E-mamta Manual 19o3p
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E-MAMTA MANUAL
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E-MAMTA MANUAL
Disclaimer: Needless to say the responsibility of any error is ours. We welcome suggestions, or queries for further clarity. We request all readers who notice discrepancies and errors or mismatches between what they read and observe, to bring the same to our notice. Please write back at: [email protected]
Department of Health and Family Welfare, Government of Gujarat Technical by NIC, Gujarat. Date of Publishing: June 2010. Copy Right: Department of Health and Family Welfare, Government of Gujarat 2 Created with Print2PDF. To remove this line, buy a license at: http://www.binarynow.com/
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E-MAMTA MANUAL All the efforts of Health department of Gujarat are driven towards improving health of the people of Gujarat by amassing partnership. This year some new initiatives like initiation of Village Clinics, E-Mamta and universal check-up of school going children have been taken up by my Department to improve the health of mother and children in the State. Access to accurate and reliable information on the health of mother and child is essential in order to provide appropriate services. The collection of this information is important not only at the health facility level, but also at the community level, given that many illnesses never reach the health facility and go unreported. Gujarat is the first State to put in place a system whereby the HMIS reports will be generated through aggregation of services and name based tracking of mother and child health services. This is also the only application of its kind which would track the migratory population, thereby allowing us to effectively cover the drop-outs. Team Gujarat looks forward to its replication by the fellow States.
Jay Narayan Vyas Minister of Health and Family Welfare, Gujarat . The E-mamta software has been implemented by the Department of Health and Family Welfare in collaboration with NIC to capture health data from the grassroots level. The district, region and State teams have been trained to collect relevant information within their villages and enter this information at the Primary Health Centre/sub-center level. This information is used by the district health authorities to direct their resources and services to where they are most needed. Simultaneously, Female Health Workers are able to generate their work plans and work in a more focused manner.
Parbat bhai Patel Minister of State for Health, 5 Created with Print2PDF. To remove this line, buy a license at: http://www.binarynow.com/
E-MAMTA MANUAL Gujarat An effective health management information system (HMIS) is an important instrument to plan and monitor health interventions and facilitate overall surveillance of the health condition of a population. Despite the availability of abundance of information, in health sector there is a need to build capacity to find, communicate or use the information effectively. The data are presented as complex spreadsheets or numerical tables that are not easily understood. Effective coordination to fill the gaps in data collection is the need of the hour. This would lead to optimal use of data for planning and monitoring. E-Mamta connects all the decision centers in the organization to improve the management of health programs and services. Each Family in the State is being given a Health Id. All pregnant mother/child will also be given a Unique ID with which the services provided to them can be tracked. Subsequently, this will result in enhancing the capacity of health department.
Rajesh Kishore IAS Principal Secretary (Medical Services and Medical Education), Gujarat E- Mamta is a step towards realizing the vision of Swarnim Gujarat and the Millennium development goals of reducing IMR & MMR in the State. I congratulate the State Rural Health Mission of Gujarat and NIC for developing this customized application to track the services provided to every Mother and Child and thereby improve the health service delivery. Now, health indicators for each and every village can be obtained through aggregation of data and information can be generated at the district, block, and village level. This makes the generation and maintenance of reports easy at the field level and eliminates data duplication caused by multiple data reporting. The deliverance of various Reproductive and Child Health services like ANC, delivery, PNC, Immunization, family Planning and Adolescent Friendly Health Services will definitely improve through this program.
Smt. V.L Joshi IAS Principal Secretary (Public Health) 6 Created with Print2PDF. To remove this line, buy a license at: http://www.binarynow.com/
E-MAMTA MANUAL Commissioner (Health), Gujarat. ABBREVIATIONS ANC: Ante natal care ASHA: Accredited Social Health Activist BPL: Below Poverty Line CY: Cheeranjeevi Yojana E: Emergency Contraceptive Pills EDD: Expected Date of Delivery FHS: Family Health Survey FHW: Female Health Worker HMIS: Health Management Information System ID: Identification Number IFA: Iron Folic Acid IUD: Intra Uterine Devices JSY: Janani Suraksha Yojana LMP: Last Menstrual Period MO: Medical Officer PHC: Primary Health Centre PNC: Post Natal Care RTI: Reproductive Tract Infections STI: Sexually Transmitted Infections
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E-MAMTA MANUAL
FOREWORD
E-Mamta is a management tool to reduce IMR/MMR/ TFR and track the health service delivery at the individual level. Here, we also look at the integration of various health information systems, decentralization of information, flexibility and cost effectiveness and compilation of health data through aggregation of services to the individual beneficiaries. E-Mamta would initiate evidence based planning, tracking of beneficiary-wise information on reproductive and child health services, adolescent health services. This would help us in knowing the left outs in essential programs like immunization, anemia, malnutrition etc so that we can reach them. The monthly work plans would enable the service providers at the grassroots level to identify the span of their work and reach the people who do not voluntarily opt for services. Through SMS messages to beneficiaries we would try to reach directly to the beneficiary to remind them of the services due to them. The monitoring reports of the State level would also be generated using this framework that would help improve the quality and utilization of information generated in the health system. We have built in value add citizen service features like Individual Immunization Record, Child Growth Chart, Weight/Hb Chart for the Pregnancy etc. To facilitate the replication of the E-Mamta in other States we have prepared this manual to get oriented with different functionalities and modules included in the software. This manual is easy to use and includes illustrated description of various functionalities and modules included in the software. Our Help desk and other Resource persons will always be available to provide further guidance. Like all other software’s, E-Mamta is under a process of constant evolution and new modules and functionalities are being added on. New versions of the manual will thus be made available to the s at periodic interval.
Anju Sharma IAS MissionDirector, State Rural Health Mission, Gujarat 8 Created with Print2PDF. To remove this line, buy a license at: http://www.binarynow.com/
E-MAMTA MANUAL
ACKNOWLEDGMENTS The current version of E E-Mamta Mamta has been developed through an enduring process. We express our sincere thanks to the Hon’ble Minister of Health, Gujarat and Hon’ble Minister of State for Health, Gujarat, for their undoubting and guidance in this initiative. We are also indebted to the Principle Secretary (Medical Education & Medical services), Principle Secretary (Health) and Commissioner Health for their unflinching and guidance. I would also thank the Ministry of Health and Family Welfare, Government of India, especially, MD, National Rural Health Mission, GOI and all our partners for financial and guidance to develop and implement the program The E – Mamta application has been conceptualiz conceptualized ed by the Mission Director NRHM Gujarat. She has provided her constant and guidance in developing the program and has also been instrumental in including some unique features in the application, especially, Birth charts, Immunization Card, Weight ccard, ard, Work Plan for Malnutrition, Stock inventory, Growth chart, HMIS Integration etc. The smooth roll out of the application was possible due to the consistent endeavor of our State Health team including all the Additional Directors - Health, Medical Education, Educ Medical Services, Family Welfare, t Director MCH, Deputy Director Rural Health. We are especially thankful to Dr. B.K. Patel Additional Director, Family Welfare and Dr. N. Dholakia, Deputy Director MCH for their constant in developing the modules and training at the grass root level and thus making the application a success. The enthusiastic participation of all Program officers, RDDs, CDHO, CDMO, RCHO, ADHO, Urban Health Officer, DPMU, Project officers, SPMU, DPC, C, PHN, District M& M&E, E, BHO, MOs, Block M&E, Block HV, ANM, ASHAs has led to the successful implementation of the E E-Mamta Mamta program in a very short period, in the State. The development and operationalization of the application has been made possible with the technical by the National Informatics Centre, Gujarat, under Shri Rajneesh Mahajan, State Informatics Officer. I would also be failing in my duties if I do not mention the contribution of Shri Anand Shah, Principle Systems Analyst and his team of Programmers as welll all the data entry operators in various health facilities of the State. I am also thankful to my staff of Vital Statistics and demographic & Evaluation branch for their timely and action taken during the training of E E-mamta.
Shri K. K Panchal Additional Director(VS) & Nodal Officer (e-mamta) (e 9 Created with Print2PDF. To remove this line, buy a license at: http://www.binarynow.com/
E-MAMTA MANUAL Table of Contents ABOUT E- MAMTA………………………………………………….…..…..11
MODULE 1: GETTING STARTED……………………………………..............14 MODULE 2: DATA ENTRY ………………. …………………….……………16 MODULE 3: DATA VERIFICATION……. …………………….…………….19 MODULE 4: GENERATING WORKPLANS ………………………….….….21 MODULE 5: GENERATING REPORTS………………………………………42 MODULE 6: VALUE ADDED SERVICES ……………………….…………..48
FEATURES OF E-MAMTA…………………………………………….54
MONITORING AND TRAINING …………………………………… 55 PLANS AHEAD……………………………………………………...….56
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E-MAMTA MANUAL ABOUT E-MAMTA
E-Mamta Name Based Information Tracking system Tracking of Pregnant mothers and children has been recognized as a priority area for providing effective Healthcare services to this group. As a major initiative in this regard, the Health and Family Welfare Department, Government of Gujarat, has introduced a Mother & child name based tracking Information management system “EMamta” in collaboration with NIC, Gujarat. E-Mamta is a generic system which aims to provide information of different health services received at the individual level, by monitoring all the encounters that an individual undergoes in his/her health program. This system aims to help the service provider (health worker or doctor) by categorizing various health services the individual person has to get (with due date) and missed services. It also provides for effective monitoring of different health services drilling down to the individual patient information. The development of the E-Mamta has been ongoing since January 2010. A. Situation analysis This has included the study of primary s and ANC/Immunization cards to understand what are the “essential data set” which must be included in each of the forms. B. System objectives The system has two broad set of objectives: 1. To provide the effective monitoring of different services at the individual level, where reports could be sorted on the following criteria- by individual patients; by village; by period; by service providers. 2. To aggregate the individual patient based data and import it into the facility based HMIS so as to avoid double ing of data and thus improve the quality of data. C. System logic
The system will allow ing: Person Object, Person Attribute Object, Person Attribute Value Object, and Person Identifier Object (This object stores all the unique health identifier of individual. A person can have single or multiple identifiers such as port number, PAN number, Driving license, UID, etc.), Identifier Type Object, Program Object (this object contain information about various health program), Program Stage Object, Program Instance Object(This object stores the relationship between person object and program object.), Program Stage Instance Object(This object stores various program stages, its due date and its execution date for particular person object.), Person data value Object, Organization Unit Object(Organization units are organized in a 11 Created with Print2PDF. To remove this line, buy a license at: http://www.binarynow.com/
E-MAMTA MANUAL hierarchy with a parent and a set of children. Each organization unit is identified by a name and possibly an organization unit code.), Data element Object (Data element refers to that which one can data for). E-Mamta, is an information management system that works towards case based tracking of all pregnant mothers and children up to 19 years of age. All girls & women (14-49 years) and all children (0-6 years) will be tracked in this program. The tool enables better service delivery by: i.
Identifying the accurate requirement and utilisation of services in specific categories
ii.
Identifying gaps in service delivery
iii.
Communicating directly with the beneficiaries/service providers through system generated SMS alerts
iv.
Assisting the program managers in planning the programs and policy formation through better monitoring and evaluation.
v.
Better financial and physical monitoring of programs and motivation of Human resource.
The system works in four phases: 1. Family Health Survey: The mammoth first step in this regard, being Family Health Survey in rural & urban areas (slum and slum like) has been successfully accomplished by the health workers. Individual records of around 75.5 lakh families comprising 38.3 million beneficiaries, covering almost 75% of population of Gujarat have already been entered in the Information system ‘E-Mamta’ till date. The benefits of the unique family healthcare ID provided is to capture the migration details and prevent loss of cases due to migration. The family survey data is being validated through physical verification by ASHA/FHW/ MOs and other senior officials in order to ensure accuracy and reliability of the data. 2. Registration of pregnant mothers and children: All mothers who are pregnant and children of age up to 6 years are being ed and provided a unique mother/child health ID. 3. Tracking of healthcare services through monthly work plans: The services provided to the pregnant mothers including ANC, delivery, PNC and immunization are captured in this program.
Thus E-Mamta facilitates service delivery through:
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E-MAMTA MANUAL
Elaborate work plans prepared at Sub centres and given to ASHA/FHW to provide services falling due to the beneficiaries
The details of services provided to the mothers and children for ANC, immunization, PNC, nutrition are recorded in E-Mamta at the PHC/village level which facilitates to identify the gaps in the continuum of care
SMS alerts will be sent to the beneficiaries/health workers for the services that fall due.
Monitoring the incentives paid to various health workers
In accordance with the Family based approach, the information could be integrated with data from School Health, ICDS, Education and thus help in giving a holistic picture on individuals regarding health, education and nutrition
The HMIS report like form no. 6,7,8,9 and no. 2,3,4 and 5 would be generated through E – Mamta by aggregation of various services.
Monitoring and Evaluation is possible through the software in least time by generating the following reports: 1. Child Immunization Record, Child Growth Chart (male), Child Growth Chart (female) is made available for every child and can be obtained through E-Sewa Kendra. 2. Monthly reporting format (Form no. 6,7,8,&9) will be prepared by aggregation of services given to the individual beneficiary to trace the services back to the beneficiaries.
3. Mother search available on eight parameters including Ration card number, RSBY card number, BPL card number, mobile number, Family ID, Health ID, Name and Village.
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E-MAMTA MANUAL MODULE 1: GETTING STARTED
Tracking of Pregnant mothers and children has been recognized as a priority area for providing effective healthcare services to this group. As a major initiative in this regard, the Mother and Child Tracking system (MCH) is name based pregnant mother and child tracking system. It is a management tool to reduce MMR/IMR/TFR and track the health service delivery at the individual level. MCH is a generic system which aims to provide information of different health services received at the individual level, by monitoring all the encounters that an individual undergoes in his/her health program. This system aims to help the service provider (health worker or Doctor) by categorizing various health services the individual person has to get (with due date) and missed services. It also provides for effective monitoring of different health services drilling down to the individual patient information. The application is designed and developed by NIC, Gujarat. The URL for MCH Tracking system is …..
http://e-mamta.guj.nic.in The Main screen of application is as follows….
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E-MAMTA MANUAL
By clicking on “” you can get the screen…..
Enter your id and .
Note : The ID and will be provided to each state respectively.
MAIN MENU
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E-MAMTA MANUAL MODULE2: DATA ENTRY
The data entry module includes the data entry of family health survey, mother registration, child registration, adolescent friendly services registration, HIV/AIDS service registration etc. The family health survey data entry module includes location details, identification details, health provider details, ANC details, pregnancy outcome details, PNC details for pregnant mother, child, adolescent, family planning etc.
SELECT District,Te hsil,PHC,S UB SC, Village as per the MASTERS you have entered
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E-MAMTA MANUAL
Family Health survey Entry
Data Entry Menus
System Generated Unique Family ID
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E-MAMTA MANUAL MODULE 3: DATA VERIFICATION
List of Families already entered in the system
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E-MAMTA MANUAL MODULE 4: GENERATING WORKPLANS
This unique feature of the application gives a comprehensive view of services to be given to different group of beneficiaries. The work plans can be generated at the PHCs level/E-Gram Kendras in village and a hard copy of the same is distributed by the Medical Officer to the field level workers (FHWs, ASHA & Additional FHWs) for field and Mamta Day(Village Health and Nutrition Day) services that are due to various groups of beneficiaries to ensure that none of these are missed out. The District and State level istration can also keep an eye on the services being provided to the beneficiary. Currently, Work plans for New Registration, ANC, Delivery, PNC Mother, Neo natal, Child service, Child immunization, Family planning can be generated through the work plan module available in E-Mamta. Work plans can be generated by the MO PHC on weekly or Monthly as per the requirement of the PHC. All the services due in the workplan must be provided to ensure complete coverage. The following are the screen shots and brief details of the work plans which can be generated after entering the required information Work Plan for Registration for Pregnant Mother
After ing data Click here for verification
WoWorkOwrkrk Plan for ANC Service
The family health survey of the village is to be conducted and the data entry of all the families surveyed must be entered. The new registration plan includes the Health ID, name of the pregnant woman, caste, age, BPL status, eligibility for JSY and CY,provision of home delivery kit, number of living children, adoption of FP methods earlier,date of ANC Registration, date of LMP, number of pregnancies and 21 Created with Print2PDF. To remove this line, buy a license at: http://www.binarynow.com/
E-MAMTA MANUAL number. This workplan covers comprehensive information required for providing a range of ANC services to a newly ed pregnant lady.
The work plan for ANC includes Family number and Health ID, name of the pregnant women, date of LMP, measurement of weight, HB and BP, details about consumption of IFA tabs and Iodized salt, istration of TT 1, 2 and booster, status of RTI/STI, benefits of JSY, danger signs, referral, abortion and maternal death with status of verbal autopsy. ANC workplans cover all the services required for standard protocol. The Health visitor and MO PHC can monitor the services due to ANC mother.
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E-MAMTA MANUAL
WorWOrk Plan for Delivery Detailsk Plan for Delivery
Planning of delivery is again a very vital component for averting the unwanted maternal deaths. The work plan for delivery covers all the crucial elements required for the safe delivery. The workplan incorporates the family number and health ID, name of the lady, Compensation for managing vehicle, use of 108 services, place of delivery, person who conducted the delivery, type of delivery, referral, date of discharge, provision of mamta kit and information about maternal death.
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E-MAMTA MANUAL
Work Plan for PNC Mother
Workplan for PNC child
The work plan for neonates (PNC Child) covers all the crucial information of postnatal period i.e. Family number, Health ID number of the neonate, Name and sex, date of birth with status of CRS registration, breast feeding within 1 hour of birth, weight, live birth or still birth status, PNC visits 3rd,7th and 14th,danger signs, referral and its place.
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E-MAMTA MANUAL The above information related with the neonate in the PNC period will ensure completeness of services in the post natal period for newborn.
The workplan for child services entails the Family number, Health ID number of neonate, name of the child,age,weight, blood group,istration of small IFA, details of childhood disease, details and status of death audit (in case of death).
The incomplete coverage of immunization services had been a huge problem since long due to the absence of an efficient tracking system. The work plan for immunization 25 Created with Print2PDF. To remove this line, buy a license at: http://www.binarynow.com/
E-MAMTA MANUAL services will provide due date of all the vaccines to be given to the child and status of its istration on a particular date. The work plan will immensely help in tracking the left out and drop outs for immunization services. This work plan will be generated according to the given date of birth of the infant.
The family planning workplan will be generated for all eligible(15-49years) married couples using no permanent method of sterilisation. It provides the information on complete range of family planning methods adopted by the benefeciary which includes Sterlization,IUDs,condoms,oral pills and E. It also provides details of any complication, referral and death due to family planning services. Workplan will act as a guide for the health worker to assess family planning need and is expected to boost the couple protection rate among the eligible couples. It will also help in counseling at the time of ANC.
Work Plan for Adolescent
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E-MAMTA MANUAL The work plan for adolescents will provide information of Hb testing, weight measurement, RTI/STI and istration of IFA tablets. The above work plan will help in providing a complete range of services required for adolescents. Workplans for other health services like anemia, malnutrition, growth monitoring, HIV/AIDS etc are under the process of development and will be available in new releases.
Work plan for malnutrition
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E-MAMTA MANUAL
Select the Mother from the list or click on Mother search option
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System will generate a unique number for tracking pregnancy of that mother during her life
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TT2 Vaccine detail
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ANC
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ANC
ANC Mother Detail
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Incentive detail
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Delivery/MTP Reg.
Delivery/MTP Reg.
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Delivery
Delivery
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PNC Visit (Mother)
PNC Visit
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Delivery PNCHistory Visit(Child)
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Child Registration and Vaccination
Child Growth Monitoring
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Vaccination Detail
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E-MAMTA MANUAL Vaccination Detail
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E-MAMTA MANUAL MODULE 5: GENERATING REPORTS
The report module generates report for various type of data entered in the software. The major reports which can be generated from this module are as under:
Family Health Survey Data Entry Status Family Health Survey 2 Mother Care No.4 Child Care No.5 Registration of Pregnant Women Registration for Child Services Pregnant Mother Summary Child Summary (0-1 yrs & 1-6 yrs.) etc. Registration of Adolescent
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E-MAMTA MANUAL Brief overviews of the various reports are as under generating reports
The above report provides the status of data entry of Family Health Survey done. This report provides a brief summary of FHS data which include total number of families, total number of family , live , number of males and females, women 43 Created with Print2PDF. To remove this line, buy a license at: http://www.binarynow.com/
E-MAMTA MANUAL in the reproductive age group (15-49) and children (0-5 yrs.). These are very basic information of each family of the state based on which various health services for different beneficiaries can be planned and tracked later on. FHS status can be tracked up to the village level. Family Health Survey Form
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E-MAMTA MANUAL
Mother Services Family Health Search Module
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E-MAMTA MANUAL Statistical data of Pregnant mothers ed in particular village
Report on Pregnant Women ed
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E-MAMTA MANUAL MODULE 6: VALUE ADDED SERVICES
This component of the software has various features like dash board indicators, notice board search options, family search etc. It also generates child immunization card, growth chart male, growth chart female, pregnant women Hb/weight chart. A record of children ed and those fully immunized can also be obtained. The most striking feature of this module is that the number of Maternal and Infant deaths occurred in the State can also be speckled on the screen.
The chart for weight and haemoglobin status of the mother can be obtained by entering the mother number in Mother Hb/Weight module. The haemoglobin chart provides the level of haemoglobin in “mg” in comparison to the period of pregnancy. The comparative view of the month of pregnancy, Hb. level, weight and IFA given can also be seen in tabular form. The Growth chart of all the children (0-5years) whose details are entered in the software can be generated through the growth chart option available in report module. The chart can be generated both for male and female child. Based on the data entry, the chart will immediately show whether the child is normal, moderately malnourished or severely malnourished.
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Page 2 of Child Immunization report shows complete immunization detail of that particular child.
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Selection of Beneficiaries Facility to send SMS in regional language
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List of beneficiaries particular month
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NOTICE BOARD
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E-MAMTA MANUAL FEATURES OF E-MAMTA DASHBOARD
Dash Board for viewing Health status of the state on single screen
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E-MAMTA MANUAL MONITORING AND TRAINING
Training of all CHC Superintendent, CDMO, Urban Health Officers has been conducted at State level. Six Regional level Training have been completed. All the of the District Health Team (RCHO/ADHO/DPC/PHN/BHO/District M and E) have been trained at regional level. Subsequently, at district level CDHOs have imparted trainings to the district, block health Teams (BHO/MO/PHN/DPC/Dist. M and E/ Block HV/HV). All the PHC and SC level functionaries have also been trained. For monitoring the quality of training, State level officers were also present. With the help of SATCOM facility available in the State, district, block and all the medical and paramedical staff have been reviewed and provided implementation instructions. All the queries were discussed and solved one to one in the Stacom Programme organized every month. National Rural Health Mission, Review and Thematic Workshop, Bhopal, 2-4 July 2010.
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E-MAMTA MANUAL PLANS AHEAD
Integration with mobile based technology. Convergence with all National level programs. Full convergence with ICDS, Primary education, school health. Supply chain management of vaccines and drugs. Generation of complete health records. Access to private service providers. Integration with E-Sewa and E-Gram at village level.
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Disclaimer: Needless to say the responsibility of any error is ours. We welcome suggestions, or queries for further clarity. We request all readers who notice discrepancies and errors or mismatches between what they read and observe, to bring the same to our notice. Please write back at: [email protected]
Department of Health and Family Welfare, Government of Gujarat Technical by NIC, Gujarat. Date of Publishing: June 2010. Copy Right: Department of Health and Family Welfare, Government of Gujarat 2 Created with Print2PDF. To remove this line, buy a license at: http://www.binarynow.com/
E-MAMTA MANUAL
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E-MAMTA MANUAL
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E-MAMTA MANUAL All the efforts of Health department of Gujarat are driven towards improving health of the people of Gujarat by amassing partnership. This year some new initiatives like initiation of Village Clinics, E-Mamta and universal check-up of school going children have been taken up by my Department to improve the health of mother and children in the State. Access to accurate and reliable information on the health of mother and child is essential in order to provide appropriate services. The collection of this information is important not only at the health facility level, but also at the community level, given that many illnesses never reach the health facility and go unreported. Gujarat is the first State to put in place a system whereby the HMIS reports will be generated through aggregation of services and name based tracking of mother and child health services. This is also the only application of its kind which would track the migratory population, thereby allowing us to effectively cover the drop-outs. Team Gujarat looks forward to its replication by the fellow States.
Jay Narayan Vyas Minister of Health and Family Welfare, Gujarat . The E-mamta software has been implemented by the Department of Health and Family Welfare in collaboration with NIC to capture health data from the grassroots level. The district, region and State teams have been trained to collect relevant information within their villages and enter this information at the Primary Health Centre/sub-center level. This information is used by the district health authorities to direct their resources and services to where they are most needed. Simultaneously, Female Health Workers are able to generate their work plans and work in a more focused manner.
Parbat bhai Patel Minister of State for Health, 5 Created with Print2PDF. To remove this line, buy a license at: http://www.binarynow.com/
E-MAMTA MANUAL Gujarat An effective health management information system (HMIS) is an important instrument to plan and monitor health interventions and facilitate overall surveillance of the health condition of a population. Despite the availability of abundance of information, in health sector there is a need to build capacity to find, communicate or use the information effectively. The data are presented as complex spreadsheets or numerical tables that are not easily understood. Effective coordination to fill the gaps in data collection is the need of the hour. This would lead to optimal use of data for planning and monitoring. E-Mamta connects all the decision centers in the organization to improve the management of health programs and services. Each Family in the State is being given a Health Id. All pregnant mother/child will also be given a Unique ID with which the services provided to them can be tracked. Subsequently, this will result in enhancing the capacity of health department.
Rajesh Kishore IAS Principal Secretary (Medical Services and Medical Education), Gujarat E- Mamta is a step towards realizing the vision of Swarnim Gujarat and the Millennium development goals of reducing IMR & MMR in the State. I congratulate the State Rural Health Mission of Gujarat and NIC for developing this customized application to track the services provided to every Mother and Child and thereby improve the health service delivery. Now, health indicators for each and every village can be obtained through aggregation of data and information can be generated at the district, block, and village level. This makes the generation and maintenance of reports easy at the field level and eliminates data duplication caused by multiple data reporting. The deliverance of various Reproductive and Child Health services like ANC, delivery, PNC, Immunization, family Planning and Adolescent Friendly Health Services will definitely improve through this program.
Smt. V.L Joshi IAS Principal Secretary (Public Health) 6 Created with Print2PDF. To remove this line, buy a license at: http://www.binarynow.com/
E-MAMTA MANUAL Commissioner (Health), Gujarat. ABBREVIATIONS ANC: Ante natal care ASHA: Accredited Social Health Activist BPL: Below Poverty Line CY: Cheeranjeevi Yojana E: Emergency Contraceptive Pills EDD: Expected Date of Delivery FHS: Family Health Survey FHW: Female Health Worker HMIS: Health Management Information System ID: Identification Number IFA: Iron Folic Acid IUD: Intra Uterine Devices JSY: Janani Suraksha Yojana LMP: Last Menstrual Period MO: Medical Officer PHC: Primary Health Centre PNC: Post Natal Care RTI: Reproductive Tract Infections STI: Sexually Transmitted Infections
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E-MAMTA MANUAL
FOREWORD
E-Mamta is a management tool to reduce IMR/MMR/ TFR and track the health service delivery at the individual level. Here, we also look at the integration of various health information systems, decentralization of information, flexibility and cost effectiveness and compilation of health data through aggregation of services to the individual beneficiaries. E-Mamta would initiate evidence based planning, tracking of beneficiary-wise information on reproductive and child health services, adolescent health services. This would help us in knowing the left outs in essential programs like immunization, anemia, malnutrition etc so that we can reach them. The monthly work plans would enable the service providers at the grassroots level to identify the span of their work and reach the people who do not voluntarily opt for services. Through SMS messages to beneficiaries we would try to reach directly to the beneficiary to remind them of the services due to them. The monitoring reports of the State level would also be generated using this framework that would help improve the quality and utilization of information generated in the health system. We have built in value add citizen service features like Individual Immunization Record, Child Growth Chart, Weight/Hb Chart for the Pregnancy etc. To facilitate the replication of the E-Mamta in other States we have prepared this manual to get oriented with different functionalities and modules included in the software. This manual is easy to use and includes illustrated description of various functionalities and modules included in the software. Our Help desk and other Resource persons will always be available to provide further guidance. Like all other software’s, E-Mamta is under a process of constant evolution and new modules and functionalities are being added on. New versions of the manual will thus be made available to the s at periodic interval.
Anju Sharma IAS MissionDirector, State Rural Health Mission, Gujarat 8 Created with Print2PDF. To remove this line, buy a license at: http://www.binarynow.com/
E-MAMTA MANUAL
ACKNOWLEDGMENTS The current version of E E-Mamta Mamta has been developed through an enduring process. We express our sincere thanks to the Hon’ble Minister of Health, Gujarat and Hon’ble Minister of State for Health, Gujarat, for their undoubting and guidance in this initiative. We are also indebted to the Principle Secretary (Medical Education & Medical services), Principle Secretary (Health) and Commissioner Health for their unflinching and guidance. I would also thank the Ministry of Health and Family Welfare, Government of India, especially, MD, National Rural Health Mission, GOI and all our partners for financial and guidance to develop and implement the program The E – Mamta application has been conceptualiz conceptualized ed by the Mission Director NRHM Gujarat. She has provided her constant and guidance in developing the program and has also been instrumental in including some unique features in the application, especially, Birth charts, Immunization Card, Weight ccard, ard, Work Plan for Malnutrition, Stock inventory, Growth chart, HMIS Integration etc. The smooth roll out of the application was possible due to the consistent endeavor of our State Health team including all the Additional Directors - Health, Medical Education, Educ Medical Services, Family Welfare, t Director MCH, Deputy Director Rural Health. We are especially thankful to Dr. B.K. Patel Additional Director, Family Welfare and Dr. N. Dholakia, Deputy Director MCH for their constant in developing the modules and training at the grass root level and thus making the application a success. The enthusiastic participation of all Program officers, RDDs, CDHO, CDMO, RCHO, ADHO, Urban Health Officer, DPMU, Project officers, SPMU, DPC, C, PHN, District M& M&E, E, BHO, MOs, Block M&E, Block HV, ANM, ASHAs has led to the successful implementation of the E E-Mamta Mamta program in a very short period, in the State. The development and operationalization of the application has been made possible with the technical by the National Informatics Centre, Gujarat, under Shri Rajneesh Mahajan, State Informatics Officer. I would also be failing in my duties if I do not mention the contribution of Shri Anand Shah, Principle Systems Analyst and his team of Programmers as welll all the data entry operators in various health facilities of the State. I am also thankful to my staff of Vital Statistics and demographic & Evaluation branch for their timely and action taken during the training of E E-mamta.
Shri K. K Panchal Additional Director(VS) & Nodal Officer (e-mamta) (e 9 Created with Print2PDF. To remove this line, buy a license at: http://www.binarynow.com/
E-MAMTA MANUAL Table of Contents ABOUT E- MAMTA………………………………………………….…..…..11
MODULE 1: GETTING STARTED……………………………………..............14 MODULE 2: DATA ENTRY ………………. …………………….……………16 MODULE 3: DATA VERIFICATION……. …………………….…………….19 MODULE 4: GENERATING WORKPLANS ………………………….….….21 MODULE 5: GENERATING REPORTS………………………………………42 MODULE 6: VALUE ADDED SERVICES ……………………….…………..48
FEATURES OF E-MAMTA…………………………………………….54
MONITORING AND TRAINING …………………………………… 55 PLANS AHEAD……………………………………………………...….56
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E-MAMTA MANUAL ABOUT E-MAMTA
E-Mamta Name Based Information Tracking system Tracking of Pregnant mothers and children has been recognized as a priority area for providing effective Healthcare services to this group. As a major initiative in this regard, the Health and Family Welfare Department, Government of Gujarat, has introduced a Mother & child name based tracking Information management system “EMamta” in collaboration with NIC, Gujarat. E-Mamta is a generic system which aims to provide information of different health services received at the individual level, by monitoring all the encounters that an individual undergoes in his/her health program. This system aims to help the service provider (health worker or doctor) by categorizing various health services the individual person has to get (with due date) and missed services. It also provides for effective monitoring of different health services drilling down to the individual patient information. The development of the E-Mamta has been ongoing since January 2010. A. Situation analysis This has included the study of primary s and ANC/Immunization cards to understand what are the “essential data set” which must be included in each of the forms. B. System objectives The system has two broad set of objectives: 1. To provide the effective monitoring of different services at the individual level, where reports could be sorted on the following criteria- by individual patients; by village; by period; by service providers. 2. To aggregate the individual patient based data and import it into the facility based HMIS so as to avoid double ing of data and thus improve the quality of data. C. System logic
The system will allow ing: Person Object, Person Attribute Object, Person Attribute Value Object, and Person Identifier Object (This object stores all the unique health identifier of individual. A person can have single or multiple identifiers such as port number, PAN number, Driving license, UID, etc.), Identifier Type Object, Program Object (this object contain information about various health program), Program Stage Object, Program Instance Object(This object stores the relationship between person object and program object.), Program Stage Instance Object(This object stores various program stages, its due date and its execution date for particular person object.), Person data value Object, Organization Unit Object(Organization units are organized in a 11 Created with Print2PDF. To remove this line, buy a license at: http://www.binarynow.com/
E-MAMTA MANUAL hierarchy with a parent and a set of children. Each organization unit is identified by a name and possibly an organization unit code.), Data element Object (Data element refers to that which one can data for). E-Mamta, is an information management system that works towards case based tracking of all pregnant mothers and children up to 19 years of age. All girls & women (14-49 years) and all children (0-6 years) will be tracked in this program. The tool enables better service delivery by: i.
Identifying the accurate requirement and utilisation of services in specific categories
ii.
Identifying gaps in service delivery
iii.
Communicating directly with the beneficiaries/service providers through system generated SMS alerts
iv.
Assisting the program managers in planning the programs and policy formation through better monitoring and evaluation.
v.
Better financial and physical monitoring of programs and motivation of Human resource.
The system works in four phases: 1. Family Health Survey: The mammoth first step in this regard, being Family Health Survey in rural & urban areas (slum and slum like) has been successfully accomplished by the health workers. Individual records of around 75.5 lakh families comprising 38.3 million beneficiaries, covering almost 75% of population of Gujarat have already been entered in the Information system ‘E-Mamta’ till date. The benefits of the unique family healthcare ID provided is to capture the migration details and prevent loss of cases due to migration. The family survey data is being validated through physical verification by ASHA/FHW/ MOs and other senior officials in order to ensure accuracy and reliability of the data. 2. Registration of pregnant mothers and children: All mothers who are pregnant and children of age up to 6 years are being ed and provided a unique mother/child health ID. 3. Tracking of healthcare services through monthly work plans: The services provided to the pregnant mothers including ANC, delivery, PNC and immunization are captured in this program.
Thus E-Mamta facilitates service delivery through:
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E-MAMTA MANUAL
Elaborate work plans prepared at Sub centres and given to ASHA/FHW to provide services falling due to the beneficiaries
The details of services provided to the mothers and children for ANC, immunization, PNC, nutrition are recorded in E-Mamta at the PHC/village level which facilitates to identify the gaps in the continuum of care
SMS alerts will be sent to the beneficiaries/health workers for the services that fall due.
Monitoring the incentives paid to various health workers
In accordance with the Family based approach, the information could be integrated with data from School Health, ICDS, Education and thus help in giving a holistic picture on individuals regarding health, education and nutrition
The HMIS report like form no. 6,7,8,9 and no. 2,3,4 and 5 would be generated through E – Mamta by aggregation of various services.
Monitoring and Evaluation is possible through the software in least time by generating the following reports: 1. Child Immunization Record, Child Growth Chart (male), Child Growth Chart (female) is made available for every child and can be obtained through E-Sewa Kendra. 2. Monthly reporting format (Form no. 6,7,8,&9) will be prepared by aggregation of services given to the individual beneficiary to trace the services back to the beneficiaries.
3. Mother search available on eight parameters including Ration card number, RSBY card number, BPL card number, mobile number, Family ID, Health ID, Name and Village.
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E-MAMTA MANUAL MODULE 1: GETTING STARTED
Tracking of Pregnant mothers and children has been recognized as a priority area for providing effective healthcare services to this group. As a major initiative in this regard, the Mother and Child Tracking system (MCH) is name based pregnant mother and child tracking system. It is a management tool to reduce MMR/IMR/TFR and track the health service delivery at the individual level. MCH is a generic system which aims to provide information of different health services received at the individual level, by monitoring all the encounters that an individual undergoes in his/her health program. This system aims to help the service provider (health worker or Doctor) by categorizing various health services the individual person has to get (with due date) and missed services. It also provides for effective monitoring of different health services drilling down to the individual patient information. The application is designed and developed by NIC, Gujarat. The URL for MCH Tracking system is …..
http://e-mamta.guj.nic.in The Main screen of application is as follows….
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E-MAMTA MANUAL
By clicking on “” you can get the screen…..
Enter your id and .
Note : The ID and will be provided to each state respectively.
MAIN MENU
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E-MAMTA MANUAL MODULE2: DATA ENTRY
The data entry module includes the data entry of family health survey, mother registration, child registration, adolescent friendly services registration, HIV/AIDS service registration etc. The family health survey data entry module includes location details, identification details, health provider details, ANC details, pregnancy outcome details, PNC details for pregnant mother, child, adolescent, family planning etc.
SELECT District,Te hsil,PHC,S UB SC, Village as per the MASTERS you have entered
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E-MAMTA MANUAL
Family Health survey Entry
Data Entry Menus
System Generated Unique Family ID
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E-MAMTA MANUAL MODULE 3: DATA VERIFICATION
List of Families already entered in the system
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E-MAMTA MANUAL MODULE 4: GENERATING WORKPLANS
This unique feature of the application gives a comprehensive view of services to be given to different group of beneficiaries. The work plans can be generated at the PHCs level/E-Gram Kendras in village and a hard copy of the same is distributed by the Medical Officer to the field level workers (FHWs, ASHA & Additional FHWs) for field and Mamta Day(Village Health and Nutrition Day) services that are due to various groups of beneficiaries to ensure that none of these are missed out. The District and State level istration can also keep an eye on the services being provided to the beneficiary. Currently, Work plans for New Registration, ANC, Delivery, PNC Mother, Neo natal, Child service, Child immunization, Family planning can be generated through the work plan module available in E-Mamta. Work plans can be generated by the MO PHC on weekly or Monthly as per the requirement of the PHC. All the services due in the workplan must be provided to ensure complete coverage. The following are the screen shots and brief details of the work plans which can be generated after entering the required information Work Plan for Registration for Pregnant Mother
After ing data Click here for verification
WoWorkOwrkrk Plan for ANC Service
The family health survey of the village is to be conducted and the data entry of all the families surveyed must be entered. The new registration plan includes the Health ID, name of the pregnant woman, caste, age, BPL status, eligibility for JSY and CY,provision of home delivery kit, number of living children, adoption of FP methods earlier,date of ANC Registration, date of LMP, number of pregnancies and 21 Created with Print2PDF. To remove this line, buy a license at: http://www.binarynow.com/
E-MAMTA MANUAL number. This workplan covers comprehensive information required for providing a range of ANC services to a newly ed pregnant lady.
The work plan for ANC includes Family number and Health ID, name of the pregnant women, date of LMP, measurement of weight, HB and BP, details about consumption of IFA tabs and Iodized salt, istration of TT 1, 2 and booster, status of RTI/STI, benefits of JSY, danger signs, referral, abortion and maternal death with status of verbal autopsy. ANC workplans cover all the services required for standard protocol. The Health visitor and MO PHC can monitor the services due to ANC mother.
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E-MAMTA MANUAL
WorWOrk Plan for Delivery Detailsk Plan for Delivery
Planning of delivery is again a very vital component for averting the unwanted maternal deaths. The work plan for delivery covers all the crucial elements required for the safe delivery. The workplan incorporates the family number and health ID, name of the lady, Compensation for managing vehicle, use of 108 services, place of delivery, person who conducted the delivery, type of delivery, referral, date of discharge, provision of mamta kit and information about maternal death.
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E-MAMTA MANUAL
Work Plan for PNC Mother
Workplan for PNC child
The work plan for neonates (PNC Child) covers all the crucial information of postnatal period i.e. Family number, Health ID number of the neonate, Name and sex, date of birth with status of CRS registration, breast feeding within 1 hour of birth, weight, live birth or still birth status, PNC visits 3rd,7th and 14th,danger signs, referral and its place.
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E-MAMTA MANUAL The above information related with the neonate in the PNC period will ensure completeness of services in the post natal period for newborn.
The workplan for child services entails the Family number, Health ID number of neonate, name of the child,age,weight, blood group,istration of small IFA, details of childhood disease, details and status of death audit (in case of death).
The incomplete coverage of immunization services had been a huge problem since long due to the absence of an efficient tracking system. The work plan for immunization 25 Created with Print2PDF. To remove this line, buy a license at: http://www.binarynow.com/
E-MAMTA MANUAL services will provide due date of all the vaccines to be given to the child and status of its istration on a particular date. The work plan will immensely help in tracking the left out and drop outs for immunization services. This work plan will be generated according to the given date of birth of the infant.
The family planning workplan will be generated for all eligible(15-49years) married couples using no permanent method of sterilisation. It provides the information on complete range of family planning methods adopted by the benefeciary which includes Sterlization,IUDs,condoms,oral pills and E. It also provides details of any complication, referral and death due to family planning services. Workplan will act as a guide for the health worker to assess family planning need and is expected to boost the couple protection rate among the eligible couples. It will also help in counseling at the time of ANC.
Work Plan for Adolescent
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E-MAMTA MANUAL The work plan for adolescents will provide information of Hb testing, weight measurement, RTI/STI and istration of IFA tablets. The above work plan will help in providing a complete range of services required for adolescents. Workplans for other health services like anemia, malnutrition, growth monitoring, HIV/AIDS etc are under the process of development and will be available in new releases.
Work plan for malnutrition
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E-MAMTA MANUAL
Select the Mother from the list or click on Mother search option
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E-MAMTA MANUAL
System will generate a unique number for tracking pregnancy of that mother during her life
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TT2 Vaccine detail
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ANC
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ANC
ANC Mother Detail
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Incentive detail
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Delivery/MTP Reg.
Delivery/MTP Reg.
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Delivery
Delivery
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PNC Visit (Mother)
PNC Visit
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Delivery PNCHistory Visit(Child)
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Child Registration and Vaccination
Child Growth Monitoring
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Vaccination Detail
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E-MAMTA MANUAL Vaccination Detail
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E-MAMTA MANUAL MODULE 5: GENERATING REPORTS
The report module generates report for various type of data entered in the software. The major reports which can be generated from this module are as under:
Family Health Survey Data Entry Status Family Health Survey 2 Mother Care No.4 Child Care No.5 Registration of Pregnant Women Registration for Child Services Pregnant Mother Summary Child Summary (0-1 yrs & 1-6 yrs.) etc. Registration of Adolescent
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E-MAMTA MANUAL Brief overviews of the various reports are as under generating reports
The above report provides the status of data entry of Family Health Survey done. This report provides a brief summary of FHS data which include total number of families, total number of family , live , number of males and females, women 43 Created with Print2PDF. To remove this line, buy a license at: http://www.binarynow.com/
E-MAMTA MANUAL in the reproductive age group (15-49) and children (0-5 yrs.). These are very basic information of each family of the state based on which various health services for different beneficiaries can be planned and tracked later on. FHS status can be tracked up to the village level. Family Health Survey Form
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E-MAMTA MANUAL
Mother Services Family Health Search Module
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E-MAMTA MANUAL Statistical data of Pregnant mothers ed in particular village
Report on Pregnant Women ed
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E-MAMTA MANUAL MODULE 6: VALUE ADDED SERVICES
This component of the software has various features like dash board indicators, notice board search options, family search etc. It also generates child immunization card, growth chart male, growth chart female, pregnant women Hb/weight chart. A record of children ed and those fully immunized can also be obtained. The most striking feature of this module is that the number of Maternal and Infant deaths occurred in the State can also be speckled on the screen.
The chart for weight and haemoglobin status of the mother can be obtained by entering the mother number in Mother Hb/Weight module. The haemoglobin chart provides the level of haemoglobin in “mg” in comparison to the period of pregnancy. The comparative view of the month of pregnancy, Hb. level, weight and IFA given can also be seen in tabular form. The Growth chart of all the children (0-5years) whose details are entered in the software can be generated through the growth chart option available in report module. The chart can be generated both for male and female child. Based on the data entry, the chart will immediately show whether the child is normal, moderately malnourished or severely malnourished.
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Page 2 of Child Immunization report shows complete immunization detail of that particular child.
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Selection of Beneficiaries Facility to send SMS in regional language
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List of beneficiaries particular month
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NOTICE BOARD
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E-MAMTA MANUAL FEATURES OF E-MAMTA DASHBOARD
Dash Board for viewing Health status of the state on single screen
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E-MAMTA MANUAL MONITORING AND TRAINING
Training of all CHC Superintendent, CDMO, Urban Health Officers has been conducted at State level. Six Regional level Training have been completed. All the of the District Health Team (RCHO/ADHO/DPC/PHN/BHO/District M and E) have been trained at regional level. Subsequently, at district level CDHOs have imparted trainings to the district, block health Teams (BHO/MO/PHN/DPC/Dist. M and E/ Block HV/HV). All the PHC and SC level functionaries have also been trained. For monitoring the quality of training, State level officers were also present. With the help of SATCOM facility available in the State, district, block and all the medical and paramedical staff have been reviewed and provided implementation instructions. All the queries were discussed and solved one to one in the Stacom Programme organized every month. National Rural Health Mission, Review and Thematic Workshop, Bhopal, 2-4 July 2010.
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E-MAMTA MANUAL PLANS AHEAD
Integration with mobile based technology. Convergence with all National level programs. Full convergence with ICDS, Primary education, school health. Supply chain management of vaccines and drugs. Generation of complete health records. Access to private service providers. Integration with E-Sewa and E-Gram at village level.
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