i HRIS Open Source Health Workforce Information Systems

i. HRIS: Open Source Health Workforce Information Systems Name Event Location - Date

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

Good Health Worker Data is Needed for… • Education and Training – to make sound decisions about education and training, quantity and type Planning • Registration – to ensure qualified supply • Deployment – to meet needs • Management – of personnel; tracking Management movements • Planning – right person, right place, right skills, right time Training Registration Deployment

The Big Picture… Ministry of Health (plus other relevant Ministries: Education, Public Service, etc) Public Service HRIS HMIS National Health Workforce Registry Local Government Training Institutions Professional Councils Facilities & Service Providers FBO Assoc NGO Assoc For Profit Assoc HRIS FBO HRIS NGO HRIS FP FBO NGO FP

National/Local, Public/Private National Private Sector Ministry of Health Public Service HRIS HMIS National Health Workforce Registry Local Government Training Institutions Professional Councils Facilities & Service Providers Local FBO Assoc NGO Assoc For Profit Assoc HRIS FBO NGO FP …

Open source health workforce information software ALL ABOUT

i. HRIS Manage is for health service delivery i. HRIS Qualify is for health professional councils i. HRIS Plan is for workforce planning and modeling i. HRIS Retain helps plan and cost retention interventions i. HRIS Train tracks preservice and in-service training

Local Innovation!

Eighteen countries actively using i. HRIS + one in the pipeline

All 19 i. HRIS Countries (Details) Country Nigeria Botswana Rwanda Ghana Mali Tanzania Uganda India Kenya Lesotho Liberia Namibia Guatemala Malawi Senegal USAID Project Capacity. Plus Tanzania HR Project Uganda Capacity Project Multiple Capacity Kenya HRAA RBHS Namibia HIV/AIDS Project CAMCAP SSDI MNCH/FP/ Malaria Project Start Year 2011 2009 2006 2009 2011 Health Workers Supported 280, 000 36, 180 37, 943 9, 144 3, 715 2008 347, 141* Chad 2006 125, 888 DRC 2010 112, 000 2007 59, 693 2007 2013 4, 174 8, 082 2012 733 2012 2014 40, 000 29, 732 2013 400 Country Togo Sierra Leone Donor & Partner WHO FSD WHO University of Dar es Salaam WHO FSD DFID IMA Start Year Health Workers Supported 2011 9, 980 2011 1, 756 2012 371 2012 TBD Total: 1, 106, 932

i. HRIS 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 – – – – Intra. Health Abt Baylor FSD IMA JSI MSH • All supporting over a million health worker records

i. HRIS Implementation Toolkit • Country ownership & stakeholder leadership • Assessment tools and procedures • Data quality • Capacity-building – technical – data demand use • Sustainability and continuous improvement strategies

If there is time and interest… EXAMPLES OF IHRIS USE

Countries are now using i. HRIS 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.

UMDPC license renewals (2001 -2011) 2500 2190 2000 1500 1303 1146 1000 842 500 183 11 6 20 21 48 55 2001 2002 2003 2004 2005 2006 0 2007 2008 2009 2010 2011

UMDPC National Attrition by Destination (2011) Australia 6% Canada 4% Others 7% Southern Africa 34% East Africa 11% Unspecified 16% Europe 22%

Gender Mix of Nurses & Midwives (n=17, 526) Female Average Years to Promotion Male 16 14 4270, 24% 12 10 13256, 76% Years to Promotion 8 6 4 2 0 Female Male Average to Promotion Average. Years to 14. 6 12. 7

Percentage of men and women by pay group 100% 90% % of men & women 80% 70% 60% 50% Male 40% Female 30% 20% 10% 0% A B C D E F G H J K L M N Pay Group (lowest to highest) P Q R S T

If there is time and interest… NEW PROJECTS BUILDING ON IHRIS

MEPI Graduate Tracker Recruitment / Retention Post. Graduation Matriculation Graduation • Rural/Urban background • Intent • Career plans • Location • Employment • Feedback Quality of Education Medical School MOH/ Medical Councils Grants Policies Curriculum Alumni Giving Workforce Planning Physician Quality Emergency Response

Community Health Worker Registry Phase 1 Planned Functionalities Promote systematic integration of CHWs into wider health workforce and national health system District by District Counting • District-level counting exercise of CHWs using i. HRIS • Build Capacity: Improve capacity of HRH managers to manage CHWs • National CHW tracking platform for http: //1 millionhealthworkers. org/operations-room-map/ Medic Mobile Demo Dashboard National HRH Analytics Platform workforce analytics (e. g. , # of CHWs, contact info, payment status, training status, etc. ) • Promote Global Standards: Use WHO Minimum Data Elements as backbone • Real-time monitoring of health workforce Integration with m-/e- Health Systems via mobile phone applications • Enhance Interoperability: Aggregate data from mobile systems + existing country e. Health architectures

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

PEPFAR HRIS Assessment Framework HRIS Function Level 1 Level 2 Function 1: Pre-service training Information No. of HW intake, pipeline and expected to graduate from Medical, Nursing, and Public Health schools and other health training institutions. Disaggregated by cadre Data from public and private training institutions collected and reported using HRIS (transition from manually to electronic). (1) Expected National or (1) Protocols for Evidence of use HW graduate international data quality of data on newly data are standards are assurance (DQA) graduating HWs managed using applied as are documented by host HRIS at the recommended in and routinely Government and national level the WHO HRH applied to HW training and sub-national MDS (e. g. ISCO graduate data in institutions for levels. (2) codes used for HRIS at the training HRH planning, Automated job disciplines) institutions and forecasting, reports are national level. (2) review of training disaggregated by Host government policies, etc. (i) key* cadres and training (ii) region (iii) institutions oversee public or private DQA procedures. training institution. Score Level 3 Level 4 Level 5

For more information visit www. ihris. org or contact: i. HRIS@intrahealth. org -- +1. 919. 313. 9100 THANK YOU VERY MUCH!