Why Government should invest more in health management information systems

By Benjamin Lutimba Mutebi

Without reliable and relevant health information, health care managers and providers cannot make decisions to allocate resources effectively, improve the quality of health services, or address epidemics such as HIV/AIDS, malaria and TB.

As health systems are re-structured, the demand for sound information and the skills to manage and use information are increasing significantly. Health Management Information Systems (HMIS) based on paper linking the various levels of the health system and addressing information needs cannot be ignored.

A computerised HMIS comes with easy and timely accessibility to updated information, provides regular statistics to support reports and gives feedback, which improves reporting and data quality. However, the paper-based HMIS should be strengthened first.

For Uganda’s case, the health information needs have changed over time due to health sector reforms and decentralisation of health planning to districts. Very many health facilities are not connected to power and those which are connected are normally hit by power cuts.

When you refer to the surveillance reports by the ESD in the MOH, most of them come in incomplete and some do not report in time. This is a clear indicator that there is inadequate training in HMIS for most of the health facility staff.

The MOH has made available all the data collection tools at the health facilities but in most cases, staffs do not know how to make these tools complete and this, therefore, leads to incomplete reports which always misinform decision making in terms of logistics supply.

This has continuously led to drug stock outs, shortage of HIV test kits and under staffing because the relevant authorities are not informed in time to make planning possible.

It is so sad to note that at so many occasions, health units experience stock outs since they are not able to forecast their needs as a result of not filling the required HMIS tools.

It is also not unusual to find expired supplies like test kits being used at one facility yet they are lacking at another. For such scenarios, it is clear that the HMIS tools that require expiry dates to be filled are not completed since it is at such a point that such issues can be identified.

Much as there are existing HMIS tools, there is need for MOH to work with partner projects or stakeholders to adjust them in a way that they only include a finite number of indicators to monitor and evaluate the health system's performance.

Data collection and flow must be streamlined and simplified. When you take a look at most of these HMIS tools, staff are even required to collect data on variables which are never used for planning and this has led to so many redundant fields in these HMIS tools. These paper-based HMIS tools should, therefore, be adjusted to answer planning needs and also be easy to complete by the already overburdened front-line health providers during the review process.

Therefore, in order to respond to these challenges, MOH has gone a long way by revising the existing paper HMIS tools and emphasis should be put on these before investing more in the Electronic system since it might not work well for remote health centers.

The writer is a monitoring and evaluation specialist