Healthcare

A to Z: I is for iHRIS

  • iHRIS – see all related posts here.

There are many reasons I went to Malawi, back in October 2012. As I discovered after arriving, iHRIS was probably the biggest reason of them all.

It is the system (and project of the same name) commissioned by the Ministry of Health, to be their new human resources management information system: a database of their healthworkers. VSO were engaged to support its implementation and with funding from THET, recruited 6 British volunteers to help that process.

iHRIS logo

iHRIS logo

iHRIS itself is a piece of free, open source software, described as a “Health Workforce Information Solution“. It has been implemented in 15 countries to date and described by the WHO (World Health Organisation) in more detail here:-

WHO logo

WHO

WHO Global Health Workforce Alliance logo

WHO Global Health Workforce Alliance

 

Many developing countries face daunting obstacles to meeting the health care needs of their people. To ensure that the right health care provider is in the right place with the right skills, countries require current, accurate data on human resources for health (HRH). A strong human resources information system (HRIS) enables health care leaders to quickly answer the key policy and management questions affecting health care service delivery.

The iHRIS Suite Open Source HRIS software supplies health sector leaders with the information they need to track, manage, and plan the health workforce, assess HR problems, plan effective interventions, and evaluate those interventions. Both the software and a program of technical assistance are provided as well as expertise to ensure that the technology is transferred effectively and serves the ability of decision-makers to use data to lead and manage. While the iHRIS Suite was designed with the health workforce in mind, it also can be adapted for other types of workforces or organizations. Some relatively advanced computer and quantitative skills are needed to use this software.

Because the software is open source, it can be downloaded for free and customized for local needs. Each product addresses a specific health workforce leadership issue:

  • iHRIS Qualify tracks health worker training, certification, and licensure
  • iHRIS Manage maintains personnel deployment, performance, and attrition information
  • iHRIS Plan models long-term health workforce needs

.

In Malawi, we were implementing the iHRIS Manage solution because personnel related issues were the most important business problem we were trying to solve. For example, “ghost workers” and the exact planned deployment (i.e. how many doctors, nurses and midwives should be working at each healthcare facility) versus actual deployment (i.e. how many are in reality working at each clinic, hospital etc.).

Regular and critical business processes which we take for granted, like payroll, are not reliable in a country like Malawi. This made collecting and organising data for almost 30,000 employees very difficult. We spent a huge amount of effort to locate a good data source and then developing a way to import it automatically, and in the process, transforming it into a more usable structure in the iHRIS database. From Microsoft SQL Server to MySQL, for those familiar with databases.

This may sound like a fairly simple process. Technically, many would probably say it is. What it meant was, we could produce reports such as how many of each of the 300 job titles were supposed to be deployed at each “cost centre”, district or region.

After some data standardisation, we could also report on some fundamental information like how many “physicians” the Ministry really employed. For this, we had to define cadre groups, by adopting the WHO Health Workforce: Aggregated Data definitions, to make sense of the numerous job titles we had in our data source. Several of which included typos, spelling errors and duplication.

Ministry of Health Employees by Cadre

Ministry of Health Employees by Cadre

In many countries, Nurses and Midwives are two separate jobs but they are combined in Malawi, in the form of a Nurse and Midwife Technician (NMT). An NMT is the entry-level job for that professional career path and who many of my fellow VSO volunteers worked to help train more of, to cope with the ever growing population.

We also found out that there were more drivers than actual vehicles! That might sound astounding at first. But many “drivers” were, in fact, casual workers who also did other jobs. Gardening, cleaning, delivering documents from room to room etc. We still had an internal paper-based memo system and runners shuttling from office to office!

Ok, infomercial over… I really do look back at my time on the iHRIS Malawi project with fondness and a sense of achievement.

There are so many funny stories and anecdotes, which will be a source of amusement (and bemusement) for the rest of my career and especially at Team iHRIS reunions! Including spending a whole week and more trying to track down the seemingly only Internet domain registrar in Malawi. After many attempts, we eventually managed to get our server online at ihris.health.gov.mw… which came after much running around to get an IP address!

Some of my colleagues are still in Malawi, training more and more HR Officers to use the system, which is arguably the crucial step and also the original brief for which we were all recruited. To my personal regret, I’m not there to help Jim, Robin and Judy any more. Although Judy still tries to get Oli and I to troubleshoot, just like this week 😉

And our response is the same as we were still there: We’ll do what we can.

Funnily enough, I began writing this blog post because I started to look into the current issue and discovered that our system is offline. The server is most probably down because there’s another power cut at our datacentre. Sorry Judes!

(Some of) the iHRIS Malawi team

(Some of) the iHRIS Malawi team

iHRIS Malawi login page

iHRIS Malawi login page

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Categories: Healthcare, Malawi, Technology, Volunteering, VSO, Work | Tags: , , , , , | 4 Comments

Umoyo Scale

Scary to think that this was almost a year ago…

Back in June 2013,  I attended The World Bank Data Literacy Bootcamp. It was a really eye-opening experience, where I learnt new skills like geocoding with Google Fusion Tables and met a lot of like-minded people who wanted to apply technology to their aid efforts. I also learnt a few funny words like “ideate“, which being reservedly British and all, I would never normally use!

Part of the #dbootcamp was dedicated to forming projects to tackle data related problems specific to Malawi. There was a $1000 seed grant for the winning project idea and pitch.

We formed a Healthcare sector team and brainstormed lots of ideas to tackle. Eventually deciding on starting up “Umoyo Scale” (Umoyo in Chichewa means health), which is a TripAdvisor like crowd-sourcing system to collect and share reviews of healthcare facilities. The main add-on is that Umoyo Scale would also be usable via SMS because most Malawians simply do not have access to the Internet.

There was stiff competition with lots of interesting ideas (see full list from our Hackpad) but we finished runner-up!

Unfortunately, due to work priorities and logistical difficulties to get the whole team together, we were not able to take this much further the submission of a concept paper. But it really was a great experience, which I hope inspired everyone to use data more creatively.

Before it fades further in my memory, I thought I’d share the ultra persuasive presentation we put together.

Categories: Healthcare, Malawi, Technology, Volunteering, VSO, Work | Tags: , , , , | Leave a comment

International Day of the Midwife

Yesterday, 5th of May, was International Day of the Midwife.

IDM2014 #ThankaMidwife

Given the current situation of very high neonatal fatalities, this is especially important for Malawi. VSO have published an article on my fellow volunteer Beth.

There is a short video explaining her work in Phalombe, in the Southern Region of Malawi. Please take a look!

Categories: Healthcare, Malawi, Volunteering, VSO | Tags: , | Leave a comment

The joy of teaching nursing students in Malawi

The poster boy of VSO Malawi (also my barber and close friend), David Atherton, explaining his work as a nurse tutor to the Scotland Malawi Partnership.

Sometimes, working here can be tough. Especially as a volunteer who is trying to introduce change – Change to make things better; Not everyone is as open to change. But David’s attitude and enthusiasm is exemplary. We definitely need more people like him to help make Malawi a better place.

Scotland Malawi Partnership

Scottish nurse and SMP member, David Atherton, shares about his experience teaching nursing students in Malawi

I am currently working for VSO Malawi as a nurse tutor at St Luke’s College of Nursing & Midwifery in the Zomba district.  I am part of a team of British nurses and midwives volunteering to aid colleges on a wide range of issues from academic, to management support.

Image 

My job is diverse, but I am happiest when I am visiting students on the wards and providing clinical teaching.  When I teach, my teaching is responsive to those who are learning and in my Malawian nursing students I have found enthusiasm and a positive outlook that makes teaching fun.  Malawian culture is quite hierarchical and so breaking down the barriers with new students is my top priority.  Once they are comfortable in our new relaxed teacher-student relationship they really shine.  They have a…

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Categories: Healthcare, Malawi, Volunteering, VSO, Work | Tags: , | 3 Comments

A to Z: C is for…

  • CCAP – Church of Central Africa Presbyterian, the main Christian church body in Malawi.
  • CHAI – The Clinton Health Access Initiative, who we work closely with at the Ministry of Health on many area, including our area of Human Resources. A lot of our friends work there.
  • CHAMChristian Health Association of Malawi is the main organisation who the Ministry of Health partners and outsource healthcare service and training to. Their employees make up the majority of healthcare workers in Malawi.
  • Chambo – Chichewa name for the most commonly eaten fish from Lake Malawi. It’s from the Tilapia family.
  • Chibuku “Shake Shake” – Fermented maize beer sold in a carton, which bluntly, looks like vomit. Pretty horrible stuff I’m reliably told!
  • Chipatala – Chichewa word for hospital or clinic. Including the VSO designated Area 18 Medi-clinic, where all VSO volunteers go for medical attention. Unfortunately, I’ve visited it (too) many times.
  • Chipata – The first town in Zambia, across the border from Mchinji. Also where Natalie has recently moved to for the second part of her placement with VSO Zambia.
  • Chipiku Plus – Probably the best supermarket in Lilongwe. Still not exempt from Malawian counter-logical pricing. Quite often, the same product in a smaller quantity is better value for money then large or bulk quantities. For example, 500 g of margarine may cost 1000 MWK but 1 kg will cost significantly more than 2000 MWK!
Chibuku "Shake Shake"

Chibuku “Shake Shake”

Categories: Healthcare, Malawi, Volunteering, VSO | Tags: , , | Leave a comment

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