IICD supported project: Health Management Information System (HMIS)

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Countries: Uganda [UG]
Sectors: health
image: project in state 1

Summary

In 2001-2002, the Ugandan Ministry of Health launched a data management tool for health workers known as the Health Management Information System (HMIS). The Uganda Catholic Medical Bureau (UCMB) joined the project in September 2004. The aim of this ambitious project is to support the Ministry of Health by using ICT to implement HMIS in over 250 Health Units and hospitals throughout the country.

Update

Updated: 2007-11-01

Digitised medical records, easy access to continuous medical education (CME), Record Officers fully trained in ICTs: these are just some of the benefits the HMIS project is bringing to rural hospitals in Uganda. Tremendous progress was made in a little over a year: by December 2005 record numbers of hospital managers and assistants had been trained; 7 out of the 25 targeted hospitals had set up a database; 22 sites plus the UCMB main office were fully operational, with internet access via a new DVB down link; all ICT equipment had been installed; and a UCMB website had been created with training modules providing online Continuous Medical Education (CME). However, some setbacks had been experienced such as recurrent connectivity problems – specifically, slow and unreliable internet access – as well as occasional hardware failures, which resulted in a six-month delay in the physical implementation.

Introduction

The Health Management Information System (HMIS) project was initiated by the Ugandan Ministry of Health to address the problems healthcare managers face in terms of inadequate and poor quality data collection, ineffective use of information and duplicated efforts by parallel health institutions. A management information database was set up in 2001-2002 to address these issues and support healthcare managers in their decision-making processes. The Uganda Catholic Medical Bureau (UCMB) – which represents about 35% of Uganda’s national health sector – is committed to this process but needed further assistance to implement the project. This support takes the form of improving information collection and data management through a programme of Continuous Medical Education (CME) at all UCMB-affiliated institutions; which include 27 hospitals (11 of which also operate Nursing Training Schools) and 230 smaller Health Units.

Objectives

The main objectives of this project are:

To upgrade existing information and communication technologies (ICTs) in UCMB-affiliated health institutions to improve their access to information and facilitate better communication between them;
To improve communications and the flow of information between the UCMB in Kampala and its 257 affiliated health institutions;
To obtain timely feedback by requesting changes in the HMIS management process;
To provide better monitoring tools to enhance the management of health institutions;
To demonstrate the value of having an effective HMIS in the health sector.

Planned outputs

Planned outputs include:

One Records Officer/Data Clerk from every health institution trained in Records and Information Management at a recognised training institute (at least 25 by the end of 2006);
Computer databases in all targeted health institutions (at least 25 by the end of 2006);
The development of a new ICT system adopting GSM-DVB technology by the end of 2005;
A UCMB website with CME online training modules in operation by the end of 2005;
At least 50 health workers trained in ICT applications by the end of 2006;
At least 25 health managers trained in HMIS and health policy planning and monitoring by the end of 2006;
Computerised HMIS available in at least 25 targeted health institutions by the end of 2006;
Improved use of data and management information by Health Unit managers to monitor and evaluate their unit's performance. This will be measured by the number of timely quarterly assessment reports submitted by the managers and based on the HMIS 106 format devised by the Ministry of Health.

Development Impacts

This project is expected to have a significant impact on the way in which health institutions in Uganda function in the future. First and foremost, this will help to improve the way in which health units are managed based on the information gathered by the staff. Other organisations in the health sector are also expected to reap the benefits of the project as better decisions are taken by UCMB-affiliated institutions as a result of more effective data management. Other organisations may also be inspired to adopt the HIMS to improve their own internal data management processes. In this way, the project hopes to contribute to achieving the general objectives of the Ugandan Health Sector Strategic Plan (HSSP), and goal number 5 in particular: “policy, planning and health information management system operational”.

Management and organisation

The project is being coordinated by the UCMB and is based on an existing legal framework that has been in place since 2001. A Project Implementation Team (PIT) of individuals from UCMB and its affiliated health institutions, led by Mr Andrea Mendelli, handle the day-to-day project management and submit quarterly progress reports. An Advisory Committee also ensures that the project remains on schedule and meets the targets set out in its workplan.

Market and finance

The project is not expected to generate any revenue as such. However, by improving the decision-making processes in the Health Sector the Ministry of Health will be able to save money that would otherwise be misspent as a result. This will therefore prevent waste and the duplication of efforts by existing Health Units.

Lessons learned

This project is expected to strengthen the ability of health centres to use and apply the information they collect to support their work and improve the overall management of their resources. In due course, an independent output-to-purpose review (OPR) will be carried out to provide useful feedback which can be distilled into lessons learned. The results of that review will be published here. The general lessons learned so far include:

Poor connectivity within a country can cause serious delays and setbacks in projects involving this type of ICT application;
Maintaining the technical infrastructure necessary for this project has proved to be very time-consuming and requires a lot of hands-on attention, particularly for hospitals in rural areas. UCMB therefore plans to drawn up a ‘maintenance contract' to address this issue.

Budget

At the end of 2005 the project coordinator provided an overview of hospitals and possible connectivity alternatives to be able to link up with the training department of each hospital, together with the cost implications. The total budget required for this in 2006 is estimated to be about USD 65,000.

Project Owner : Uganda Catholic Medical Bureau (UCMB)

Project Contact : IICD