HR Information Systems

The deficiencies of health workforce information in Africa, a continent with heavy burden of disease, are exacerbated by its health workforce crisis. It recognized that drastic improvement of the HRH evidence base was fundamental toward resolving this crisis The development of national policies and plans evidence depend on the maintaining of accurate data with good quality. However, the existing HRH information systems in the African countries are mostly not able to support adequately the development, implementation, monitoring and evaluation of such actions. The data are mostly poor, fragmented and kept by various agencies. The entire systems depend on different sources such as health professional regulatory bodies, health facilities staffing, Health training institutions, faith based organizations, censuses or surveys, payroll records and other various services in statistics for which the completeness, timeliness and comparability are widely variable with the challenges of combining and compilation information from multiple sources. In addition, other major problems affect also the functioning of the existing HRIS, among them, there are:

1. The limited access to the communication technologies as well as lack of infrastructure that have thus far limited the capacity of countries to collect, compile and analyse workforce data. HRH Information Systems still use mostly paper rather computerized data. The 2004 survey conducted by the WHO Regional Office for Africa showed that 22% of health workforce departments of ministries of health in the region did not have computer facilities, 45% had no electronic mail access.

2. The indicators, tools and forms used are inadequate and not standardized. Most valuable data/information is not made available immediately after the event to which it relates because filled forms are submitted too late. Moreover, the databases lack timely and reliable information on the various areas of HRH, such as distribution by sector, geography, gender and age. In addition, the systems do not cover all aspects of key data required for management and planning;

3. The quality and the quantity of data produced including the accuracy are also inadequate for HR planning and management purposes. Even, when the quantity and quality of data are adequate, there are further limitations to the effective use of these data, due largely to the absence of core health workforce indicators and clear classifications of occupations. Moreover, where data are relatively available, the translation of data into evidence for decision-makers has been greatly hindered by the lack of data consistency and capacity in data processing.

4. The shortage in human resources for HRIS is also another critical issue in different levels. The tasks of collecting and reporting are often given to overburdened health service providers, who see this as unwelcome additional work and they can’t see themselves as accountable for HR data collection and reporting.

This situation does not allow generating timely a comprehensive picture of workforce movements, identification of major gaps and weaknesses in order to support HRH policies and plans. This pushes certain countries to organize time to time costly HRH censuses and surveys instead of strengthening the systems in order to enhance the coverage, management and sustainability. In this regard, most of the Directorates of the HRH units of the Ministries of Health have thus far limited their capacity in managing and identifying the HRH issues and in monitoring adequately the HRH imbalances and uncontrolled staff development and career management.

To improve HRIS, required attention should be given to address these issues and challenges. Infrastructures and communication technologies and appropriate tools and mechanisms with skilled staff such as statisticians, demographers and computer programmers to oversee data quality and standards for collection, and to ensure the appropriate analysis and utilization of information for decision making, are needed.

Useful tools and documents

Handbook on monitoring and evaluation of human resources for health

With special applications for low- and middle-income countries

This Handbook offers health managers, researchers and policy makers a comprehensive and standard reference for monitoring and evaluating human resources for health. It brings together an analytical framework with strategy options for improving the health workforce information and evidence base, as well as country experiences to highlight approaches that have worked. The Handbook can be downloaded [pdf 3.4 Mb] from www.who.int/hrh/documents/en/.

2. Framework and Standards for Country Health Information Systems, second edition.

Geneva, Health Metrics Network and World Health Organization, 2008

The Framework explains why and how countries can build stronger systems to gather, manage, analyse and distribute health information. The Second Edition has important new contributions from countries and partners, particularly in the elaboration of methods and standards.

3. Kampala Declaration and Agenda for Global Action.

Geneva, Global Health Workforce Alliance and World Health Organization, 2008 .