Measuring and Monitoring the Health Workforce Using Open Source Tools

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Measuring and Monitoring the Health Workforce
Using Open Source Tools

• Pamela A. McQuide
• Workforce Planning and Policy Advisor
• Dykki Settle
• Informatics Advisor
• Capacity Project
• IntraHealth International

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What is the Capacity Project?

• Five year USAID cooperative agreement that offers
  human resources technical assistance, knowledge
  and tools for planning, developing and supporting
  the health care workforce through
• Improving workforce policies and planning
• Developing better education and training
• Strengthening systems to support workforce
  performance

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Presentation Objectives

• Identify the need for accurate and timely human
  resource information systems for use in
  developing countries
• Outline the Capacity Projects HRIS strengthening
  process and iHRIS suite of tools using Open
  Source solutions
• Present case studies using data from iHRIS to
  train, register, manage and plan health workforce
  needs in Uganda and Swaziland

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Need for Human Resources for Health (HRH) Data

• HR challenges in the developing world
• The demand for health workers is increasing
• In response to global health issues
• While the supply is decreasing
• Inappropriate distribution of health workers in
  rural vs. urban areas
• Health workers are emigrating to other countries
  or leaving the sector

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Good HRH Data is Needed for

• Education and Training to make sound decisions
  about education and training, quantity and type
• Registration to ensure qualified supply
• Deployment to meet needs
• Management of personnel tracking movements
• Planning future needs
• Data exist, but
• in paper form
• in different agencies, smaller cells
• making it very difficult to work with!

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Systems Strengthening Approach

• Stakeholder Leadership Group
• Infrastructure Strengthening
• Software Solutions
• Data-Driven Decision-Making
• Capacity Building and Sustainability

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Participatory Approach

• Generate ownership
• Build capacity
• Empowerment
• Share with other
• Ministries and Sectors
• Countries

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Capacity Projects HRIS Software Principles

• Minimal Cost
• Initial
• Ongoing
• Cost of replication
• Maximum Extensibility
• Now
• In the future
• Maximum Ease-of-Use
• Simple, familiar interface
• Clear online and paper documentation

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Capacity Projects HRIS Software Approach

• Free/Open-Source Software
• International development and support community
• Development for one country or application made
  available to all
• Web-Based
• Maximum utility, access and compatibility
• Familiar interface
• Regional and Global Partnering
• Sustainability
• Standards for sharing and contextual analysis

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Case Study 1 Swaziland

• Developing a health professional management
  system using a step solution

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Information FlowBefore HRIS
MoPSI (Ministry of Public Service Information)
MoPSI HR Database
Memos, instruments
MoHSW Personnel Unit (Ministry of Health and
Social Welfare)
Memos, instruments
Facilities and Departments
Source Samuel Johnson, MoHSW, 2008
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Information FlowWith HRIS
MoHSW Statistics Unit
MoPSI (Ministry of Public Service Information)
MoPSI HR Database
Maintain
Downloads
Memos, instruments
MoHSW Personnel Unit (Ministry of Health and
Social Welfare)
HRIS
Corrections
Memos, instruments
Inventory Reports
Facilities and Departments
Reports
Source Samuel Johnson, MoHSW, 2008
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Swaziland HRIS Results

• Comparison of Ministry of Public Service payroll
  data with whos actually working by cadre and
  location.
• Development of HRH five year strategic plan
• Identification and reduction of bottlenecks in
  the health worker recruitment process.

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Case Study 2 Uganda

• Developing an integrated data system for decision
  making, beginning with the Nursing Council

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Paper-based HRIS

• Problem
• Reliable data about the health workforce is not
  available for MOH, MOPS and MOE to make informed
  training, management and policy decisions.

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Integrated HRIS

• Activities
• Installed Local area network (LAN) at the Nursing
  Council, completed data entry at Nursing Council
• Implemented LAN at Allied Health, Medical and
  Dental and Pharmacy Council
• Will complete data entry at four Councils and
  link agreed upon data at MOH
• Integrate data from HRM, MOE with Council data at
  Resource Center

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How can an HRH Information System answer Ugandas
policy questions?
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Annual out put of enrolled and registered nurses
between 1995 - 2005
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How many student nurses entered training, took
the final exam, passed the final exam and
registered 1970-2005? (N 28,064)
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What percent of student nurses passed the final
exam and registered by school district 1970
present?
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Number of Nursing Enrollments and Registrations
since 1970 Relative to Total Clinical AIDS Cases
as of District Population and Location of
Health Facilities
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Successes

• Network and strategic alliances
• Established functional stakeholder leadership
  group
• Improving information availability
• Increasing focus and prioritization of HRH

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Conclusions

• HRIS solutions should be designed around
  country-specific needs
• Progress at a gradual pace will allow for gradual
  adaptation, without overwheming the current
  system
• HRIS stakeholder involvement is essential in
  encouraging information exchange and improving
  the overall utility of the HRIS
• Training is critical in ensuring that the HRIS
  adds value and remains sustainable

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• Thank You!
• www.capacityproject.org/hris