health services. India has a district planning process involving departments for local resource-allocation based on shared data. This study assesses the decision-making process at the district level, with a focus on the extent of local data-use for resource allocation for maternal and child health.
Direct observations of key decision-making meetings and qualitative interviews with key informants were conducted in two districts in the State of West Bengal, India. Content analysis of the data maintained within the district health system was done to understand the types of data available and sharing mechanisms. This information was triangulated thematically based on WHO health system blocks.
There was no structured decision-making process and only limited inter-departmental data-sharing. Data on all 21 issues discussed in the district decision-making meetings observed were available within the information systems. Yet indicators for only nine issues-such as institutional delivery and immunisation services were discussed. Discussions about infrastructure and supplies were not supported by data, and planning targets were not linked to health outcomes.
Existing local data is highly under-used for decision-making at the district level. There is strong potential for better interaction between departments and better use of data for priority-setting, planning and follow-up.
为了做出合理的卫生服务决策，多个部门（包括数据共享）之间需要进行有效的协调。印度有一个地区规划流程，涉及各部门根据共享数据进行本地资源分配。本研究评估了地区层面的决策过程，重点关注当地数据在孕产妇和儿童健康资源配置方面的使用程度。
在印度西孟加拉邦的两个地区进行了关键决策会议的直接观察和关键信息提供者的定性访谈。对地区卫生系统中保存的数据进行了内容分析，以了解可用数据的类型和共享机制。根据世界卫生组织卫生系统模块，对这些信息进行了主题三角分析。
没有结构化的决策过程，只有有限的部门间数据共享。在观察到的地区决策会议上讨论的所有 21 个问题都有数据在信息系统中可用。然而，只有九个问题（如机构分娩和免疫服务）的指标得到了讨论。关于基础设施和供应的讨论没有数据支持，规划目标也没有与健康结果挂钩。
现有的本地数据在地区层面的决策中被高度低估。部门之间有很大的潜力进行更好的互动，并更好地利用数据进行优先事项设定、规划和后续跟踪。
