HRIS Strengthening Implementation Toolkit
Building stronger human resources information systems
HRIS Strengthening Implementation Toolkit
Building stronger human resources information systems
Health care leaders need current, accurate data on human resources for health (HRH) in order to quickly answer key questions affecting health care service delivery. Understanding the current health workforce enables decision-makers to create informed, effective strategic plans designed to ensure a steady supply of trained health professionals and retain health worker skills and experience in the country.
The Capacity Project's human resources information system (HRIS) strengthening process is designed to foster better understanding of the current health workforce picture. This understanding prepares decision-makers to effectively plan for recruitment, training, deployment and retention of health professionals to meet health care needs.
The goal of this Toolkit is to provide a package of HRIS strengthening procedures and tools to HRH stakeholders, HR managers and software developers in order to facilitate applying the HRIS strengthening processes and implementing the HRIS software developed by the Capacity Project. The Toolkit collects briefs and tools to assist with the five steps of the HRIS strengthening process:
Many developing countries encounter serious constraints to maintaining accurate health workforce data and information, including a lack of well-functioning national HRH databases. Few, if any, electronic versions of health workforce records are readily available. While a paper-based system can represent a functioning HRIS, there are often serious limitations to the use of these data.
In most paper-based systems, data are collected on multiple forms, which often contain duplicate information. When so many forms for so many people must be completed, filed and tracked, the system becomes unworkable. Problems with data quality, such as incomplete forms and inconsistencies across forms, are harder to identify and correct. It becomes increasingly difficult to track an individual health worker moving through the system. Aggregating the data for meaningful analysis turns into a labor-intensive, time-consuming process, preventing policy and management decisions from being made in a timely manner. All of these issues create gaps when deploying health workers to the places where they are most needed.
The most efficient, up-to-date way to track changes to a health workforce is to use data from a routine information system, or a human resources information system. These systems are typically used by administrative organizations such as licensing boards, ministries of health and professional associations to qualify, manage and plan the health workforce. Strengthening the HRIS and related processes improves the accuracy and quality of HRH information that is available to HR managers and workforce planners, improving their ability to make well-informed decisions and meet health care needs.
A human resources information system collects and manages information used in HR decision-making. A complete HRIS links all human resources data from the time professionals enter pre-service training until they leave the workforce. Typically, the system is computerized and consists of a database for storing the information, software for entering and updating data, and reporting and analysis tools.
A simple HRIS may rely on paper forms or on electronic files such as spreadsheets housed in different departments that do not link together, but such a system often does not adequately meet the country's needs. Putting in place a computerized, integrated HRIS achieves the following objectives:
The goal of HRIS strengthening is to progress from any systems that are currently in place—retaining the processes that are working while improving weaker parts and filling in gaps—to a complete and mature HRIS. A mature HRIS is defined by the following characteristics:
If well designed, managed and maintained, an HRIS can provide a cost-effective yet extremely useful source of information with which to monitor and evaluate the impacts of changes in HRH policy at the national and sub-national levels.
The HRIS development and strengthening process comprises five key stages using a participatory approach (see Figure 1). The participatory approach involves stakeholders in HRH information from various ministries and sectors from the outset and increases local ownership of the system.
Figure 1: Flowchart of the HRIS Strengthening Process
The five steps of the HRIS strengthening process are:
The Capacity Project advocates a country-level participatory approach to strengthening HRIS in order to generate ownership of the system among all stakeholders and build capacity within the country to support, use and improve their HRIS. The foundation for the participatory approach is the Stakeholder Leadership Group, in which all producers and consumers of HRH data are represented. Working collaboratively enables stakeholders to exchange data with one another—often for the first time—as well as reduces redundant data collection and provides a comprehensive picture of human resources from both the public and private sectors.
The SLG model brings all stakeholders together in one room to assess their common needs for an HRIS. Together, they develop the specifications for the system and initiate, lead and monitor all HRIS strengthening activities. The result is an HRIS that is appropriate for their context and tailored to their needs—a system they designed for themselves.
Section I includes the following tools for organizing and managing a SLG:
Once formed, the first task of the SLG is to assess the systems that are already in place for supporting a strengthened HRIS. This comprehensive assessment should consider not only any existing electronic HR information systems, but also paper-based systems, data collection forms and processes for gathering data about the health workforce. In addition, the information and communications technology (ICT) infrastructure needed to support a software-based HRIS should be considered.
The assessment provides a complete picture of how HR information is currently collected, managed and reported; the tools and processes that are in place for managing HR data; and the gaps that need to be addressed to meet the most pressing needs. Often the results are surprising. During the assessment phase, the SLG may discover underused sources of HR information managed by different departments or organizations that can be linked together to immediately improve HRH data access for all.
Following the assessment, the SLG typically can recommend rapid improvements to ICT infrastructure to appropriately bring networks, Internet connectivity, hardware, software and even electrical supply up to standards that can support an HRIS. These improvements can generally be implemented quickly and often result in increased efficiency and productivity. In addition to improving the ICT infrastructure, recommendations for improving data collection, training procedures and technical support should be made at this point in the process. Data quality is of primary importance and should be emphasized at every step of the process, from initial data collection to data analysis and interpretation.
Section II includes the following tools for assessing and improving existing systems that support the HRIS:
Once the infrastructure can support an HRIS, the next step is to develop HRIS solutions that are customized for the country context and answer the key HR policy and management questions for that country. These solutions may consist of interim, or "step," solutions that build on tools and processes already in use or, if appropriate, one or more of the mature solutions in the Capacity Project's iHRIS software suite.
A "step" solution is most appropriate for contexts that do not yet have the resources or infrastructure to support a complete and mature HRIS. The step solution uses and improves existing tools, systems and processes to quickly start collecting and using HR data while progressing in manageable steps toward a more complete HRIS.
The Capacity Project iHRIS (integrated human resources information system) suite comprises three core software solutions to address the most critical health workforce planning and management issues:
Working together in a country setting, these three systems provide a powerful feedback loop for analyzing, planning and managing workforce resources and needs. Each of the three systems may also be deployed independently or integrated with software products already in place to provide a customized, contextual solution, filling in any gaps that existing systems may have left. Distributed as Open Source code, all three products can be downloaded, used and modified with no licensing fee.
Section III provides the following tools for developing HRIS software solutions and deploying the iHRIS Suite:
The primary aim of any HRIS should be to promote better use of data to drive effective decision-making for addressing daily challenges and positively impacting HR policies and practice. Even when policy-makers and other key stakeholders have access to extensive information about the health workforce, it may be difficult to see uses for these data beyond the usual reports previously generated with paper records. All stakeholders should be engaged in understanding how they use data, both individually and organizationally, and what factors are important in their context for using data effectively.
This step of the process focuses on providing opportunities for stakeholders to experience critical decision-making scenarios so they can develop their skills using real data in real-life situations. Stakeholders will understand different models for projecting health workforce needs into the future as the basis for strategic planning. At this point, it is often helpful to improve communication among users of data and leverage opportunities for improved data-sharing across different levels of the organization and with other stakeholders.
Section IV provides the following tools for improving the use of data to make decisions:
An information system requires ongoing support and improvement to ensure maximum utility and sustainability. Depending on the context and needs of the country, sustainability strategies include continuous collection of feedback from stakeholders about changing data needs and rolling out improvements that align with those needs. The early involvement of stakeholders with the design and eventual implementation of the HRIS encourages their sense of ownership.
Skills development is necessary for maintaining and improving computerized information systems. This step of the HRIS strengthening process should include ongoing training of data collectors, information system support staff and data managers to support and improve technology infrastructure, data quality and integrity. Linking disparate systems often results in improved data use and quality. A sustainability strategy could also include developing regional user communities to facilitate problem solving and share system improvements, possibly in collaboration with local educational institutions.
Section V provides the following tools for ensuring sustainability and continuous improvement of the HRIS:
If you are planning to develop a new human resources information system or improve an existing system, we highly recommend that you read through the entire Toolkit and develop a plan for implementing the HRIS strengthening procedures before you start system development.
Several steps in the HRIS strengthening process must be completed before actually starting to develop the HRIS, including forming a Stakeholder Leadership Group, conducting an HRIS assessment and improving existing systems, infrastructure and data collection procedures. It may seem like these steps will take a lot of time, but we have found them to be essential in ensuring that the HRIS strengthening activity is successful and can be sustained over the long term. The initial planning steps will make certain that the HRIS you develop actually meets your needs and saves costs and time when software development gets underway.
HRIS strengthening activities and this Toolkit are primarily aimed at national-level ministries of health and similar bodies with the aim of improving the HRIS for the country's health workforce. However, we have found that the methods and tools described in this Toolkit, and the accompanying iHRIS software, may readily be adopted by other large organizations seeking to improve HRIS. Other groups that will benefit from applying these methods include: private or nongovernmental organizations managing health workers in the country; districts adopting an HRIS to track local health staff; professional licensing or certification associations tracking a cadre of qualified health workers; or large hospitals seeking to better manage employees. These methods are general enough that with a little adaptation, they may also be applied to other sectors besides health.
The information provided on this website is not official U.S. Government information and does not represent the views or positions of the U.S. Agency for International Development or the U.S. Government. HRIS Strengthening is a program of the Capacity Project, a USAID-funded global project designed to strengthen human resources for health. The Capacity Project partnership is led by IntraHealth International.
Publication Date: April 2009