Helen Lugina, HRIS Champion

Helen Lugina is the coordinator for the Human Resources Development and Capacity Building program of the East, Central and Southern Africa Health Community (ECSA-HC). Based in Arusha, Tanzania, ECSA-HC is an inter-governmental organization, currently consisting of 10 member countries. ECSA-HC’s mandate is to improve the quality of health care delivery in member countries, working mostly through advocacy and policy development. Dykki Settle, Capacity Project HRIS team leader, describes Helen as “our greatest champion in the ECSA region.” Helen has been a huge supporter of establishing and strengthening HR information systems (HRIS) in member countries, and she is responsible for presenting Capacity’s HRIS strengthening concepts to Health Ministers (ECSA-HC’s highest governing body) at their annual conferences.

ECSA-HC has many programs, including HR Development and Capacity Building, Health Systems Development, HIV/AIDS, Food and Nutrition, Family and Reproductive Health, and Information, Communication and Dissemination. Although ECSA-HC has an overall strategic plan, most of the programs also have their own individual plans. Recently, by working with USAID, the HR Development and Capacity Building program developed a draft strategic HR plan and presented it at a Direct Joint Consultant Committee (DJCC) meeting in September 2007. The DJCC advises the ECSA-HC secretariat on operational and technical issues.  The draft plan addresses issues such as retention, migration, and leadership in management, and focuses on strengthening HRIS in member countries.

The draft plan states that one of the major Human Resources for Health (HRH) challenges among member countries is the lack of accurate and reliable HR information for decision making. To address this, one of the strategic objectives is to improve HR intelligence in these countries through HRIS, documentation and dissemination of best practices.  Better HR intelligence will help countries establish, monitor and evaluate national Health Workforce Observatories that will ensure accurate HRH data is readily available for planning purposes. Helen describes the Observatories as being composed of teams of “gatekeepers” that analyze and monitor HR intelligence in their countries. She explains that they are emphasizing HRIS so that countries will “know the type of data that should be generated to answer their policy questions.”

Helen points out that the ECSA-HC member countries are at different levels in developing their HR information systems, “it is a major challenge that we really need to work on in most of the countries.”  Some countries, like Kenya and Uganda, have partnered with Capacity Project and other projects/organizations to strengthen their HRIS. Capacity was also working to strengthen HRIS in another member country, Swaziland, and the work was transferred to the South Africa Human Capacity Development Coalition (SAHCD) last year.  Helen says ECSA-HC is delighted to be working with both the Capacity Project and SAHCD and hopes that ECSA-HC will eventually take the lead in strengthening HRIS in the region. “Through the SAHCD Coalition in Swaziland, ECSA hopes to identify a person to conduct trainings so that we can continue to provide technical assistance to the countries.”

“HRIS can tell policy makers and decision makers the status of the health workforce in the country,” states Helen.  She explains that, without an accurate HRIS, countries cannot know, for example, the numbers of health workers they need to train, how much they should invest in training and where to deploy them after they are trained.  When it comes to the management of day-to-day HR issues, Helen says that “if you don’t know who is there to do what, in terms of skill mix, then you don’t know how to utilize them according to your needs.” She adds that the required mix can often be present but inequitably distributed. “If you don’t know who you have, you might be leaving women to be attended by unskilled birth attendants, which is a risk for maternal and neonatal death. So that is just one example that if you have the right person at a certain moment, then it can prevent a lot of deaths.”

From the Capacity Project’s work in the ECSA region, including the strengthening of Stakeholder Leadership Groups, Helen has witnessed progress in several member countries.  She singled out Uganda as a country where she sees all the important stakeholders beginning to “own” entire issues and planning together, making sure they know exactly how to use the data that is available. “It is one thing to have nice and beautiful graphs and data and databanks and so forth, but the second thing is for this information to be used by the decision makers.” She described notable progress in this regard. Helen also recognized Capacity’s commitment to presenting at African Health Workforce Observatory conferences and ECSA Health Ministers' Conferences and added that, as a result of this, the health ministers have come to know and value HRIS as one of the major priorities in the region. Helen explains that “the Ministers know that without a sound information system there is no backbone to the decisions people make.”

“It is almost like each year we have a minister’s conference, there is a resolution coming out working to strengthen HR information systems.  For example, the next minister’s meeting is this February in Seychelles. We [previously] presented the whole workforce observatory concept including the HRIS, and they are going to ask where we are.  So we needed to really follow up and monitor and, as much as possible, inform them of the progress.”

Helen believes it is important the HRIS strengthening work the Capacity Project has helped start in the region continues, even after the project ends, and that there exists a “capacity in the African region or in the ECSA region to walk in the footsteps of Capacity Project.”  She also has hopes ECSA or similar organizations are able to help other countries set up their information systems, implement software that is sustainable and then ensure that countries are able to continue generating and interpreting information for use in policy development.  She concludes that what really needs to be followed up on is “the support for capacity development, in terms of knowing the software, how to do the data analysis and how to use the data itself for projections and for planning.”