1. Identify all those who are or should be using each type of information (volunteers, community leaders, clinical and other professional workers, fieldworkers, supervisors, administrators, and managers).
2. Assess the short- and long-term objectives of the organization, program, department, or service delivery site where you work.
3. Identify the information that is needed to help the different people in the family planning program to perform effectively and efficiently, and eliminate the information that is being collected but is not being used.
4. Determine which of the current forms and procedures for collecting, recording, tabulating, analyzing, and reporting information are not complicated or time-consuming and meet the needs of the different workers, and which forms and procedures need to be improved.
5. Revise any existing forms and procedures for collecting and recording information that need improvement, or prepare new ones.
6. Set up or improve the manual or computerized systems for tabulating, analyzing, and reporting information so that they are most useful to the different workers in the family planning program.
7. Develop procedures for confirming the accuracy of the data.
8. Train and supervise staff in using the new forms, registers, summary sheets, and other instruments to collect, tabulate, analyze, present, and use the information.

To prepare this overview of the existing management information system, start by meeting with your staff, colleagues in other health services, community leaders, volunteers, and clients. Collect the information systematically, writing down the answers clearly so they can be reviewed later on.

Consider the special information needs of your family planning program. For example:

Is the program in an early stage or in a more advanced stage? Consider that:

• A program that is just starting out will need basic information, such as the number of new users and continuing users.
• A program that has reached all the target group members will need information to monitor the quality of services.

Is the program clinic-based or community-based? Consider that:

• A clinic-based family planning program that provides oral contraceptives, IUDs, and injectable contraceptives will need to collect information on side effects and complications.
• A community-based distribution (CBD) program will need information on the number of pill cycles and condoms distributed by each CBD worker.

Is the program completely subsidized or do clients pay fees? Consider that:

• A program that is subsidized will need information on the number of visits per service provider in order to set reimbursement rates.
• A program in which users pay will require information on all service-related costs, in order to determine fair and affordable fees. Charging for services or commodities improves the reliability of the information collected.

Consider the type of information that is currently available in forms, registers, and records which can be used in decision-making. For example:

• Client records may provide important demographic and health information.
• Registers may provide important information about new clients, continuing users, and method switchers.
• Supervisory forms may provide important information about contraceptive supply requirements.

Consider the information you need that is not being provided by existing records, registers, and forms. For example:

• Client records may not provide information about side effects, complications, and clients who have not continued with the program.
• Supervisory forms may not provide information about the quality of clinical services.
• Registers may not provide information to distinguish continuing users from new clients.
• Inventory forms may not provide clear information on how quickly contraceptive stocks are being used, which is necessary for determining how much should be ordered and when orders should be made.

Consider what information is needed regularly and frequently and what information is needed only periodically. For example:

• Information on new clients and methods may be required regularly and frequently in order to monitor the program's progress in achieving objectives at the community and at the regional level.
• Information on method switchers and those who have not continued with the program may sometimes be useful to assess continuation rates and satisfaction with specific contraceptive methods.
• Financial information may be required regularly and frequently to keep track of expenditures and budgets.

Consider simple and inexpensive methods of collecting information to supplement the information provided by records, registers, and forms. For example:

• Rapid assessments (or small scale surveys) are useful for information on such things as method switching, clients who have not continued with the program, the effects of contraception on fertility, etc.
• Focus groups (guided discussions of specially selected persons) provide good information on reasons for the clients' satisfaction or dissatisfaction with clinical or other types of services and personnel, the effectiveness of IEC messages, the receptiveness and readiness of special groups for contraception, etc.

• Small operations research projects provide information on different methods of distributing contraceptives, or on the effectiveness of such channels of distribution as public and private sector outlets.

Consider how the information can be used by different groups working in family planning to help them in their work. For example:

• The community may need information on potential and current family planning clients to set up a community-based distribution program.
• The CBD workers may need information on the status of each client in order to plan counseling visits and determine the amounts of contraceptives they will need.
• Supervisors may need information on the number of clients being served by each CBD worker to determine the most effective means of providing the CBD workers with incentives and support.
• Managers may need summary information on service cost and quality, client satisfaction, and reasons for discontinuation or method switches, in order to determine how to improve program strategies and quality.

Consider whether you and your staff have the appropriate information in a usable form at the time when it is needed. For example:

• CBD workers may use village maps to keep track of where family planning clients live and what kind of contraceptives they are receiving.
• Supervisors may monitor the effectiveness of individual CBD workers by using simple charts that show the results of home visits for each CBD worker they supervise.
• Clinic managers may use simple graphs and charts depicting the number of family planning clinic visits, the number of new clients, and the number of continuing users to monitor and evaluate the status of their program.

Consider how to use information to provide effective feedback to your staff. For example:

• Supervisors can motivate their staff to work harder by allowing them to see how their performance compares with that of their colleagues.
• Feedback can be used to show the program's achievements, which can be used to generate political support.

Vignette - The Importance of Accurate and Timely Information

Your review will tell you in what areas you need to improve your MIS. There are a number of ways in which an information system can be improved. Most improvements will be made by:

• Eliminating unnecessary information
• Improving the way you give feedback
• Involving your staff in the regular use of the information for planning, monitoring, and evaluating their activities

Below are examples of simple actions to take which can greatly improve the effectiveness of the management information system:

Data Collection: Clinic forms are often illegible because there isn't enough space to record the required information. This problem can be resolved by eliminating unnecessary information and redesigning the form, incorporating any suggestions made by the staff that fills out the form and training staff in the use of the new form.

Data Recording: Staff members make many mistakes in totalling information from registers. Simple summary sheets with instructions and training in their use may help reduce these mathematical errors.

Data Analysis and Interpretation: The CBD program supervisors may not use the monthly information on the number of users to monitor the performance of each CBD worker because the reports are too difficult to read. A simple graph that visually illustrates the performance of each CBD worker may improve monitoring and the performance of CBD workers.

The manager should make clinical service personnel aware of the importance of accurately collecting, tabulating, and analyzing data for reporting. One of the ways to do this is use the reports as a means of evaluating the performance of clinical service personnel and giving feedback on the basis of the reports.