Strengthening Tanzania's health worker registry
Under the Data Use Partnership (DUP), the government of Tanzania partnered with PATH to update its Human Resource for Health Information System (HRHIS) to facilitate better tracking of health worker credentials—from training throughout their employment.
Health Information Systems
Digital Health
Human-Centered Design
Agile Software Development
Mr. David Lenga, Monitoring & Evaluation Officer and Mr. Nassania Shango, Nursing Officer from the Ministry of Health participate in a Data Use Partnership implementation team meeting held in Morogoro, Tanzania. Photo: PATH
The challenge
In 2009, the government of Tanzania established a Human Resource for Health Information System (HRHIS) to collect educational and employment data on health workers in the country’s public and private facilities. Though the HRHIS was well designed and has a strong foundation, it was outdated. It was used infrequently and required duplicative data entry. Health managers had to use a web of disconnected systems to consult data on training, professional development, and other employment details. Without unique identification for individual health workers, tracking them across their careers was difficult. Faced with health worker shortages and surging demand, governments must have a clear picture of their current workforce to respond to gaps in services and evolving health trends.
The approach
Using a “health worker registry” approach, the Data Use Partnership (DUP) updated the system to track health worker credentials, training, professional registration status, and employer and employment location. The improved HRHIS is based on a data exchange model using an application programming interface (API) to ensure that other digital systems can uniformly and securely report and access health data. Before, this data was fragmented in different systems. The system now links and pulls data from other systems, including the regulatory professional councils, government, training, and university databases, centralizing the data in a singular database.
To achieve this vision, we used the Collaborative Requirements Development Methodology to gather requirements through a series of workshops conducted with the stakeholders and users at various levels of the health system in Tanzania. This methodology is one approach to defining functional architecture and requirements based on collaboration with the stakeholders/users of the system to develop a shared understanding of and agreement on what the system must do. The process ensures the result accurately reflects the reality and needs of the users and buy-in and agreement from stakeholders.
Additionally, we applied the agile software development methodology throughout the development of the improved HRHIS. This approach relies on several iterations. Each iteration involves design, development, integration, testing, and deployment of one or more of the improved HRHIS features in a staging environment. Using this approach enabled timely feedback from users through regular review sessions.
The new system was also tested with the user advisory group to ensure that the functionality will meet the needs of the range of stakeholders using it.
To improve the Human Resource for Health Information System feedback was gathered through a series of workshops conducted with the stakeholders and users at various levels of the health system in Tanzania. Photo: PATH
“A strong health workforce is the backbone of every health system. We need accurate and timely health workforce data for planning, training, regulatory licensing, employment, and deployment of our health professionals.”— Martin Mapunda, Assistant Director, Dept. Human Resources & Planning
The solution
The improved HRHIS ensures that other digital systems can uniformly and securely report and access health data. The updated HRHIS facilitates continuous tracking of health workers, providing an uninterrupted record of their work histories and certifications.
For example, the data received from the university informs the government about how many students are enrolled and have graduated, which helps inform future staffing plans. This will provide accurate, up-to-date information for human resources for health planning, while providing verification services across organizations. It will also serve as a communications platform for health workers for updates on the latest health guidance and peer learning opportunities. Health workers will soon benefit from trainings through new eLearning platforms that will ensure they are equipped with the latest data quality and use skills.
The impact
Together, these and other digital initiatives under DUP are bringing about unparalleled change. The system will benefit a range of national and subnational stakeholders, including members of the Ministry of Health, public and private health facilities, training institutions, and universities, among others. With more visibility into the health workforce and increased use of human resource for health data to support decision-making, facilities can be adequately resourced and program managers at the national level can effectively plan recruitment and distribution of the workforce and track the credentials and professional development of in-service health workers. For health workers, they can self-report changes to their employment and information and leverage the platform to receive broader health worker communications. Collectively, the improved system will result in better working conditions for health workers and better service for patients.