title: District decision-making for health in low-income settings: a qualitative study in Uttar Pradesh, India, on engaging the private health sector in sharing health-related data.
abstract: Health information systems are an important planning and monitoring tool for public health services, but may lack information from the private health sector. In this fourth article in a series on district decision-making for health, we assessed the extent of maternal, newborn and child health (MNCH)-related data sharing between the private and public sectors in two districts of Uttar Pradesh, India; analysed barriers to data sharing; and identified key inputs required for data sharing. Between March 2013 and August 2014, we conducted 74 key informant interviews at national, state and district levels. Respondents were stakeholders from national, state and district health departments, professional associations, non-governmental programmes and private commercial health facilities with 3-200 beds. Qualitative data were analysed using a framework based on a priori and emerging themes. Private facilities registered for ultrasounds and abortions submitted standardized records on these services, which is compulsory under Indian laws. Data sharing for other services was weak, but most facilities maintained basic records related to institutional deliveries and newborns. Public health facilities in blocks collected these data from a few private facilities using different methods. The major barriers to data sharing included the public sector's non-standardized data collection and utilization systems for MNCH and lack of communication and follow up with private facilities. Private facilities feared information disclosure and the additional burden of reporting, but were willing to share data if asked officially, provided the process was simple and they were assured of confidentiality. Unregistered facilities, managed by providers without a biomedical qualification, also conducted institutional deliveries, but were outside any reporting loops. Our findings suggest that even without legislation, the public sector could set up an effective MNCH data sharing strategy with private registered facilities by developing a standardized and simple system with consistent communication and follow up.
authors: IDEAS Project, London School of Hygiene and Tropical Medicine, London, UK, meenakshi.gautham@lshtm.ac.uk.
authors: Meenakshi
authors: M
authors: Gautham
authors: IDEAS Project, London School of Hygiene and Tropical Medicine, London, UK.
authors: Neil
authors: N
authors: Spicer
authors: Impact Partners in Social Development, Malviya Nagar, New Delhi, India.
authors: Manish
authors: M
authors: Subharwal
authors: Impact Partners in Social Development, Malviya Nagar, New Delhi, India.
authors: Sanjay
authors: S
authors: Gupta
authors: Public Health Foundation of India, Vasant Kunj Institutional Area, New Delhi, India.
authors: Aradhana
authors: A
authors: Srivastava
authors: Public Health Foundation of India, Vasant Kunj Institutional Area, New Delhi, India.
authors: Sanghita
authors: S
authors: Bhattacharyya
authors: IDEAS Project, London School of Hygiene and Tropical Medicine, London, UK.
authors: Bilal Iqbal
authors: BI
authors: Avan
authors: IDEAS Project, London School of Hygiene and Tropical Medicine, London, UK.
authors: Joanna
authors: J
authors: Schellenberg
mesh_terms: D000288:Administrative Personnel / Q000458:organization & administration; D003625:Data Collection; D003657:Decision Making; D003695:Delivery of Health Care / Q000458:organization & administration*; D003906:Developing Countries; D063005:Health Information Systems / Q000458:organization & administration / Q000592:standards; D006801:Humans; D007194:India; D033181:Information Dissemination / Q000379:methods*; D007407:Interviews as Topic; D000068101:Maternal-Child Health Services / Q000458:organization & administration; D011203:Poverty; D017149:Private Sector / Q000458:organization & administration*; D055818:Public-Private Sector Partnerships / Q000458:organization & administration*; D036301:Qualitative Research
keywords: Data sharing; MNCH data; health management information system; private health sector; public health sector; public–private engagement