Assessment of Health Management Information System in Tanzania - Report Example

Assessment of Health Management Information System in Tanzania By Table of Contents Section A Introduction At the present, up to business organisations have become more and more dependent on their information systems to handle the complication and unpredictability of the environment in which they work. In addition, current, absolute and correct information has turned out to be a necessity to carry on in an increasingly competitive world. As a result, business requirements to information systems increase at an amazing pace. In this scenario, an information system consists of all people (such as employees, employers, customers and so on), machines (hardware) and activities (operations and processes) aimed at collecting and performing operations on data to supply the information need of people inside and outside the organisation (Octium, 2012; University of Technology, 2012; Laudon & Laudon, 1999). This report discusses some of the important aspects of health management information system (HMIS) in Tanzania. Basically a health management information system (HMIS) is an information system which allows health care centers or hospitals to collect, record, and process data for policy development, public health planning, evaluation and implementation of health programs. Additionally, this kind of information systems is vital for facts based policy and well-informed decision-making at all levels varying from national down to the corporate and healthcare institutional levels. In addition, such kind of evidence based health care decision making is really crucial in order to make suitable usage of limited resources mainly in resource limited nations similar to Tanzania. On the other hand, the health management information systems in most of the third world nations are ineffective as well as are very much influenced by unreliability of data resulting from dirty data and underreporting. According to the reports of health care institutes from sub Saharan Africa specifies that very important decisions of health care sector are formulated on the basis of basic estimates of disease as well as treatment loads (Nyamtema, 2010; Evans & Stansfield, 2003; Smith et al., 2008). This report is aimed at presenting some of the major issues in healthcare sector of Tanzania. In this scenario, this report will discuss the implementation of HMIS in Tanzania, it’s working and related issues. Background Application of health information systems generates data and information in order to notify health planners and decision makers on what is occurring at health sector. Additionally, health information systems play a significant role in improving the health management and administration as a precondition for high-quality health and medicines delivery services. Therefore, the basic aim of implementing health information systems is to fill the gap between disease occurrence and the response of health staff to fight with the disease. In addition, HMIS is essential for knowledgeable decision making, evidence-based policy-making all through planning, implementation and evaluation of health policies and programs, and for suitable usage of resources at all the levels of health care management system (Lungo, 2003; Nyamtema, 2010). In Tanzania, the initial version of HMIS was introduced in 1993 and 2nd in 1998. Though, the initial version was totally based on English language and it was very difficult to understand for those people who had imperfect commands in this system and language thus it was later on moved to Kiswahili, the national language of Tanzania. In Kiswahili language, the Health Management Information System is called as Mfumo wa-Taarifa-za-Huduma-za-Afya (MTUHA) (Lungo, 2003; Nyamtema, 2010). Moreover, later version entails manual information and data entry into 12 HMIS brochures. Additionally, the system involves all the health programs and services. However, the major objective of this system is to help health sector improve its capabilities and performance by offering adequate and timely information required by the health managers to verify, assess and plan their tasks. Its success needs a system that is decentralized, integrated, useful and dependable (Lungo, 2003; Nyamtema, 2010). Influences of HMIS in Policy Development and Management In order to assess the impact of HMIS on healthcare policy development and management we need to analyze the basic capabilities of system and local support available for the system working and operations. It is assessed that computer databases were previously installed at local, provincial and nationwide levels of the health information systems in Mozambique and Tanzania, and could be established at regional levels. The experimental assessment of revealed significant issues that designated that, those services are themselves barriers for reporting practices health delivery services (Lungo, 2003; Nyamtema, 2010). While assessing HISP project for healthcare policy management it was perceived that it is same as a “silver bullet” that has the potential to resolve the issues of healthcare data and information systems in Tanzania, however the experiential assessment once more counteracted that supposition. The assessments offered that the progress of HISP project in Mozambique to be dawdling. In this new healthcare arrangement the research data were transferred from the national technology based database of the Ministry of Health in Mozambique to the HISP healthcare database, DHIS, a procedure predictable to accelerate the level of HISP database in a lot of districts. However, it was not the actual situation because HISP faced various socio political technical disputes. Last but not least, the experiential assessments offered a lack of logical health information policy at Ministries of Health. Consequently, there are a lot of parallel self-governing systems concerned in reporting health deliverance services magnificent load to the health staff at the data and information peripherals (Lungo, 2003; Nyamtema, 2010). Influences of HMIS in Planning and Management Decisions The Ministry of Health and Social Welfare (MoHSW) takes pleasure in presenting a report of the current evaluation of the national Health Information System (HIS). Given that there is always growing need for evidence on improved performance as well as evidence based on the planning and decision making in the features of national and global development program like that National Strategy intended for growth and reduction of poverty, Healthcare Millennium Development Goals, Health Sector Reforms, Vision 2025, Health sector economic support and lots of such programs, the MoHSW has paid a great deal attention on HIS (WHO, 2007; Lungo, 2003; Nyamtema, 2010). In addition, the assessments shown that the healthcare information and data being stated were not enough to support health sector in planning and informed decision-making. The major reasons of behind this flaw included low quality data comprising erroneous, incomplete and premature reporting, lack of assets and office space, continuation of legacy information systems, and the reality of equivalent reporting systems in the health sector data and information systems. Moreover, the results as well showed the foremost challenges in initiating computer databases to be the contribution of clients as well as the existing computer database arrangements. Furthermore, the assessments confirmed that the DHIS is appropriate software for the health information systems and data protected in legacy information systems that could be carefully taken out and migrated to new information systems (WHO, 2007; Lungo, 2003; Nyamtema, 2010). Issues of the current Health Information Systems This section presents a detailed analysis of some of the critical issues of HMIS health information systems in Tanzania: (Archangel, 2007; Eldis, 2012; Lungo, 2003; Nyamtema, 2010; HEALTH DEVELOPMENT PARTNERS GROUP IN TANZANIA, 2012) Information efforts perceived as a burden Many researchers have shown that majority of health facilities are understaffed. As a result, most of the health staff feels being overloaded when inquired to gather data. Moreover, a report presented by Bagamoyo District Medical Office also shows 62 percent under-staffing level at health centers, 33 percent at dispensaries and 14.2 percent at district hospitals. In such conditions the overall process of effective data collection and management becomes much harder and really complex. In addition, the collected data is also not of high quantity that could offer better decision support. Lack of Designs and availability of data registers There are numerous researches which show unavailability of data registers in a number of phases of the calendar year. In this scenario, majority of health staff (93 percent) learned that the data registers are not always available. In addition, health staff utilizes loose papers in place of registers, they begin once more to move the entire data and information from the loose locally planned registers to the official healthcare registers. This is troublesome and is supposed again as a load to the health workers. These factors also affect the working of new technology based stuff at local levels. Lack of feedback and untimely reporting In case of application of HMIS at Tanzania the method of gathering, analyzing, presenting and transmitting health data is hence tedious since the time a report is generated, the data is out of date and decisions are frequently made without dependence on some information input. In addition, health planners and decision makers monitor deadlines and time restrictions particularly with a lot of tasks on their hands because of shortage of staff. In this scenario the overall process of effective decision making can be really influenced. Lack of information strategy procedures in the Ministry of Health of Tanzania The nationwide reporting arrangements in both the nations Mozambique and Tanzania, have not been for a synchronized attempt to tackle data and information requirements of health planners and managers. In addition, a number of contributing organisations and national programs covered by Ministries of Health have developed their individual specialized information arrangements. In both the information systems, there are no details and information with a comprehensive and complete indication of the health information accessibility. Legacy information systems at Tanzania While talking about HMIS arrangement working and operations, both databases MTUHAPROG and SISPROG were based on similar methods in which data elements are stored like column heads of the information and data tables, files that is, the curriculum codes and the health data report are mixed jointly. Moreover, this was a terrible design for the reason that these data constituents are subject to alter at some time, and consequently with this database design, the technology based source codes have to be altered normally; a job that needs software development and programming abilities, which are hardly ever discovered among health workers. Section B Measures for Improvement This section presents some suggestions and feasible measures (strategies or activities as appropriate) to address challenges identified in the previous section. Here I will discuss strategies which can be adopted to address the identified challenges: Issue: Information seen as burden Solutions: This issue could be resolved by offering appropriate staff training, technical support; implementing excellent tools for management of information system Issue: Inadequate Access to data Solutions: Promote data collection, cascade system performance, re-writing software to improve operational performance, staff training Issues: Poor Preparation of data for use Solutions: Improving strategies for data and information sharing, offering more user friendly data filling forms, staff training, improving and implementing enhanced quality control Issue: Weak analysis of Data Solutions: Providing sufficient training to data analysts. Linking data collection, analysis, planning and assessment Issue: Poor capacity for decision Solutions: Analyzing capacity at all healthcare sector levels, offering peer reviews and management of data management to encourage quality of data that can lead to quality decisions and on-time suitable action taken Issue: Low initiative for using data Solutions: Strengthen supportive supervision and data analysis feedback, establishing effective connection to performance assessment and funding References Archangel, N., 2007. The critical issues affecting the introduction of Health Management Information Systems in developing countries in Africa. [Online] Available at: http://www.iicd.org/files/Thesis_HMIS_Nicole%20Archangel.pdf [Accessed 10 February 2012]. Eldis, 2012. Key issues: Health management information systems. [Online] Available at: http://www.eldis.org/go/topics/resource-guides/health-systems/key-issues [Accessed 08 February 2012]. Evans, T. & Stansfield, S., 2003. Health information in the new millennium: a gathering storm? Bulletin of the World Health Organization, 81(12), p.856. HEALTH DEVELOPMENT PARTNERS GROUP IN TANZANIA, 2012. UNITED REPUBLIC OF TANZANIA; Ministry of Health and Social Welfare (MoHSW). [Online] Available at: http://hdptz.esealtd.com/fileadmin/documents/Key_Sector_Documents/Monitoring___Evaluation/Proposal_to_Strengthen_Health_Information_System.pdf [Accessed 09 February 2012]. Lungo, J.H., 2003. Data Flows in Health Information Systems. [Online] Available at: http://www.ub.uib.no/elpub/Norad/2003/uio/thesis01.pdf [Accessed 09 February 2012]. Nyamtema, A.S., 2010. Bridging the gaps in the Health Management Information System in the context of a changing health sector. BMC Medical Informatics and Decision Making, 10(26). Octium, 2012. What is an Information System? [Online] Available at: http://www.octium.eu/en/index.php/information-systems/what-is-an-information-system [Accessed 11 February 2012]. Smith, M., Madon, S. & Anifalaje, A., 2008. Integrated Health Information Systems in Tanzania: Experience and Challenges. The Electronic Journal of Information Systems in Developing Countries, 33(1), pp.1-21. University of Technology, 2012. Welcome to the IS Group. [Online] Available at: http://is.tm.tue.nl/ [Accessed 10 February 2012]. WHO, 2007. ASSESSMENT OF THE COUNTRY HEALTH INFORMATION SYSTEM IN TANZANIA. [Online] Available at: http://www.who.int/healthmetrics/library/countries/HMN_TZA_Assess_Draft_2007_05_en.pdf [Accessed 12 February 2012]. Read More