Accurate and dependable data management systems are critical for demonstrating the success of a family planning program. The data can identify key challenges and serve as a foundation for course correction strategies and improved performance.

The Population Welfare Department (PWD) and Department of Health (DOH) provide family planning services in Sindh, as they do in other parts of Pakistan. Data on contraceptive use is collected at the facility and district levels using the Commodities Logistic Management Information System (cLMIS). This data is then collated at the provincial headquarters of the PWD and DOH for further analysis and reporting to relevant stakeholders and decision-makers.

Before The Challenge Initiative (TCI) began engaging the Sindh government in September 2022, stock-outs were frequent, particularly contraceptives, which adversely affected family planning service delivery. The real problem remained unidentified, though, as it was not discussed or highlighted at any level of the relevant local government departments.

After launching its program, TCI observed frequent commodity stock-outs in Karachi South & Hyderabad districts. A deeper analysis revealed variations and gaps in the reported data vs. the actual clients served, leading to inconsistencies between stock supplied and services provided at the health facility level. Stock-outs resulted because the health system stakeholders and management believed facilities had larger contraceptive supply levels than they actually did.

Because of recurrent stock-outs and service disruption, TCI city managers individually met with District Health Officers (DHOs) and District Population Welfare Officers (DPWO) to highlight this data reporting challenge and advocate for solutions so both departments could achieve their goal of increasing family planning uptake in their respective districts.

DOH and PWD leadership held one-on-one discussions with the facility staff and data entry officers. An in-depth analysis of the entire reporting chain revealed a technical flaw in the cLMIS software for the South Karachi district, which led to incorrect statistics for the district. In Hyderabad district, however, the data entry officers and facility-in-charge had capacity issues that led to non-compliance with reporting standards, including missed entries. This caused the inventory to appear higher than it actually was at the health facilities.

Dr. Aneela with the DOH in Hyderabad noted:

 We didn’t know there were serious issues faced at the facility level due to the lack of compliance at the data management system. It was badly affecting our family planning services, and people were really suffering. We are grateful for the TCI City Manager in Hyderabad for highlighting such issues.”

An action plan was subsequently created by DHOs and DPWOs with assistance from TCI. Teams from the Hyderabad district participated in several capacity-strengthening sessions that were designed for facility in-charges and data entry staff. At the same time, numerous meetings, discussions, and information exchanges took place between the district, provincial, and central cLMIS management teams to resolve the system error in Karachi South.

Since these changes have been implemented, the number of stock-outs has significantly declined. Dr. Aashique with the DOH shared:

 Data management and ensuring timely updates can work as a backbone for the success and sustainability of a program. Monitoring and evaluation in this regard are also very important, which is done by the TCI Manager – although it was our responsibility. We will ensure the oversight of data updates as our core responsibility.”

After TCI actively engaged the specific districts, there are now regular meetings, strong coordination, and exchange of information and updates between government departments like DOH and PWD. This not only leads to regular cLMIS updates for timely correction of data-related issues but is also very helpful in supporting the district health and population welfare authorities in all geographies to develop a regular and robust system to periodically check the data reporting systems and avoid these issues in the future.