The Health Information System in Tanzania The Mainland case

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The Health Information System in Tanzania The
Mainland case

• By
• Faraja Mukama Igira

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Presentation outline

• Health care structure and HMIS
• Collected information
• Working situation Problems
• Problems Effects to the HMIS
• The Health Information Systems Programme (HISP)

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Health care structure The HMIS
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Collected information

• Main source Routine health care
• - Outpatients Dispensaries, Health centers,
  Hospitals
• - Inpatients Health centers and Hospitals
• - Mother and Child Health (MCH) immunization,
  family planning, weighing, antenatal services
• - Community outreach Working with Village
  Health Workers (VHW), Traditional Birth
  Attendants (TBA), Community Based Distributors
  (CBD)
• Additional Survey data

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Data collection and reporting

• Originating at the health facility level
• - Routine health care activities
• Using designed registers and forms
• HMIS- (MTUHA)
• - Twelve registers in total
• - Tally sheets children vaccination, weighing
• Vertical programmes
• Using Vertical programmes forms e.g. TB, Dental
  care
• Reporting to the higher level in the hierarchy
  quarterly
• Manually at the health facility level,
  computerized at District (started in November
  2004), Regional and National level.

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MCH section Children Weighing
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Report preparation Health facility level
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Report preparation at the district level Before
computerization
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Working Situation Problems

• Parallel reporting systems
• Lack of resources or disproportional distribution
  of resources
• - human
• - material tools for data analysis, storage
  tools (folders) including transport
• Lack of data collection and managerial skills
• - No regular training
• Late receiving of data collection tools from the
  MoH
• Poor/lack of supervision and feedback

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The HMIS reporting structure
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Dispensary Outpatient section Patients in a queue
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Data storage
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Problems Effects to the HMIS

• gaps in data collection
• poor (minimal) analysis of data
• Late reporting resulting in incompleteness of
  reports
• minimal use of information
• - Information flows reflecting the requirements
  of higher levels, without addressing the local
  levels information needs

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HISP Aims

• Build local information culture
• - addressing fragmentation of data
• - a software for data analysis and reporting
• - through training health workers
• Improving work practices and routines e.g.
  changing from quarterly to monthly reporting
• Reduce the burden of report preparation

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HISP Process

• Initiated in July 2002
• Two Masters students did their research in two
  districts of the Coastal region
• became pilot sites for HISP
• Starting with the district level
• Manual data processing during this time
• DHIS software customized to contain datasets from
  existing MTUHA paper forms
• Training health workers workshops and short
  courses

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MTUHA challenges to HISP

• The installed MTUHA software at the district
  level
• Competing technologies
• DHIS to be MTUHA
• Inheriting MTUHAs strengths and limitations
• Long-term institutionalization of MTUHA
• Lack of Top-level support on HISP activities

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HISPs activities and achievements to date

• Continuous negotiations with health officials and
  managers at various levels
• Mimicking the MTUHA forms
• Illuminating the weaknesses of MTUHA
• Improving health workers knowledge and skills in
  HMIS
• Research on work practices within the HMIS

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Thanks