Zimbabwe's Human Resources for health Information System (ZHRIS)-an assessment in the context of establishing a global standard

Abstract

Introduction: There have been numerous global calls to action to utilize human resources information systems (HRIS) to improve the availability and quality of data for strengthening the regulation and deployment of health workers. However, with no normative guidance in existence, the development of HRIS has been inconsistent and lacking in standardization, hindering the availability and use of data for health workforce planning and decision making (Riley et al., 2012). CDC and WHO partnered with the Ministry of Health in several countries to conduct HRIS functional requirements analyses and establish a Minimum Data Set (MDS) of elements essential for a global standard HRIS. As a next step, CDC advanced a study to examine the alignment of one of the HRIS it supports (in Zimbabwe) against this MDS.

Method: For this study, we created a new data collection and analysis tool to assess the extent to which Zimbabwe's CDC-supported HRIS was aligned with the WHO MDS. We performed systematic "gap analyses" in order to make prioritized recommendations for addressing the gaps, with the aim of improving the availability and quality of data on Zimbabwe's health workforce.

Results: The majority of the data elements outlined in the WHO MDS were present in the ZHRIS databases, though they were found to be missing various applicable elements. The lack of certain elements could impede functions such as health worker credential verification or equitable in-service training allocation. While the HRIS MDS treats all elements equally, our assessment revealed that not all the elements have equal significance when it comes to data utilization. Further, some of the HRIS MDS elements exceeded the current needs of regulatory bodies and the Ministry of Health and Child Care (MOHCC) in Zimbabwe. The preliminary findings of this study helped inspire the development of a more recent HRH Registry MDS subset, which is a shorter list of priority data elements recommended as a global standard for HRIS.

Conclusion: The field-tested assessment methodology presented here, with suggested improvements to the tool, can be used to identify absent or unaligned elements in either an HRH Registry or a full HRIS. Addressing the prioritized gaps will increase the availability of critical data in the ZHRIS and can empower the MOHCC and councils to conduct more strategic analyses, improving health workforce planning and ultimately public health outcomes in the country.

Keywords: Data standards; Global public health informatics; Health workforce registry; Human resources for health (HRH); Human resources information systems (HRIS); Minimum data set (MDS); Workforce surveillance.

Fig. 1. –

Snapshot of sample rows from the HRIS Alignment Assessment Data Collection Tool.

Fig. 2. –

Number of Person Identifiable Elements aligned for MOHCC (ordered by missing elements).

Fig. 3. –

Number of WHO Lifecycle Elements aligned for MOHCC (ordered by lifecycle phase).