Leadership through CollaborationCase Study: Kenya Human Resource

Information System (HRIS)

Chris Rakuom, CNO Elizabeth Oywer, Registrar NCK Agnes Waudo, Country Project director

Challenges, Solutions, and Benefits of Collaboration

Kenya Health Workforce Information System

• Sponsored by CDC and implemented by the Lillian Carter Center at Emory University in collaboration with the Ministries of Health, professional councils and boards in Kenya.

Senior Technical Advisor- Patricia Riley,

CDC, Atlanta

Principal Investigator – Dr. Martha Rogers,

Emory University

Project Technical Advisor – Tom Oluoch, CDC Kenya

Background

• The Kenya Health Workforce Information System started in 2002 with nursing database at NCK.

• In 2005 it incorporated nurses deployment data at the DON.

• In 2008 it encompassed data on doctors/dentists, laboratory technologists/technicians and clinical officers.

• South-to-South collaboration with other countries

Problem Statement

Before the project started in 2002,

– Kenya healthcare workforce’s supply and demand data existed in paper forms

– that were difficult to retrieve and use for HR management

– There was no reliable national workforce data in an efficient manner on HRH production, recruitment, deployment, migration, and attrition

Problem Statement

• MOH lacked accurate data on the number of health workers by age, position, cadre, qualification, region, and rate of attrition for workforce planning

• Kenyan training institutions lacked data on national training & deployment needs with regards to the health professionals.

Project Objectives

• Establish electronic health workforce information systems that can provide accurate data for national policy and planning for HRH.

• Increase the capacity of the Kenyan leaders in data driven decision making for HRH management, research, and policy development.

• Utilize data for program planning especially the roll out of HIV prevention, care and treatment programs.

Project Collaborators• Kenya Health Workforce Information System is a

long-term collaborative venture between the Government of the Republic of Kenya, Regulatory Boards, Emory University and CDC Atlanta

• Other collaborators are PEPFAR, CDC Kenya

-Training Institutions, universities, KMTC

-Professional Associations

-Parastatals Institutions, i.e. KNH, Moi TRH

-FBOs and private health institutions

Collaborators cont’d

• Within the Government, ministries brings together the line departments and divisions, provincial, district management systems and health service delivery facilities

• Other Ministry departments are HR & ICT

• Technical experts- IT specialists (hardware engineer)

Software Engineer

Data Analyst

Professional consultants

Determinants of Collaboration Framework

• Systemic determinants– Outside the organization

• Organizational determinants– Conditions within an organization

• Interaction determinants

–Interpersonal interactions between team

San Martin-Rodriguez, Beaulieu D’Amour and Ferrada Videl, 2005

Collaboration StrengthsOrganizational Factors

Shared goals and visions

Strong and experienced leadership

Resources allocated were adequate

Clear boundaries were created

Trust between partners

Recording systems (at organizations) were quite strong

Agreements to share data

Collaboration Strengths

Systemic Factors

Political readiness

Support for innovation (funding by donors)

Project was allowed a considerable independence in controlling own budget

Training and education provided

Strong evidence of desirable outcome

Collaboration Strengths

Interaction FactorsPrevious existing relationships

Commitment at individual and group levels

Agreeing to set aside personal interests and concentrate the bigger project picture

Collaborative working style

Role clarity

What Worked?• Development of MOU and data confidentiality &

protection policy for each agency

• Formed an all inclusive national joint steering committee & project team to ensure implementation of project activities.

• Identify coordinators at national and provincial level for each agency

• Sensitization of stakeholders including all provinces, councils and boards.

• Sensitized non-health stake holders including security and provincial administration

What Worked?

• KNWIS country office set up

• Appointment of contact persons in DON and at the Nursing Council

• Sharing of experiences through meetings and workshops

• Joint inter-professional meetings

• Joint meetings with private sector including FBOs

What Worked?

• User specification for database system for each cadre including regulation and service delivery

• Assessment for equipment needs for each cadre

• Planning and facilitation for training, data collection and entry

• Provided logistical & administrative support

Database SystemData linked to MOH deployment server via satellite Internet connection-

now on fiber optic connections

Regulatory(Supply)

MOH(Demand)

NBI NYZ RV W E NE CST C

MOHRegulator

y Boards

Human Resources

Dept

Provincial quarterly HRH staffing data

District quarterly HRH staffing data

Sub-district HRH staffing data: health posts, dispensaries

(public, private, faith-based)

Data flow from Health facility to National level

Regulator

y Boards

Regulator

y Boards

Regulator

y Boards

MOHRegulator

y Boards

MOHRegulator

y Boards

MOHRegulator

y Boards

Human Resources

Dept

MOHRegulator

y Boards

Human Resources

Dept

MOHRegulatory

Boards

Challenges

• Technical know how

• Demand for capacity building

• Buy in for country ownership

• Communication barriers

• Different perspectives

• Bureaucracy

• Competing tasks affects coordination of activities according to timeline

• High demand for hardware equipment

• Data incompleteness

Solutions

• Technical advisors from relevant institutions

• Sensitization/training to address the challenges

• Consultation with all stakeholders to build consensus

• Point persons/coordinators at various levels

• Joint supervision to project sites

• Official feedback mechanism to facilitate communication at all levels

Benefits• Established a functional and successful HRIS

• Improved HRH management on deployment, training

• Improved skills on data management and usage to inform health workforce decisions

• Improved skills in IT

• Encouraged research culture among stakeholders

• Publications—dissemination of findings

• The Award for Excellence at the Second Global Forum on Human Resources for Health

Asante Sana

Thank You