Evaluation in Uganda Shows Impact of HRIS Strengthening

In January, an evaluation was performed in Uganda to assess the Capacity Project’s HRIS strengthening work thus far. A team of evaluators conducted qualitative interviews with over 20 key informants involved in improving the country’s HRIS at the central and district level, including representatives from Capacity Project Uganda, the Health Workforce Advisory Board (HWAB), the four professional health councils, the Ministry of Health (MOH), and two pilot districts.

Preliminary results emphasized the significance of the HWAB, a stakeholder leadership group established with Capacity Project support, in ensuring local ownership, driving implementation of the Project’s iHRIS software and promoting sustainability. iHRIS Qualify—the Project’s licensure and registration software—was installed in the four councils beginning with the Nursing and Midwives Council in 2006, and iHRIS Manage—the Project’s HR management system—was installed in the MOH and in two pilot districts this past fall.

The evaluators found that although the councils and MOH are at different stages of software implementation, producing reports and using the data from the system, they all reported that the systems saved time locating records and aggregating information.

• The Nursing Council is the farthest along, and advised they are now able to report a much more accurate # of nurses working in the country and are using the system to verify registrations, enforce policy and uncover impersonation.
• The Pharmacy Council informed the evaluators that reports from the iHRIS Qualify software have been used to lobby parliament for an increase in pharmacist production.The council used that same information to present to development partners and pharmaceutical industries and have secured scholarships for pharmacy students.
• The Allied Health Professional Council reported the software saves them time locating files – before they had to go through a lot of manual files and forms just to get one person’s complete record. They said they have produced some reports, such as lists of registered allied health professionals by cadre.
• The Medical and Dental Council said they have produced a few standard reports, like staff lists, and wanted training on how to produce more complex reports to aggregate data in other ways, like cross tabulation of gender and first degree.
• The central MOH reported they had just completed data entry and were verifying data. They said they see the promise of software, when its fully operational, to influence HR decisions, such as recruitment at central and district level. They, however, wished they were farther along with implementation and through the process of adopting the software have realized they need to build a policy around the coding of classification and cadres.

Some top recommendations resulting from the evaluation were for all councils and departments to adopt a common coding structure for the health workforce and to also begin producing more standard, regular reports that are shared with top management. To ensure sustainability, additional training is needed on the functions and abilities of the software, and analytical skills need to be developed in the councils MOH, and districts. It was also apparent that users and decision makers in the districts have different needs compared to the central MOH, mainly operational, and different challenges such as infrastructure constraints that need to be considered.

Initial findings and recommendations were presented at a HWAB meeting and were endorsed by all members present. The team and Project leaders then met separately with Ms. Mary Nanono, the Permanent Secretary, and Honorable Dr. Stephen Mallnga, the Minister of Health, to brief them on the Project’s activities in country, give an overview of HRIS strengthening, and present the most notable findings and recommendations, which they both endorsed. The Permanent Secretary requested a detailed demonstration of the iHRIS software as soon as possible, and it was later presented to senior management. The Minister was enthusiastic about the HRIS work, explaining that he “cannot plan without data,” and indicated that he has not had the data he requires to address his information needs. He was very keen on sustainability and ensuring that there is capacity in Uganda to continue using the iHRIS software after the Project ends. He said he was very happy and thanked the Project for all the wonderful work , adding, “Data is very important. So, you (Capacity Project) have come at the right time.”

This work is part of a wider evaluation of the Project's HRIS activities in Rwanda, Swaziland and Uganda. An evaluation was conducted in Swaziland in November, and one will be held in Rwanda in March.