Jhpiego TR Executive Summary - Malawi Health Human Resource Information Systems: Supporting the Development and Monitoring of Health Human Resource Deployment and Training Policies and Plans

The Malawi Fourth National Health Plan states that the achievement of an "adequate and equitable distribution of appropriately trained and effective staff to provide planned health services in Malawi" is a national goal. Deployment and training policies and plans grounded in and monitored and evaluated according to reliable health human resource data would provide a guide for Malawi's health sector leaders as they attempt to realize this desired outcome.

WHO, World Bank, and other human resources for health experts globally have recognized the dearth of human resource data for the health sector in many developing countries. In the present assessment, Jhpiego reviewed the availability of staff deployment and training data from routine information systems in Malawi to inform the Ministry of Health and Population (MOHP) of deficiencies that would need to be addressed in order to better inform the development and ongoing monitoring of deployment and training policies and plans.

This report is the result of a number of technical assistance site visits to Malawi between February 2001 and December 2002, in addition to the review of several reports and consultant documents focused on human resources and training monitoring systems in the Malawian health sector.

The report divides human resources for health (HRH) data into two categories: demand and supply. Demand data tell a health sector leader how many personnel in each cadre in each type of facility, and in which geographical areas, are needed. Supply data tell the decision-makers how many personnel there are presently or will be available. Demand sources reviewed in the present assessment include the current establishment and functional review of HRH in Malawi, and the World Health Organization (WHO) Human Resource for Health computer model, used by Jhpiego and Keele University in 2003 in Malawi to project HRH demand. The review of supply data revealed that 10 parallel data sources on HRH are in place covering Malawi MOHP personnel, while one streamlined data source was in place at the Christian Health Association of Malawi.

Training data sources from preservice institutions and family planning/reproductive health (FP/RH) inservice programs were also reviewed as part of this assessment.

As a result of the present review, Jhpiego recommends the following specific actions be taken with the goal of improving the routine HRIS for the MOHP:

Human Resources Management and Development (HRMD) and the instituting department for parallel uses and outputs of the system should jointly examine each MOHP HRH data source listed in this report.

A formal systems requirement analysis and process should be followed with HR information systems vendors to achieve the desired outcomes for routine HR data.

Jhpiego recommends the following specific actions be taken with the goal of strengthening the MOHP HRH planning function:

Specific Malawi MOHP personnel should be identified for capacity building using the WHO HRH Projection Model so that they can gain the needed knowledge and skills to carry forth HRH model updates in future years.

District Health Office (DHO) staff and central hospital administrators should be identified to work with the WHO HRH modeling team, to support the decentralization of HR planning functions.

Jhpiego recommends the following specific actions be taken with the goal of applying HRH data to preservice and inservice training:

Each training institution should use the HRH model training projections, from the Malawi Human Resources for Health Sector Strategic Plan, to come up with their own annual training plans, which together will fill the national needs for health human resource production over the next decade. This process responds directly to recommendations from the WHO/World Bank consultative meeting on HRH in Africa, that "intake into training institutions should be guided by strategic human resources plans for the Ministry of Health."¹

Starting with HRH data inputs, use the computer model ProTrain™ to project needed numbers of RH service providers over the next decade. Use the Reproductive Health Unit's TIMS^© database to assess whether current levels of inservice training will meet intended targets shown from ProTrain results.

¹ World Health Organization/Regional Office for Africa (WHO/AFRO). Building Strategic Partnerships in Education and Health in Africa: Consultative Meeting on Improving Collaboration between Health Professionals, Governments and Other Stakeholders in Human Resources for Health Development, Addis Ababa, 29 January-1 February 2002, report on the consultative meeting. http://www.afro.who.int/hrd/consultative_meeting_report.pdf, p. 11.