iHRIS: Open Source Health Workforce Information Systems

NameEvent

Location - Date

WHY IS HRIS IMPORTANT?The need for strong health workforce information systems

Good Health Worker 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 – right person, right place, right skills, right time

Training

Registration

DeploymentManagement

Planning

The Big Picture…

Ministry of Health (plus other relevant Ministries: Education,

Public Service, etc)

Local Government Trai

ning

Ins

tituti

ons

Professional Councils

Public Service

HRISHMIS National Health

Workforce RegistryFBO

FBO Assoc

NGO Assoc

For Profit Assoc

FP

FBO NGO FP

FBO NGO FP

NGOHRIS HRIS HRIS

Facilities & Service Providers

FBO

National/Local, Public/Private

Ministry of Health

Local Government Trai

ning

Ins

tituti

ons FBO

AssocNGO Assoc

For Profit Assoc

Professional Councils

Public Service

HRISHMIS National Health

Workforce Registry…

FBO NGO FP

FBO NGO FP

HRIS HRIS HRIS

Facilities & Service Providers

Private SectorNational

Local

ALL ABOUT Open source health workforce information software

iHRIS Manage is for health service delivery

iHRIS Qualify is for health professional councils

iHRIS Plan is for workforce planning and modeling

iHRIS Retain helps plan and cost retention interventions

iHRIS Train tracks pre-service and in-service training

Local Innovation!

Eighteen countries actively using iHRIS + one in the pipeline

All 19 iHRIS Countries (Details)

CountryUSAID Project

Start Year

Health Workers

SupportedNigeria

CapacityPlus

2011 280,000Botswana 2009 36,180Rwanda 2006 37,943Ghana 2009 9,144Mali 2011 3,715

Tanzania Tanzania HR Project 2008 347,141*

UgandaUganda Capacity Project

2006 125,888

India Multiple 2010 112,000

Kenya Capacity Kenya 2007 59,693

Lesotho HRAA 2007 4,174Liberia RBHS 2013 8,082

NamibiaNamibia HIV/AIDS Project

2012 733

Guatemala CAMCAP 2012 40,000Malawi SSDI 2014 29,732

SenegalMNCH/FP/ Malaria Project

2013 400

CountryDonor & Partner

Start Year

Health Workers

Supported

Togo WHOFSD 2011 9,980

Sierra Leone

WHOUniversity of Dar es Salaam

2011 1,756

Chad WHOFSD 2012 371

DRC DFIDIMA 2012 TBD

Total: 1,106,932

iHRIS global community ihris@googlegroups.com

• 150 active participants in open source community

• Nearly 300 issues raised, addressed and resolved in one year of operation

• Six donors– USAID– CDC– Canada– DFID – WHO– World Bank

• Seven implementers– IntraHealth– Abt– Baylor– FSD– IMA– JSI– MSH

• All supporting over over a million health worker records

iHRIS Implementation Toolkit

• Country ownership & stakeholder leadership

• Assessment tools and procedures

• Data quality• Capacity-building

– technical– data demand and use

• Sustainability and continuous improvement strategies

EXAMPLES OF IHRIS USEIf there is time and interest…

Countries are now using iHRIS to…

• improve governance and accountability• improve the efficiency of health worker

support systems• save money and other resources • help increase the quantity and quality of the

health workforce• increase awareness of gender discrimination

and related issues

Some specific examples…

• Save money – 187 ghost doctors identified at $1100 a month each is $2,468,400 a year back into health services

• Address deployment issues – one country discovered that 60% of their facilities didn’t have OB/GYN specialists. They are now:– Recruiting more specialists– Offering incentives for rural and hard-to-reach facilities– Training Medical Officers in EMOC.

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 20110

500

1000

1500

2000

2500

11 6 20 21 48 55183

1146

842

1303

2190

UMDPC license renewals (2001-2011)

Southern Africa

34%

Europe 22%

Unspecified 16%

East Africa 11%

Others 7%Australia 6%

Canada 4%

UMDPC National Attrition by Destination (2011)

13256; 76%

4270; 24%

Gender Mix of Nurses & Midwives (n=17,526)Female Male

Average Years to Promotion0

2

4

6

8

10

12

14

16

Average Years to Promotion

Year

s to

Prom

otion

A B C D E F G H J K L M N P Q R S T0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Percentage of men and women by pay group

MaleFemale

Pay Group (lowest to highest)

% o

f men

& w

omen

NEW PROJECTS BUILDING ON IHRISIf there is time and interest…

Matriculation Graduation Post-

Graduation

Recruitment / Retention

• Rural/Urban background

• Intent

• Career plans • Location• Employment

Quality of Education

• Feedback • Feedback

GrantsPoliciesCurriculumAlumni Giving

MOH/Medical Councils

Medical School

Workforce PlanningPhysician QualityEmergency Response

MEPI Graduate Tracker

Community Health Worker RegistryPlanned Functionalities

• District-level counting exercise of CHWs using iHRIS

• Build Capacity: Improve capacity of HRH managers to manage CHWs

District by District Counting

• National CHW tracking platform for workforce analytics (e.g., # of CHWs, contact info, payment status, training status, etc.)

• Promote Global Standards: Use WHO Minimum Data Elements as backbone

National HRH Analytics Platform

• Real-time monitoring of health workforce via mobile phone applications

• Enhance Interoperability: Aggregate data from mobile systems + existing country e-Health architectures

Integration with m-/e- Health Systems

Phase 1

Medic Mobile Demo Dashboard

Promote systematic integration of CHWs into wider health workforce and national health system

http://1millionhealthworkers.org/operations-room-map/

A Provider Registry is the central authority for unique identities of & basic information on all health workers within the country.

Provider Registry

PEPFAR HRIS Assessment Framework

HRIS Function Level 1 Level 2 Level 3 Level 4 Level 5

Function 1: Pre-service training Information

Data from public and private training institutions collected and reported using HRIS (transition from manually to electronic).

 (1) Expected HW graduate data are managed using HRIS at the national level and sub-national levels. (2) Automated reports are disaggregated by (i) key* cadres (ii) region (iii) public or private training institution.

 National or international data standards are applied as recommended in the WHO HRH MDS (e.g. ISCO codes used for job disciplines)

 (1) Protocols for data quality assurance (DQA) are documented and routinely applied to HW graduate data in HRIS at the training institutions and national level. (2) Host government and training institutions oversee DQA procedures.

 Evidence of use of data on newly graduating HWs by host Government and training institutions for HRH planning, forecasting, review of training policies, etc.

No. of HW intake, pipeline and expected to graduate from Medical, Nursing, and Public Health schools and other health training institutions. Disaggregated by cadre

Score          

THANK YOU VERY MUCH!

For more information visit www.ihris.org or contact:iHRIS@intrahealth.org -- +1.919.313.9100