Case Study: Developing an HRIS Step Solution

Immediate implementation of a mature software-based HRIS such as the iHRIS Suite is sometimes not feasible or appropriate (see Figure 1). For example, the required infrastructure to support this type of system may not be in place, or there might not be people on staff with the required expertise to support it. The need to implement an HRIS solution quickly can take precedence over making these long-term improvements. After assessing existing HR information systems, data management tools, processes, technical support staff and operational procedures, it may make more sense to put in place a "step solution" instead.

HRIS strengthening activities initiated by the Capacity Project

Figure 1. Over the five-year Capacity Project, HRIS strengthening activities were initiated in ten African countries; this map shows where mature HRIS were installed, where step solutions were implemented and where no HRIS is yet in place.

A step solution to manage human resources for health (HRH) data is an interim solution building on existing HR tools and systems, which can be deployed quickly to immediately address pressing problems. Then, you can implement gradual improvements to the step solution and proceed step by step to the final goal of a mature HRIS. This iterative process reduces the effect of too much change occurring too rapidly, creates an opportunity for capacity development among system owners and allows time to collect additional data required to address key policy and management questions. Data collectors and managers, technical support staff and decision-makers receive training at each stage, become comfortable with the new system and then take the next step when they are ready.

Some examples of step solutions include:

  • Convert a paper-based system to an electronic register, using a spreadsheet program such as Microsoft Excel
  • Convert an electronic register to a database, using a desktop database program such as Microsoft Access
  • Expand an existing database to capture additional data
  • Improve data collection forms—either electronic or paper—to reduce redundancy and inaccuracies, and ensure all required data fields are included
  • Improve data-quality procedures to reduce errors in the system and validate existing datasets
  • Create linkages among existing systems and improve data flow among users and producers of HRH data.

We applied all of these measures to improve the HRIS in Swaziland without installing a mature HRIS such as iHRIS Manage. This case study describes the steps we took in Swaziland to illustrate how such a step solution may be implemented, if appropriate, in your context.

The Situation in Swaziland

The Ministry of Health and Social Welfare (MOHSW) in Swaziland needed better HRH data. No one had a complete understanding of where health workers were deployed or what jobs they were doing. Some employees were not taken off the payroll after leaving the Ministry's employment and became "ghost workers" in the system, receiving a paycheck even though they no longer worked for the government. Since workers were not removed from the system, replacement workers were placed in incorrect positions just so they could be put on the payroll, making the system unreliable for workforce management and planning.

An HRIS assessment in Swaziland revealed the sources of these problems. HR data were stored in separate systems, some electronic and some paper-based, which were not linked. Information flowed slowly between systems and didn't reach everyone who needed it, so that systems were not updated or errors were introduced. The systems also could not be queried to produce analyses or reports.

The country's Stakeholder Leadership Group prioritized requirements for a comprehensive solution:

  • Create electronic records for all health care staff, regardless of employer (including the private sector)
  • Include additional data items relevant to HRH, such as registration numbers and facility codes
  • Institute tight security to protect access to data
  • Complement rather than duplicate an existing Public Service HR database.

Implementing the Step Solution

To quickly address these problems, the Capacity Project developed a step solution and implemented it over time. The Project took the following steps:

  1. Develop a data collection form to include additional data items and distribute it to health facilities to capture a snapshot of current health worker data.
  2. Program a simple database in Microsoft Access to run alongside the existing Public Service HR database and hold records of non-Public Service health workers.
  3. Generate a staffing report from both databases and circulate it to all health facilities for updating and correction to validate the accuracy of the new data. Make corrections in the Microsoft Access database.
  4. Institute data-quality procedures to improve the accuracy and timeliness of data inputs.
  5. Establish a monthly updating process and develop forms to capture data changes. Updates are regularly made to each database separately by the owner of that database.
  6. Combine records from both databases to produce a single dataset that is updated monthly, enabling reports and analysis on all health workers in the country.

The Microsoft Access database is installed in a server at the Ministry of Public Service and is updated centrally by the MOHSW's Personnel department. The database is protected by a Windows login. Confidential information is only accessible by authorized staff from the office of the Principal Personnel Officer, but summary reports and simple staff listings are available to all staff.

Reporting is done through a simple user interface, making queries on HR data very easy. Several standard reports were created for regular access, while detailed queries can be completed using Microsoft Excel pivot tables. All offices at the MOHSW building are connected to the database, but access is limited to printing standard reports. The office of the Principal Personnel Officer prints and distributes reports to users who are not directly linked to the databases.

The step solution has improved information flow between various systems and among groups that use HR data (see Figure 2). Health workforce data from the original Public Service HR database are downloaded monthly into the new HRIS database. Reports from this database are sent to health facilities and departments. The facilities and departments use these reports to send monthly updates to the MOHSW.

Information flow in Swaziland using a step solution

Figure 2. Information flow in Swaziland using an electronic HRIS "step solution." The red items refer to new systems and process that were instituted as part of the step solution.

The step solution facilitated data reconciliation among the separate systems, and we identified a large number of discrepancies. These range from simple data-entry errors to the elimination of the "ghost worker" problem.

The MOHSW used new and accurate data to analyze vacancies and manage deployments, as well as to develop the country's long-term Health Workforce Strategic Plan.