Improving the flow of information in Tanzania’s hospitals

Afya software was specifically designed by NPK Technologies, a Tanzanian company, to address the issues of lack of digitalised hospital systems in Tanzania. The innovative approach that this company takes is that the software is available for free, even though it is not open source. The company charges only for the implementing side of their business which works on project- and change management issues.

One unique feature of this software is that it is not fully workflow based. This works best in the local context as each level can work independently of each other. If one level is not completed, it does not hold up the work flow on another.

Currently, Afya has been been implemented in 8 health facilities in Mwanza Region, in  Magu District Hospital and in Kinondoni Municipals Council Health Facilities. From April 2007 4 more hospitals will be implemented with external assistance: 3 Tanga District hospitals and the llala Municipal Hospital. 

The strengths of this company are that 2 small teams specialise in what they do best: the first team specialises in developing and customising the software, and the second team purely implements project- and change management.  They help setting up the project management structure through the establishment multi-stakeholders committees and a operational management team. They provide basic ICT training to staff and medical officers, formal training on the AfyaPro software, and on the job training to users while performing their specific tasks in the new computerised environment.  In their change management activities they do not restrict themselves to the implementation of their software (AfyaPro), but they also offer their services when another HMIS program is used.  The company has strong ethics, they are against monopoly structures and want hospitals to be able to decide which they want. Another strength is that the company is run and managed entirely by Tanzanians, thus can easily communicate with local and illiterate people.

Typical training consists of one month of basic computer training. This enables hospital administrators to go from not having seen a computer before, to being able to use basic computer packages. There is then additional training in the area of the software that the administrator requires specifically for their job: about 2 weeks. A train-the-trainer approach is used to continually train others so that the system is never without trained persons. At the moment, 6 departments within these hospitals are working with computers (registration, laboratory, medical records data entry etc.).

There are some savings for patients: records are digitalised so they are not penalised if their ID card is lost which formerly forced them to buy a new one. There is also savings in time for habitual patients. Doctors save time on their monthly administrative workload, have easy access to patients’ medical history and the time between treatment and billing, as well as the time between invoicing at the National Health Insurance Foundation and and reimbursement is cut, so hospitals need smaller cash flow and accountability is better assured.  Due to the fact that the Ministry accepts this system and the reports the system generates for them there is also time saved at the end of the system due to the quicker medical records data entry at the beginning.

For more information on NPK Technologies:

www.npktechnologies.com

www.afyapro.com