Design and Implementation of Health Management Systems: Experiences from HISP-SA

1. Design and Implementation of Health Management Systems: Experiences from HISP-SA HISA 2008

2. An information system is as good as the human resource efforts put into and attitudes towards the system

3. Introduction We discuss two projects in South Africa and Zambia that effected changes to the health information systems. We describe how the gap between information system design and the political/behavioural and technological realities of developing country organisations can be reduced. The systems that were deployed were modularized, and the implementation process was participatory and scaled � important consideration for DC contexts

4. Mpumalanga: Strengthening of Hospital Information Systems 6 Month project Analysis of current hospital information systems and data collection tools. Identify problem areas and challenges in existing information systems. Development of an Excel based electronic collection and collation tool customised for every hospital in the province. Training in the new system and user support. Training in the use of hospital information for planning and budgeting of services in hospitals.

5. Zambia: Revitalisation of the HMIS 18 Month project to revise the National Health Management Information System in Zambia Analysis of existing HMIS Develop a new National Indicator Data Set (NIDS) Migration of data to the new system (DHIS) Piloting of the new system in one province. Local capacity building with a Training of Trainers programme. Feedback of pilot and changes to NIDS/DHIS system Roll-out of the system to other provinces Post Roll-out support Expansion of system to include Notification Module

6. Implementation of new Health Management Information Systems (HMIS) System designers need to be in touch with user realities.

7. Strategies to close the design to reality gaps in the Mpumalanga and Zambia Projects

8. Strategy 1:Find and use Hybrids to Close IS � User Reality Gaps

9. Strategy 1: Enrolling users as designers:Examples from Mpumalanga and Zambia

10. Addressing Design to Reality Gaps continue�

11. Addressing Design to Reality Gaps continue�

12. Modularity / Incrementalism Generic approaches to gap reduction that may limit the extent of change at any given time: Modularity (supporting one business function at a time) and Incrementalism (providing stepped levels of support for business functions) within DC IS projects

13. Modular Approach Zambia

14. Modular Approach Mpumalanga

15. To Summarise In both examples the success of the implementation can be ascribed to an implementation process which paid attention to the following: Through small scale experimentation and adaptation of tools and the software, users were enrolled and became proponents of the system; The small scale experimentation and deployment enabled a team of trainers to emerge, who then further supported the roll-out independent of the initial facilitator support; Through the use of simple standards and processes, the local use of information can be encouraged � an aspect vital to its further adoption; Constant attention to external influences both at a macro level (senior management and external political influences) and at a micro level (effects of data collection systems on local users) is important if the IS is to be adopted.

16. Conclusion

17. Thank You