Social Inclusion Information System in the

Context of Nepalese Public Health

Informatics

(concept paper)

For
Workshop on Disaggregate (social inclusion and
marginalized group) Data System

Organised by:
Department of Health Services
Teku, Kathmandu, Nepal

Prepared by

Dhruba Raj Ghimire

Susheel Chandra Lekhak
May 2009
 Table of Contents

Introduction 1

What is social inclusion 4

Who and how socially excluded 6

Impact of social exclusion/inclusion 8

Relation between social inclusion and health 8

Need and Importance of social inclusion data 10

Difficulty in measuring social inclusion 11

Proposed indicators for social inclusion information system 12

Proposed social inclusion information system 13

References 16
 Introduction

The concept of social inclusion in the field of development administration

is relatively new aspect. As O'Brien & O'Brien (1996) documented,
international network of people working to reverse the exclusion of
people with physical, sensory and learning disabilities began to form in
the 1970s and 1980s. According to Stegeman & Costongs (2003), the first
use of the term has been attributed to Lenoir, the French Secretary of
State for Social Action in Government in 1974.

The root of social inclusion in Nepal can be traced in Sixth Plan (1980 –
85), in this plan women's development was incorporated. Subsequently,
identification of 16 deprived groups in 1994; incorporation of sections on
indigenous groups and downtrodden community; formulation of
National Committee for Development of Nationalities (NCDN) in 1997;
formulation of Committee for Upliftment of Downtrodden, Oppressed
and Dalit Classes (CUDODC) in 1997; upgrading of NCDN to National
Foundation for Development of Indigenous Nationalities (NFDIN),
establishment of National Women commission (NWC) and National
Dalit Commission (NDC) in 2002; Road map policies on economic and
social transformation in 2003; Committee on Reservation
Recommendation, and policy announcement on job reservation in 2004.
Those institutional arrangements made shows that though government
has identified the need to empower and facilitate the different excluded
groups but the approach seem to be piece meal in nature instead of
adopting holistic approach. In the words of Dr. Gurung, in a paper on
Social Inclusion and Nation Building in Nepal, all these measures except
NFDIN had no legislative foundation and are inherently ad hoc and
unstable.

Socially inclusion agenda became main agenda of the government after

the popular people's movement of 2006, especially to build a just and
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Concept Paper on Social Inclusion Information System Page [1]
prosperous an equitable society eliminating the caste-wise, regional and
gender-based disparities long-rooted in Nepal. It is legitimised in the
Interim Constitution 2007. Three Years Interim Plan (TYIP) aims to
contribute for sustainable peace by means of reducing unemployment,
poverty and inequality in the country. TYIP has considered social
inclusion as one of the six strategic pillars. Interim plan has the policy of
improving the living standard of women, dalits, indigenous
nationalities/peoples, madhesis, disables, and the poor.

The need of disaggregated data (social inclusion data) has been

emphasised by Subba (2008) in his presentation paper, in his own
words: "according to Nepal Demographic and Health Survey, 2006
maternal mortality ratio has been decreased to 281 per 100,000 live
births from the level of 539 in 1996. Similarly, child, infant and neo-natal
mortality rates have also substantially been reduced. Gender, caste and
ethnicity disaggregated data are not available and so, it is difficult to see
which section of society benefited most from health services." To fulfill
the informational need for inclusive policy, strategic and operational
planning there is high demand of socially disaggregated data. Before
fiscal year 2064/65 (2007/08) HMIS is collecting disaggregated
information by age and sex in some public health data/information
reporting, but that disaggregating is not sufficient to analyse the
situation of exclusion. In fiscal year 2064/65 (2007/08) HMIS has revised
all recording and reporting tools used by system. In this revision, an
additional column has been added to codify the caste/ethnicity group of
the user in each recording tool. This codification prepared base for the
collection of social inclusion data from existing routine HMIS.

During the Annual Work-plan Progamme and Budget (AWPB)

preparation, numbers of consultative meetings were held between
UNICEF and HMIS, where felt the need of disaggregated data in
immunization to adopt a strategic plan to meet the universal coverage.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Concept Paper on Social Inclusion Information System Page [2]
To fulfil this gap HMIS has initiated a project to pilot disaggregated
information system in 10 districts and UNICEF is ready to support this
project. To implement the project, number of preliminary meetings has
been organized in between HMIS and UNICEF. Those meetings have
identified need of a conceptual framework which will guide this project
execution as well as future plan of action. To address the issue this
concept paper has been prepared, where we have tried to sketch out a
complete framework for the social inclusion information system in
context of Nepalese public health informatics. This concept paper is
prepared to guide and provide base for the development and expansion
of the project in health sector of Nepal.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Concept Paper on Social Inclusion Information System Page [3]
Before developing conceptual framework for social inclusion
information system in health sector, we need to know about what social
inclusion means, who and how socially excluded, what may be
consequences or impact of social exclusion, what is the relation between
social exclusion and health, what is the importance of social inclusion
data in health sector. So this paper will first put highlight on the areas
mentioned above. This paper further explores the difficulties in
measuring social inclusion, suggests some indicators that might be
useful from the social inclusion perspective in health sector and
accordingly a comprehensive information system to provide
information on the proposed indicators. This proposed system will not
only intends to propose a system which will provide information on the
indicators mentioned rather it concentrate to propose a comprehensive
platform of information system which will be able to identify, capture,
process, analyse, and disseminate necessary information related with
social inclusion issues in health sector effectively and efficiently.

What is social inclusion

Social inclusion is defined differently by different scholars, in different

contexts and social conditions. The term 'social inclusion' is complex to
define. Social inclusion is multi-dimensional in nature, due to which
there is difficulty in reaching agreement on the universal definition of
the term.

Social inclusion concept can be better understood after describing

exclusion. It is defined by DFID as "Social exclusion describes a process
by which certain groups are systematically disadvantaged because they
are discriminated against on the basis of their ethnicity, race, religion,
sexual orientation, caste, descent, gender, age, disability, HIV status,

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Concept Paper on Social Inclusion Information System Page [4]
migrant status or where they live" (DFID 2005). Similarly according to
Cappo (2002) "Social exclusion is the process of being shut out from the
social, economic, political and cultural systems which contribute to the
integration of a person into the community."

So from the above definition we can conclude that some people, group,
communities and areas are systematically disadvantaged to enjoy the
socio-economic, political and any other services offered by the state.

Social inclusion is a process by which those disadvantaged groups be

able to enjoy the services rendered by state without any discrimination.
Social inclusion leads social integration and helps to reduce poverty
rapidly. In another word social inclusion is a process to make all citizens
able to achieve the basic level of well being. In the own words of Sen
(2001) “(social) inclusion is characterised by a society’s widely shared
social experience and active participation, by a broad equality of
opportunities and life chances for individuals and by the achievement of
a basic level of well-being for all citizens.” According to Cappo (2002) "A
socially inclusive society is defined as one where all people feel valued,
their differences are respected, and their basic needs are met so they can
live in dignity. (Quoted in VicHealth Research Summary 2)

"Social exclusion is a multidimensional process of progressive social

rupture, detaching groups and individuals from social relations and
institutions and preventing them from full participation in the normal,
normatively prescribed activities of the society in which they live"
(Silver, 2007). Operationally, Social Inclusion is the removal of
institutional barriers and the enhancement of incentives to increase the
access of diverse individuals and groups to development opportunities
(World Bank, 2002).

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Concept Paper on Social Inclusion Information System Page [5]
Social inclusion requires improvements in incentives and capacity
within different level of organizations so that these organizations can
and will respond equitably to the demands of all individuals –
regardless of their social identity. In socially inclusive system, the
individual’s identity as a citizen trumps all other identities (e.g. gender,
ethnicity, caste, religion, income level and geographical identity) as a
basis for claims for state services and commitments (e.g. justice, social
service provision, investment in public infrastructure, police protection)
through the constitution and legal system.

From the above discussion we can conclude that social inclusion is the
process how people, group, communities are included in the
mainstream of society or able to enjoy their rights without any
discrimination. Social inclusion process empowers and facilitates
excluded people to access, utilize, participate and control health related
decisions by eliminating the socio-economic, political and legal barriers
that excludes them changing policies, rules, regulations, process,
procedure, project, programmes and practices.

Who and how socially excluded

According to Orr (2005) an individual is socially excluded in case two

conditions are met – 1) the individual is not participating for reasons
beyond his/her control, and 2) he or she would like to participate.

There are number of problems that are contributing social exclusion,

those are different in different societies. Among them some can be listed
as below:

• Unemployment,
• Poor educational attainment,
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Concept Paper on Social Inclusion Information System Page [6]
 • Ill Health (mental health problem, disability, HIV/AIDS etc.)
• Low income,
• Crime,
• Remoteness,
• Gender,
• Language,
• Caste,
• Religion and culture etc.

DFID's policy paper on reducing poverty by tackling social exclusion, 2005

has identified women and girls were excluded, this paper further adds
that people are discriminated on the basis of age, case, descent,
disability, ethnic background, HIV or other health status, migrant status,
religion, sexual orientation, social status or where they live.

As Nepal being multi-cultural, multilingual, multi-ethnic and multi-

religious communities there is higher chances of social exclusion and
number of difficulties to bring them in the national development
mainstream. According to Subba (2008) "the large share of national
population has been excluded on the basis of gender, language, caste,
religion and culture limiting their access to social space, productive
resources and national governance." In each society some groups are
socially excluded, however the groups affected and the degree of
discrimination vary from one society to another. The 4th report on
assessment of implementation of Poverty Reduction Strategy Paper
(PRSP) identified the dimensions and basis of exclusion in Nepal, those
are - a) Caste/ethnicity (Dalits, Janajatis, other minorities); b) Gender
(Women and girls); c) Location (Remote areas); d) Income Poverty (The
vicious circle). In this report Women, Dalits and Janajatis and people of
remote areas were identified as the most disadvantaged.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Concept Paper on Social Inclusion Data in HMIS Page 7 of 19
DFID emphasised to focus on the understanding of the processes by
which people are excluded, which will help to tackle social exclusion.
Institutions and behaviour that reflect, enforce and reproduce prevailing
social attitudes and values, particularly those of powerful groups in
society was regarded as a basic cause of exclusion. This paper broadly
identifies two ways of exclusion - one is deliberate and another is rigid
social systems and prejudices of their society.

Impact of social exclusion/inclusion

Social exclusion is a complex issue or phenomenon. This threatens the

wellbeing of both individuals and their communities. DFID has
identified the outcome of social exclusion as – poverty; reduces
productive capacity; increases level of economic inequality in society;
and leads to conflict and insecurity. Similarly, according of European
Union (1993) social exclusion causes segregation or the weakening of
traditional forms of social relations and leads towards the risk of a dual
fragmented society. Social inclusion intends to bring the system-level
institutional reform and policy shift to remove inequities in the external
environment (DFID 2004). Therefore the process of social inclusion not
only maintains peace and harmony in the society but also
empowers/facilitates excluded groups so that they can better contribute
for the rapid societal development.

Relation between social inclusion and health

Emphasis on good health and equal access to medical services is critical

to human development and to achieving political, economic and social

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Concept Paper on Social Inclusion Data in HMIS Page 8 of 19
objectives. Reducing equity gaps and increasing social inclusion in
health together create the basic conditions necessary for improving the
health status of the poorest people.

Figure 1: Relation between poverty, health and social exclusion, adapted

from Stegeman & Costongs 2003

There is close relationship between the poverty, health and social

exclusion. This is similar to that of the vicious cycle of poverty. Poor
health leads toward poverty and exclusion. Similarly, poverty also
diminishes health and leads social exclusion. At the same time socially
excluded people are unable to access and utilize the health services and
leads toward poverty.

In a concept paper on Social capital formation in Nepal: MDGs and

social inclusion Dr. Subba has emphasised the need to improve
equitable access to the quality health services as per the spirit of Interim
Constitution ensuring fundamental right of the people to get basic
health service free of cost. According to him, there is a need to realize
the rights to and delivery of universal access to essential health care
mobilizing more human resources to remote districts to deliver quality
services, particularly services for mothers and children, family planning,
and HIV/AIDS.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Concept Paper on Social Inclusion Data in HMIS Page 9 of 19
One example that is relevant in term of health is delay in decision making,
one of three delays causing maternal death. Delay in decision making to
carry obstetric complication cases to health facility is a major cause of
maternal death in Nepal. The family has to wait for the decision by the
head of the family or husband to carry her to health institution. This sort
of traditional social behaviour is excluding pregnant mothers to
entertain the right to utilize health services provided by the state.

From the above discussion, we can conclude that social exclusion not
only reduces social integrity and hampers overall national development
but also increases mortality by deteriorating personal health.

Need and Importance of social inclusion data

Further Analysis of the 2006 Nepal Demographic and Health Survey

entitled Caste, Ethnic and Regional Identity in Nepal showed the wider gap
in the utilization of available health services by different caste groups in
Nepal. Percentage of deliveries in a health facility ranges from 5 percent
to 70 percent by Terai/Madhesi Dalit and Terai/Madhesi
Brahman/Chhetri ethnic/caste groups respectively. The situation is
similar in the case of assistance by skilled birth attendent during
delivery which ranges from 5 to 70 percent in the above mentioned
ethnic/caste groups.

According to Subba (2008), in Nepal, most of the MDGs could be met at

the national aggregate level, efforts are needed to reduce the regional,
ethnic and gender based inequality in the achievement of these goals.
He has emphasised the need of pro-poor growth process,
mainstreaming gender equality, empowerment and social inclusion
agenda in all the sectors and localization of MDGs is a most to address

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Concept Paper on Social Inclusion Data in HMIS Page 10 of 19
regional, ethnic and gender disparities in the achievement of these goals.
This shows the need of disaggregated data to measure the MDGs. He
has indicated that the socio-economic indicators of some of the
disadvantaged indigenous nationalities are very low compared to the
national averages. According to him this is due to the low access of
these communities in productive resources, state delivered goods and
services and also due to structural barriers to the access of these groups
to national policy and decision making levels. In his paper he has
mentioned that the health services are not adequately targeted for
Madhesi women.

From the above discussion we can conclude that there is need of

disaggregated data/information on the major health indicators. This
system will capture data/information on the access and utilization of
health services by the socially excluded groups. At the same time there
is need of information to be collected on the level of participation in
health related decision process and factors hindering for access,
utilization, participation and control to enjoy their rights guaranteed by
constitution without any discrimination.

The availability of social inclusion related data in health sector can

facilitate the local level planning to improve the health status of the
people and can significantly contribute to meet the MDG, national
targets for different health services.

Difficulty in measuring social inclusion

Measurement of social inclusion is as complex as the definition of social

inclusion. As social inclusion is being multi-dimensional in nature it is

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Concept Paper on Social Inclusion Data in HMIS Page 11 of 19
so to measure. At the same time subjective and objective domain of
social inclusion makes it more complex to measure. Need of qualitative
analysis more than the quantified analysis in social inclusion also makes
social inclusion measurement more difficult.

Proposed indicators for social inclusion information

system

• Access to basic primary health care services by excluded groups

• Percentage of people who have utilized health care services at

Hospitals, PHC, HP, SHP by excluded groups

• Percentage of members at Health Facility Management Committee

(HFMC) representing excluded groups of society

• Percentage of Female Community Health Volunteers (FCHV)

from excluded groups among total FCHVs

• Mortality Rate (maternal, under five, infant, neonatal) in different

excluded groups

• Proportion of baby with low birth weight among different

excluded groups

• Suicide rate

• HIV prevalence among 15-24 year old pregnant women

• Number of rules and regulations discriminating people on the

ground of health problems

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Concept Paper on Social Inclusion Data in HMIS Page 12 of 19
• Number of social practices discriminating people on the ground of
health problems

Proposed social inclusion information system

From the system perspective an information system should take input

(generally data) from different sources, then process into necessary
information (analysis in particular context) and provides as an output to
the users as per shown in the figure below:

Managers
routine information system
research, survey,
Census,

EDPs, I/NGOs
Researchers
General people

Web-portal
Process Output
Input

Figure 3: Information system

This system should capture, process and provide access to information

on access, utilization, participation and control over the health services
and decision process. This system will capture information from census,
research/surveys and from routine information system. A
comprehensive social inclusion information system needs to be
developed, so that it will facilitate decision making process at different
levels of health system. For this purpose in addition to information on
above areas it will also capture data/information on input, process,

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Concept Paper on Social Inclusion Data in HMIS Page 13 of 19
output, outcome and impact of social inclusion programme, projects or
interventions at different levels.

The information system should be developed to provide the subjective

and objective information on social inclusion on health services. This
system should provide information on access and utilization of health
services by remote people, excluded caste/ethnic groups, income level
and gender etc. This should also cover the information on the causes of
exclusion or barriers in health services by excluded groups. Social
inclusion related information needs to be collected in the major health
indicators from census, surveys (NDHS) like total fertility rate, mortality
rate, disease burden etc. Similarly, information on the people, group,
communities which are excluded in the mainstream of society due to
health related problem (due to deformity, stigma etc.) also needs to be
collected systematically.
m
ste
Sy

Process
n

<
tio

Os
ey
ma

G
rv

en

N
u
or

• Access
nm

I/
S
Inf

,
h/

Ps
er

• Utilization
rc

ED
ov
ne

• Participation Health policy,

G
se
uti

Re
Ro

• Control Interactive web portal strategies, operational plans,

• Exclusion program, projects
or

due to health
ct

et

Output,
<

ci
<

problems
s

Outcome,
so
e

Input
at

Impact
vi
iv

Ci
Pr

Census
Health Discrimination
service as due to health
a right problems

Figure 2: Social Inclusion Information System

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Concept Paper on Social Inclusion Data in HMIS Page 14 of 19
Social Inclusion deals with the ways by which social exclusion can be
overcome. These can include changes in law, changes in the policies and
practices of organizations and institutions, support for communities,
provisions and appropriate or improved services, increasing
employment and educational or training opportunities and
improvements in access to services (Lothian Anti Poverty Alliance,
2001). This system should also provide the information on the change in
laws, policies and practices of health institutions for improvement in
access to health services.

This information system will take input from census, research, survey
and from routine health management information systems and process
it to make understandable in the particular context for decision making
as well as for research purpose. The following figure shows the
proposed information system for social inclusion in context of Nepalese
public health informatics.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Concept Paper on Social Inclusion Data in HMIS Page 15 of 19
 References

Bennett, Lynn, Dilli Ram Dahal and Pav Govindasamy, 2008. Caste,
Ethnic and Regional Identity in Nepal: Further Analysis of the
2006 Nepal Demographic and Health Survey. Calverton,
Maryland, USA: Macro International Inc.
DFID Nepal Country Assistance Plan (CAP), Feb 2004.
European Commission Green Paper on European Social Policy Options
for the Union 1993:20-1
Ministry of Health and Population (MOHP) [Nepal], New ERA, and
Macro International Inc. 2007. Nepal Demographic and Health Survey
2006.
O'Brien & O'Brien, 1996 (cited in Learning About Mental Health
Practice, Theo Stickley and Thurstine Bassett, Published by John
Wiley and Sons, 2008)
Orr, Shepley W., 2005, Social Exclusion and the Theory of Equality:The
Priority of Welfare and Fairness in Policy, Centre for Transport
Studies, Department of Civil and Environmental Engineering,
University College London
Reducing poverty by tackling social exclusion, A DFID policy paper,
Published by the Department for International Development,
September 2005
Resilience Amidst Conflict: An Assessment of Poverty in Nepal 1995-96
and 2003-04, CBS/World Bank/DFID/ADB, September 2006.
Sen A. Development as Freedom. Oxford University Press, 2001
Silver, Hilary. Social Exclusion: Comparative Analysis of Europe and Middle
East Youth. Middle East Youth Initiative Working Paper
(September 2007).

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Concept Paper on Social Inclusion Data in HMIS Page 16 of 19
Social Analysis Sourcebook: Incorporating Social Dimensions into Bank-
supported projects, (working draft) August 2002, p.2, Social
Development Department, World Bank, Washington.D.C.
Social Inclusion and Nation Building in Nepal, paper presented by Dr.
Harka Gurung at Civil Society Forum Workshop for Research
Programme on Social Inclusion and National Building in Nepal,
organised by Social Inclusion Research Fund.
Stegeman, Ingrid & Costongs, Caroline. Health, Poverty and Social
Inclusion in Europe. EuroHealthNet. 2003
Subba, Chaitanya. 2008. Social capital formation in Nepal: MDGs and
social inclusion.
Walker, Alan & Wigfield, Andrea. The Social Inclusion Component of
Social Quality, 2004
www.correlation-net.org
www.darlington.org.uk
www.health-inequalities.eu
www.health-inequalities.eu
www.library.nhs.uk
www.mobilityagenda.org
www.sochealth.co.uk
www.socialinclusion.org.uk
www.undp.sk

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Concept Paper on Social Inclusion Data in HMIS Page 17 of 19