Understanding and valuing the broader health system benefits of Uganda’s national Human Resources for Health Information System investment

Human Resources for Health

Ismail Wadembere²  Twaha Kabocho³  Kate Tulenko⁵  David Potenziani⁴  Dykki Settle⁴  Julia Driessen¹ 

[1] University of Pittsburgh, Crabtree A614, 130 De Soto St., Pittsburgh 15261, PA, USA;IntraHealth International, Kampala, Uganda;Pwani Health Informatics, Pwani University, Kilifi, Kenya;IntraHealth International, 6340 Quadrangle Drive, Suite 200, Chapel Hill 27517, NC, USA;CapacityPlus, IntraHealth International, 1776 Eye Street, NW, Washington 20006, DC, USA

关键词: Workforce strengthening;    Global health;    Human resources for health;    HRIS;    Human resources information system;   

Others  :  1225544
DOI  :  10.1186/s12960-015-0036-0

 received in 2015-02-28, accepted in 2015-05-24,  发布年份 2015

【 摘 要 】

Background

To address the need for timely and comprehensive human resources for health (HRH) information, governments and organizations have been actively investing in electronic health information interventions, including in low-resource settings. The economics of human resources information systems (HRISs) in low-resource settings are not well understood, however, and warrant investigation and validation.

Case description

This case study describes Uganda’s Human Resources for Health Information System (HRHIS), implemented with support from the US Agency for International Development, and documents perceptions of its impact on the health labour market against the backdrop of the costs of implementation. Through interviews with end users and implementers in six different settings, we document pre-implementation data challenges and consider how the HRHIS has been perceived to affect human resources decision-making and the healthcare employment environment.

Discussion and evaluation

This multisite case study documented a range of perceived benefits of Uganda’s HRHIS through interviews with end users that sought to capture the baseline (or pre-implementation) state of affairs, the perceived impact of the HRHIS and the monetary value associated with each benefit. In general, the system appears to be strengthening both demand for health workers (through improved awareness of staffing patterns) and supply (by improving licensing, recruitment and competency of the health workforce). This heightened ability to identify high-value employees makes the health sector more competitive for high-quality workers, and this elevation of the health workforce also has broader implications for health system performance and population health.

Conclusions

Overall, it is clear that HRHIS end users in Uganda perceived the system to have significantly improved day-to-day operations as well as longer term institutional mandates. A more efficient and responsive approach to HRH allows the health sector to recruit the best candidates, train employees in needed skills and deploy trained personnel to facilities where there is real demand. This cascade of benefits can extend the impact and rewards of working in the health sector, which elevates the health system as a whole.

【 授权许可】

   
2015 Driessen et al.

【 参考文献 】

• [1]Buchan J. What difference does (“good”) HRM make. Hum Resour Health. 2004; 2(6):1-7.
• [2]The world health report: 2006: working together for health. 2006.
• [3]Riley PL, Zuber A, Vindigni SM, Gupta N, Verani A, Sunderland NL et al.. Information systems on human resources for health: a global review. Hum Resour Health. 2012; 10(7):10.1186.
• [4]Kinfu Y, Dal Poz MR, Mercer H, Evans DB. The health worker shortage in Africa: are enough physicians and nurses being trained? Bull World Health Organ. 2009; 87(3):225-30.
• [5]Spero JC, McQuide PA, Matte R. Tracking and monitoring the health workforce: a new human resources information system (HRIS) in Uganda. Hum Resour Health. 2011; 9:6. BioMed Central Full Text
• [6]Dussault G, Dubois C-A. Human resources for health policies: a critical component in health policies. Hum Resour Health. 2003; 1(1):1. BioMed Central Full Text
• [7]Campbell J, Dussault G, Buchan J, Pozo-Martin F, Guerra Arias M, Leone C et al.. A universal truth: no health without a workforce. World Health Organization, Geneva; 2013.
• [8]CapacityPlus/IntraHealth International. Learn more about iHRIS software Available from: http://www.ihris.org/ihris-suite/. Accessed:4 Feb 2015.
• [9]Baltussen R, Adam T, Tan Torres T, Hutubessy R, Acharya A, Evans D et al.. Generalized cost-effectiveness analysis: a guide. World Health Organization, Geneva; 2002.
• [10]Mathauer I, Imhoff I. Health worker motivation in Africa: the role of non-financial incentives and human resource management tools. Hum Resour Health. 2006; 4(1):24. BioMed Central Full Text
• [11]Fritzen SA. Strategic management of the health workforce in developing countries: what have we learned? Hum Resour Health. 2007; 5(1):4. BioMed Central Full Text
• [12]Kyaddondo D, Whyte SR. Working in a decentralized system: a threat to health workers’ respect and survival in Uganda. Int J Health Plann Manag. 2003; 18(4):329-42.
• [13]Manongi RN, Marchant TC, Bygbjerg IC. Improving motivation among primary health care workers in Tanzania: a health worker perspective. Hum Resour Health. 2006; 4(1):6. BioMed Central Full Text
• [14]Chen L, Evans T, Anand S, Boufford JI, Brown H, Chowdhury M et al.. Human resources for health: overcoming the crisis. Lancet. 2004; 364(9449):1984-90.
• [15]Driessen J, Cioffi M, Alide N, Landis-Lewis Z, Gamadzi G, Gadabu OJ et al.. Modeling return on investment for an electronic medical record system in Lilongwe, Malawi. J Am Med Inform Assoc. 2013; 20(4):743-8.
• [16]Wang SJ, Middleton B, Prosser LA, Bardon CG, Spurr CD, Carchidi PJ et al.. A cost-benefit analysis of electronic medical records in primary care. Am J Med. 2003; 114(5):397-403.
• [17]Gori A. Countries save $177 million with iHRIS. CapacityPlus/IntraHealth International, Washington, DC; 2014. Available from: http://www. ihris.org/2014/09/countries-save-177-million-with-ihris/. Accessed: 4 Feb 2015