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The state of Jharkhand in India is partnering with the IntraHealth-led CapacityPlus project to expand access to health care by rolling out iHRIS, IntraHealth’s free, open source data management software developed with support from the US Agency for International Development.
iHRIS (pronounced “iris”) helps countries around the world to track and manage their health workforce data, arming decision-makers with the information they need to better plan and budget for their health sectors.
In 2010, IntraHealth partnered with the government of India to strengthen health workforce data in the states of Bihar and Jharkhand. We piloted a modified version of iHRIS in one district in each state. Now Jharkhand is scaling up the program statewide.
Jharkhand’s customized iHRIS data now provide a comprehensive picture of the state’s public health workforce, including where each worker is posted, employment and training history, specialization, and projected retirement date.
Working closely with the Department of Health and Family Welfare and the State Health Mission, IntraHealth helped Jharkhand officials to develop data entry protocols and build staff capacity for data entry, data verification, data use, and software customization to meet the state’s needs.
India has a shortage of health workers. Only 15.2 skilled health workers are available for every 10,000 people, while the World Health Organization recommends a minimum of 22.8 per 10,000 people. And health workers are unevenly distributed throughout the country, concentrated mostly in urban areas.
Health sector leaders in Jharkhand are now using iHRIS to more effectively recruit and deploy health workers.
For example, Jharkhand’s principal secretary of health reviewed iHRIS reports that showed where obstetricians and anesthesiologists were situated throughout the state. Based on these data, the state redeployed some 112 of these specialists to health centers designated as first referral units—district or subdivisional hospitals or community health centers that offer specialist and surgical services such as caesarean sections—to ensure more equitable availability of emergency obstetric care and life-saving anesthesia skills.
Some 56,000 women die every year in India during pregnancy or childbirth. Making sure first referral units are adequately staffed and functioning is key to saving more mothers’ and newborns’ lives.
Now 36 out of 52 first referral units in the state are considered to be fully functioning, up from about 18 in 2011.
In another example, the Department of Health and Family Welfare in Jharkhand addressed an additional need revealed by iHRIS reports by recruiting nearly 450 new medical officers between 2012 and 2013—a 34% increase—and posting them in high-vacancy districts. These medical officers will provide care for about 2,000 clients per year, expanding access to health care to an additional 900,000 residents.
Jharkhand’s experience illustrates the important role information systems play in making progress toward India’s goal of universal health coverage.
Information on India’s health workforce has been limited and mostly kept in disparate paper files that are often not up-to-date. As part of its five-year strategic plan (2012–2017), the government of India has made it a priority the develop a web-based system such as iHRIS.
Nineteen countries are now using iHRIS to manage over one million health worker records. iHRIS has saved countries $177 million in licensing fees they would have incurred if they had used proprietary software instead.
The IntraHealth-led CapacityPlus project is supported by the US Agency for International Development.