PEI (Partnership for equity & Inclusion)

Introduction

Nepal is in the process of institutionalizing federalization. Three tires of government, as per the new structure, includes a federal government, seven provincial governments and 753 local governments. In the federal structure, health is one of the most decentralized sectors where basic health services falls under the exclusive functions of local government. The Health Management Information System (HMIS) provides a strong base for evidence informed decision making in the Nepal health system. Nepal’s health system needs accurate, comprehensive and disaggregated data to measure its performance, and to identify disparities among social groups and geographic areas. HMIS record health service utilization of private providers, however private providers use their own information management systems (IMS). Evidence showed that neither public nor private IMS have been systematically assessed against gender and equity framework thus gap in knowledge exists. PEI (Partnership for Equity and Inclusion) is a research project that studies intersectional gender and equity in public and private sector IMS and design an evidence-informed framework that promotes gender equitable health services.

Objective

The objective of the project is to assess intersectional gender and equity in public and private sector IMS and design an evidence-informed framework that promotes gender equitable health services.

Methodology

This study will be cross-sectional exploratory study using desk-based review of IMS policies of public and private service providers, and a qualitative study by conducting 12-15 key informant interviews (KIIs) at federal, provincial and local levels, and formation of a technical working group to assess the MIS.  Cases studies of four health facilities, one from public, one from private health facility, one from rural municipalities and one from urban municipalities will be conducted. Desk based document review including review of existing IMS policies, process, guidelines, principles, forms, formats, recording and reporting system and review of DHIS-2, which is a web-based reporting platform of HMIS that also facilitate analysis and visualization of data will be performed. Policy documents and qualitative data will be analyzed using thematic framework analysis approach.

Expected output

The findings from the project will identify gaps in existing IMS and help and support to strengthen routine health information system at all levels, from federal to community. The project is anticipated to develop a framework incorporating gender equality and intersectionality in routine health information system through the engagement of local government, HFOMC and community people. Learning from the project will inform local planning process to use the framework and to inform larger research project in other municipalities to strengthen delivery of routine health services ensuring gender equality and focus on intersectionality.

Partnership

This project is implemented in partnership with Ministry of Health and Population (MOHP), HMIS section of the Management Division, provincial health directorate, Health Facility Operation Management Committee (HFOMC) and local level representatives. This study is part of a research Cluster that aims to build on the work of five existing GCRF international research networks/projects focused on equity in key public institutions.