Understanding Health Information Needs and Gaps in the Health Care System in Uttar Pradesh, India

Figures & data

Table 1. Number, location, and types of key informant interviews, by health system level

Health system level	Number	Location	Types
National	6	New Delhi	United States Agency for International Development officials, international nongovernmental organization, and nongovernmental organization staff
State	10	Lucknow	National Rural Health Mission officials
District/block	11	Mahilabad, Mohanlalganj, and Sarojini Nagar blocks	District health officer, district community mobilizer, block health education officer, medical officer, and laboratory technician
Village/subcenter	9	Mahilabad, Mohanlalganj, and Sarojini Nagar blocks	Accredited social health activists, auxiliary nurse-midwives
Network	10	Lucknow	Members of professional networks
Total	46

Table 2. Definitions of information at different levels of the health system

Health system level	Types of information	What does information mean?	How information is used
National	Evidence-based information Best practices	“Our mantra is to use evidence to inform programs.” “I like executive summaries—not pure data.”	Policy planning
State	Health services and health coverage information, aggregated at district and state levels	“How many gynecologists in the state, district? How many deliveries at the PHC?”	Program planning
District/block	Government guidelines	“We get government circulars, which we read. The government keeps on taking out circulars with new information.”	Program implementation
Village	Referral information Transportation information How to use thermometers Verbal communication	“Generally people in the village sit outside so we explain to them there only. They come to meet us even at one call. Everybody calls me didi (sister) and respects me.” “Information related to how to give a message, how to organize meetings.”	Motivation for behavior change; referrals; how to handle emergencies

Figure 1 Information flow within the government health system. ANM = auxiliary nurse-midwife; ASHA = accredited social health activist. (Color figure available online.).

Table 3. Information sharing at various levels of the health system

Information sharing	State	District/block	Village
With whom?	District authorities Nongovernmental organizations District officials in remote areas	District shares with medical officer in-charge and block health education officers Block shares with auxiliary nurse-midwives and accredited social health activists	Auxiliary nurse-midwife shares with accredited social health activist and village women Accredited social health activist shares with village women, mothers-in-law, other villagers
How?	Meetings Print copies E-mail Letters to remote areas	Meetings Telephone calls	Home visits Meetings Telephone calls
In what form?	Guidelines Circulars Posters Pamphlets (to remote areas)	Guidelines	Guidelines Responses to queries from the community

Table 4. Barriers to the five parameters of actionable information, by health system level

	Barriers by Health System Level
Parameters of actionable information	National	State	District/Block	Village
Language	Research data are complex Reports are lengthy	Reading and understanding English is difficult Reports are lengthy	Information in English is not always relevant Reading and understanding English is difficult	High-level Hindi is not easily understood English is not understood
Time and timeliness	Lack of time Information-sharing forums are difficult to organize Conducting searches takes time	Internet is often down Government websites are not updated	Letters are late. Instructions are received verbally Internet access does not exist Computers are inadequate	Information does not reach the village when needed Auxiliary nurse-midwife is the only source of information
Simplification	Key issues in the data are not highlighted	Information is not integrated across departments	There is a language barrier. Posters, pamphlets are not useful	There is a language barrier Simple information linked to health-related queries is lacking Simple information on referrals is lacking
Amount of information	Information is not presented succinctly	Too much information is of no use	Technical information is too lengthy	Practical information in small quantities is lacking
Access to information	Internet is often down	Internet is often down Power often gets cut off	Internet is down Mobile phone networks are weak Power often gets cut off	Internet access does not exist Power often gets cut off Literacy is lacking