Democratic Republic of the Congo https://www.intrahealth.org/ en Integrated Performance and Quality Management: Combining the Optimizing Performance and Quality and Collaborative Quality Improvement Approaches to Improve HIV Service Delivery in the Democratic Republic of the Congo https://www.intrahealth.org/resources/integrated-performance-and-quality-management-combining-optimizing-performance-and-quality <span>Integrated Performance and Quality Management: Combining the Optimizing Performance and Quality and Collaborative Quality Improvement Approaches to Improve HIV Service Delivery in the Democratic Republic of the Congo</span> <time datetime="2022-09-14T12:00:00Z">2022</time> <span><span lang="" about="/users/ihadmin2" typeof="schema:Person" property="schema:name" datatype="">ihadmin2</span></span> <span><time datetime="2023-01-11T11:39:27-05:00" title="January 11, 2023 11:39 AM">January 11, 2023</time> </span> <div class="field field-name-body field-type-text-with-summary field-label-hidden field--name-body field--type-text-with-summary field--label-hidden field__items"> <div class="field__item"><p>The main objective of the IHAP-HK project is to build local capacity to ensure the continuum of quality HIV care and services at multiple levels of the health system (health zone, health facilities, community sites). To achieve this, beginning in September 2017, IHAP-HK combined IntraHealth’s Optimizing Performance and Quality (OPQ) methodology with a collaborative quality improvement approach to create the Integrated Quality and Performance Management (IQPM) approach. OPQ is a stakeholder-driven, cyclical process for analyzing human and organizational performance and setting up interventions to improve performance and quality and build on strengths and successes. IQPM is an innovative approach that allows health stakeholders to solve performance and quality problems at health facilities and generate best practices to achieve desired performance levels.</p> </div> </div> <a href="/sites/default/files/ihapiqpmdrcenglish.pdf" class="resource-button">Download</a> <div class="field field-name-field-other-attachments field-type-file field-label-hidden field--name-field-other-attachments field--type-file field--label-hidden field__items"> <select class="fancy"> <option value="">Other Resources</option> <option value="/sites/default/files/ihapiqpmdrcfrench.pdf">Download</option> </select></div><div class="field field-name-field-thumbnail field-type-image field-label-hidden field--name-field-thumbnail field--type-image field--label-hidden field__items"> <img loading="lazy" src="/sites/default/files/styles/resource_thumbnail/public/resource-thumbnail-images/ipqmscreenshoteng1.jpg?itok=w3GLQsn3" width="150" height="194" alt="" typeof="foaf:Image" /> </div><div class="field field-name-field-countries field-type-entity-reference field-label-above field--name-field-countries field--type-entity-reference field--label-above field__items"> <strong class="field__label">Countries</strong> <a href="/countries/democratic-republic-congo" hreflang="en">Democratic Republic of the Congo</a></div><div class="term-list field field-name-field-projects field-type-entity-reference field-label-above field--name-field-projects field--type-entity-reference field--label-above field__items"> <strong class="field__label">Projects</strong> <a href="/projects/integrated-hivaids-project-haut-katanga" hreflang="en">Integrated HIV/AIDS Project in Haut Katanga</a></div><div class="field field-name-field-topics field-type-entity-reference field-label-above field--name-field-topics field--type-entity-reference field--label-above field__items"> <strong class="field__label">Topics</strong> <a href="/topics/hiv-aids" hreflang="en">HIV &amp; AIDS</a><a href="/topics/education-performance" hreflang="en">Education &amp; Performance</a></div>By <a href="/people/cecile-edambolo-yema" hreflang="en">Cecile Edambolo Yema</a>, <a href="/people/cyprien-tendo" hreflang="en">Cyprien Tendo</a>, <a href="/people/jean-claude-kiluba" hreflang="en">Jean-Claude Kiluba</a>, <a href="/people/melanie-joiner" hreflang="en">Melanie Joiner</a>, <a href="/people/osee-lieke" hreflang="en">Osée Lieke</a>, <a href="/people/pascal-milenge" hreflang="en">Pascal Milenge</a>, <a href="/people/sujata-bijou" hreflang="en">Sujata Bijou</a> Wed, 11 Jan 2023 16:39:27 +0000 ihadmin2 5533 at https://www.intrahealth.org Strong Data Systems Are Crucial during Coronavirus https://www.intrahealth.org/vital/strong-data-systems-are-crucial-during-coronavirus <span>Strong Data Systems Are Crucial during Coronavirus </span> <span><span lang="" about="/users/kseaton" typeof="schema:Person" property="schema:name" datatype="">kseaton</span></span> <span><time datetime="2020-05-04T09:40:27-04:00" title="May 04, 2020 09:40 AM">May 04, 2020</time> </span> <div class="field field-name-field-publish-datetime field-type-datetime field-label-hidden field--name-field-publish-datetime field--type-datetime field--label-hidden field__items"> <div class="field__item"><time datetime="2020-05-04T12:00:00Z">May 04, 2020</time> </div> </div><div class="intro"> <p>When data systems are weak, their flaws can become dangerous. </p> </div> <hr> <div class="field field-name-body field-type-text-with-summary field-label-hidden field--name-body field--type-text-with-summary field--label-hidden field__items"> <div class="field__item"> <p>Data systems are crucial for health care all the time, but during a natural disaster, war, or pandemic like COVID-19, functioning data systems can mean the difference between life and death.</p> <p>Data help us know what the health needs are, what capabilities each nearby hospital and clinic has, and where health workers should be deployed. Essential for responding to a pandemic, these data help monitor the spread and intensity of disease and help everyone, not just health workers, understand its severity and impact on society.</p> <p>If the systems are operating smoothly, we don’t even realize they’re there. For example, the World Health Organization’s <a href="https://www.who.int/influenza/gisrs_laboratory/flunet/en/">FluNet</a> platform, an open source data tool that shares data on the influenza virus, helped <a href="https://www.who.int/influenza/gisrs_laboratory/GISN_Meeting_Report_apr2011.pdf">prevent SARS from becoming endemic</a> after the 2003 outbreak and allowed for an efficient, rapid, and comprehensive response to the 2009 H1N1 pandemic.</p> <p class="tweetparent"></p><a href="https://twitter.com/intent/tweet?text=But+when+data+systems+are+old+or+clunky+or+weak%2C+their+flaws+become+clear%E2%80%94and+dangerous....&amp;url=https://bit.ly/2Wxk8gq" class="twitterintent-wrap" target="_blank"> <span class="twitterintent-text">But when data systems are old or clunky or weak, their flaws become clear—and dangerous.</span> <svg class="twitterintent-icon" viewbox="0 0 19 16" xmlns="http://www.w3.org/2000/svg"><path d="M16.76175 2.529539c.80519-.499205 1.42302-1.29077 1.71298-2.233713-.75389.463382-1.58696.798497-2.47579.979922C15.28966.489961 14.27593 0 13.15402 0c-2.15238 0-3.89658 1.808465-3.89658 4.038712 0 .316625.03234.625162.09925.919832C6.1181 4.789831 3.2464 3.183591 1.32265.738408c-.33568.598585-.5275 1.291926-.5275 2.031489 0 1.400549.68809 2.637008 1.73417 3.362704-.63902-.0208-1.24013-.204535-1.76651-.504983v.04969c0 1.957532 1.34273 3.590351 3.12819 3.960132-.32787.094757-.67136.142135-1.02823.142135-.25093 0-.49627-.024267-.7327-.071645.49516 1.603929 1.93491 2.773364 3.64119 2.804565-1.33492 1.083923-3.01555 1.72873-4.84117 1.72873-.31449 0-.62563-.017334-.93009-.055467C1.72525 15.330926 3.7739 16 5.97535 16c7.17086 0 11.08974-6.154557 11.08974-11.492128 0-.175646-.00223-.350137-.01003-.522317C17.81675 3.41586 18.47919 2.70403 19 1.893977c-.69924.321248-1.4509.538494-2.23825.635562z" fill-rule="evenodd"></path></svg></a> Lack of information leads to government inaction, like in Puerto Rico during the aftermath of Hurricane Maria, when a lack of data on where people should go for medical care and what steps health facilities should take<a href="https://qz.com/1390559/how-many-people-died-in-hurricane-maria-an-investigation/"> led to preventable deaths</a>. <p>One investment that really pays off (and becomes invisible during an emergency) is making sure a country’s data systems are interoperable. That is, making sure different digital health systems can talk to each other, using the same formats and terminology across all platforms. This helps the technology work seamlessly so health officials can focus on the emergency at hand rather than trying to wrangle data from a dozen different systems.</p> <blockquote> <p>Most sub-Saharan countries have multiple sources of data and limited support to use the data in a unified way.</p> </blockquote> <p>In the Democratic Republic of the Congo (DRC), for example—a country whose health system has faced Ebola outbreaks, war, and now COVID-19—a <a href="https://jhia-online.org/index.php/jhia/article/view/239">report</a> published in the Journal of Health Informatics in Africa by Gérard Bisama, a health informatics technical advisor for IntraHealth, found that “data use has remained a persistent challenge in digital health implementations, especially in environments that have rapidly transitioned from data scarcity to data overload. All too often, digital data remain siloed in a variety of locations and formats or furnish duplicate information.”</p> <p>The DRC has a shortage of health workers, <a href="https://www.who.int/workforcealliance/countries/cog/en/">with 0.28 physicians and 1.91 nurses and midwives per 10,000 people</a>. This leaves significant gaps in the health system, which are exacerbated by a multitude of data systems that don’t speak to each other.</p> <p>Take <a href="https://www.ihris.org/">iHRIS</a>, for example. The government of DRC used IntraHealth International’s free, open source software to conduct a payroll analysis. But they had to merge the iHRIS workforce data with the country’s payroll management system manually using Excel spreadsheets because each system had a different format and different terminologies.</p> <blockquote class="tweetparent"> <a href="https://twitter.com/intent/tweet?text=When+health+systems+suffer%2C+everyone+suffers.&amp;url=https://bit.ly/2Wxk8gq" class="twitterintent-wrap" target="_blank"> <span class="twitterintent-text">When health systems suffer, everyone suffers.</span> <svg class="twitterintent-icon" viewbox="0 0 19 16" xmlns="http://www.w3.org/2000/svg"><path d="M16.76175 2.529539c.80519-.499205 1.42302-1.29077 1.71298-2.233713-.75389.463382-1.58696.798497-2.47579.979922C15.28966.489961 14.27593 0 13.15402 0c-2.15238 0-3.89658 1.808465-3.89658 4.038712 0 .316625.03234.625162.09925.919832C6.1181 4.789831 3.2464 3.183591 1.32265.738408c-.33568.598585-.5275 1.291926-.5275 2.031489 0 1.400549.68809 2.637008 1.73417 3.362704-.63902-.0208-1.24013-.204535-1.76651-.504983v.04969c0 1.957532 1.34273 3.590351 3.12819 3.960132-.32787.094757-.67136.142135-1.02823.142135-.25093 0-.49627-.024267-.7327-.071645.49516 1.603929 1.93491 2.773364 3.64119 2.804565-1.33492 1.083923-3.01555 1.72873-4.84117 1.72873-.31449 0-.62563-.017334-.93009-.055467C1.72525 15.330926 3.7739 16 5.97535 16c7.17086 0 11.08974-6.154557 11.08974-11.492128 0-.175646-.00223-.350137-.01003-.522317C17.81675 3.41586 18.47919 2.70403 19 1.893977c-.69924.321248-1.4509.538494-2.23825.635562z" fill-rule="evenodd"></path></svg></a> </blockquote> <p>The payroll analysis took a while but eventually identified ghost workers—that is, workers who were still on the payroll but no longer actually working those jobs. Now that those ghost workers are no longer being paid, <a href="https://www.intrahealth.org/news/democratic-republic-congo-tackles-ghost-workers-mobilizes-resources-real-health-workers">the government has more funds to pay actual health workers</a>.</p> <p>But the DRC is not alone. Most sub-Saharan countries face the same challenges. “They have multiple sources of data and limited support over time to maintain their system and to use the data in a unified way,” Bisama says.</p> <p>As the coronavirus continues to spread around the world, poor data systems that don’t speak to each other may mean lives lost. Important information isn’t readily available and health systems suffer. But when health systems suffer, everyone suffers.  </p> <p class="tweetparent"></p><a href="https://twitter.com/intent/tweet?text=%E2%80%9CDuring+the+coronavirus%2C+we+can+introduce+true+innovations+in+an+emergency+by+leveraging+existing+systems+and+familiar+technology+that+are+already+adopted+at+scale%2C%E2%80%9D...&amp;url=https://bit.ly/2Wxk8gq" class="twitterintent-wrap" target="_blank"> <span class="twitterintent-text">“During the coronavirus, we can introduce true innovations in an emergency by leveraging existing systems and familiar technology that are already adopted at scale,”</span> <svg class="twitterintent-icon" viewbox="0 0 19 16" xmlns="http://www.w3.org/2000/svg"><path d="M16.76175 2.529539c.80519-.499205 1.42302-1.29077 1.71298-2.233713-.75389.463382-1.58696.798497-2.47579.979922C15.28966.489961 14.27593 0 13.15402 0c-2.15238 0-3.89658 1.808465-3.89658 4.038712 0 .316625.03234.625162.09925.919832C6.1181 4.789831 3.2464 3.183591 1.32265.738408c-.33568.598585-.5275 1.291926-.5275 2.031489 0 1.400549.68809 2.637008 1.73417 3.362704-.63902-.0208-1.24013-.204535-1.76651-.504983v.04969c0 1.957532 1.34273 3.590351 3.12819 3.960132-.32787.094757-.67136.142135-1.02823.142135-.25093 0-.49627-.024267-.7327-.071645.49516 1.603929 1.93491 2.773364 3.64119 2.804565-1.33492 1.083923-3.01555 1.72873-4.84117 1.72873-.31449 0-.62563-.017334-.93009-.055467C1.72525 15.330926 3.7739 16 5.97535 16c7.17086 0 11.08974-6.154557 11.08974-11.492128 0-.175646-.00223-.350137-.01003-.522317C17.81675 3.41586 18.47919 2.70403 19 1.893977c-.69924.321248-1.4509.538494-2.23825.635562z" fill-rule="evenodd"></path></svg></a> says Wayan Vota, IntraHealth’s digital health director. “Focusing on solutions with measured and appropriate digital health technology will allow us to be efficient and effective in our response to COVID-19.” <p><em>Alongside our partner organization PATH, the <a href="https://www.intrahealth.org/projects/integrated-hivaids-project-haut-katanga-and-lualaba">Integrated HIV/AIDS Project in Haut Katanga and Lualaba</a> project ensures that those affected by HIV in DRC are </em><a href="https://www.intrahealth.org/countries/democratic-republic-of-the-congo"><em>identified, referred, and receive high-quality care</em></a><em>, treatment, and support services. IntraHealth also leads efforts to make stakeholder data systems interoperable for more efficient reporting of project-level data between various reporting systems, facilitating more accurate tracking of people living with HIV. The project is funded by USAID.</em></p> <p><em>The Role of Interoperable Health Information Systems in Improving Health Outcomes: The Case of the Democratic Republic of Congo</em>,<em> is available to read <a href="https://www.intrahealth.org/resources/role-interoperable-health-information-systems-improving-health-outcomes-case-democratic">here</a>.</em></p> </div> </div> <div class="author"> By <div class="author "> <a href="/people/katherine-seaton"> <div class="img"> <div class="image" style="padding-bottom: 100%;"> <div class="field field-name-field-thumbnail field-type-image field-label-hidden field--name-field-thumbnail field--type-image field--label-hidden field__items"> <img loading="lazy" src="/sites/default/files/styles/large/public/event-participant-images/ksheadshot.jpg?itok=rsl-iRJ2" width="480" height="480" alt="" typeof="foaf:Image" /> </div> </div> </div> <div class="by">By <strong>Katherine Seaton</strong></div> <span class="title"><div class="field field-name-field-job-title field-type-string field-label-hidden field--name-field-job-title field--type-string field--label-hidden field__items"> <div class="field__item">Former communications manager</div> </div></span> </a> </div> </div> <a href="/projects/integrated-hivaids-project-haut-katanga" hreflang="en">Integrated HIV/AIDS Project in Haut Katanga</a> <a href="/topics/digital-health" hreflang="en">Digital Health</a> <a href="/topics/health-workforce-systems" hreflang="en">Health Workforce &amp; Systems</a><a href="/countries/democratic-republic-congo" hreflang="en">Democratic Republic of the Congo</a><div class=" image-caption"> </div> <div class="field field-name-field-thumbnail field-type-image field-label-above field--name-field-thumbnail field--type-image field--label-above field__items"> <div class="field__label">Vital Thumbnail Image</div> /sites/default/files/event-thumbnail/commonthumbnailtechnology.png </div> Mon, 04 May 2020 13:40:27 +0000 kseaton 5034 at https://www.intrahealth.org Our Work Gérard Bisama https://www.intrahealth.org/people/gerard-bisama <span>Gérard Bisama</span> Health Informatics Technical Advisor <span><span lang="" about="/users/kseaton" typeof="schema:Person" property="schema:name" datatype="">kseaton</span></span> <span><time datetime="2020-04-21T09:58:09-04:00" title="April 21, 2020 09:58 AM">April 21, 2020</time> </span> <div class="field field-name-field-thumbnail field-type-image field-label-hidden field--name-field-thumbnail field--type-image field--label-hidden field__items"> <img loading="lazy" src="/sites/default/files/styles/large/public/event-participant-images/person-default_0.png?itok=Spd5TL9p" width="480" height="480" alt="" typeof="foaf:Image" /> </div><div class="field field-name-body field-type-text-with-summary field-label-hidden field--name-body field--type-text-with-summary field--label-hidden field__items"> <div class="field__item"><p>Gérard is a health informatics technical advisor for IntraHealth International in the Democratic Republic of the Congo.</p> </div> </div><div class="field field-name-field-countries field-type-entity-reference field-label-hidden field--name-field-countries field--type-entity-reference field--label-hidden field__items"> <div class="field__item"><a href="/countries/democratic-republic-congo" hreflang="en">Democratic Republic of the Congo</a></div> </div><div class="field field-name-field-weight field-type-weight field-label-above field--name-field-weight field--type-weight field--label-above field__items"> <div class="field__label">Weight</div> <div class="field__item">24</div> </div><div class="field field-name-field-in-queue field-type-boolean field-label-above field--name-field-in-queue field--type-boolean field--label-above field__items"> <div class="field__label">In Queue</div> <div class="field__item">On</div> </div><div class="field field-name-field-queue-weight field-type-integer field-label-above field--name-field-queue-weight field--type-integer field--label-above field__items"> <div class="field__label">Queue Weight</div> <div class="field__item">24</div> </div> Tue, 21 Apr 2020 13:58:09 +0000 kseaton 5010 at https://www.intrahealth.org The Role of Interoperable Health Information Systems in Improving Health Outcomes: The Case of the Democratic Republic of Congo https://www.intrahealth.org/resources/role-interoperable-health-information-systems-improving-health-outcomes-case-democratic <span>The Role of Interoperable Health Information Systems in Improving Health Outcomes: The Case of the Democratic Republic of Congo</span> <time datetime="2020-04-20T12:00:00Z">2020</time> <span><span lang="" about="/users/kseaton" typeof="schema:Person" property="schema:name" datatype="">kseaton</span></span> <span><time datetime="2020-04-21T09:56:31-04:00" title="April 21, 2020 09:56 AM">April 21, 2020</time> </span> <a href="/sites/default/files/attachment-files/239-articletext-1025-1-10-202001081.pdf" class="resource-button">Download</a> <div class="field field-name-field-thumbnail field-type-image field-label-hidden field--name-field-thumbnail field--type-image field--label-hidden field__items"> <img loading="lazy" src="/sites/default/files/styles/resource_thumbnail/public/resource-thumbnail-images/gerardscreenshot.jpg?itok=Bh7nWL7N" width="150" height="194" typeof="foaf:Image" /> </div><div class="field field-name-field-countries field-type-entity-reference field-label-above field--name-field-countries field--type-entity-reference field--label-above field__items"> <strong class="field__label">Countries</strong> <a href="/countries/democratic-republic-congo" hreflang="en">Democratic Republic of the Congo</a></div><div class="field field-name-field-topics field-type-entity-reference field-label-above field--name-field-topics field--type-entity-reference field--label-above field__items"> <strong class="field__label">Topics</strong> <a href="/topics/digital-health" hreflang="en">Digital Health</a></div><div class="field field-name-field-publisher field-type-string field-label-above field--name-field-publisher field--type-string field--label-above field__items"> <strong class="field__label">Publisher</strong> Journal of Health Informatics in Africa</div>By <a href="/people/gerard-bisama" hreflang="en">Gérard Bisama</a>, <a href="/people/david-potenziani" hreflang="und">David Potenziani</a>, <a href="/people/john-liebhardt" hreflang="und">John Liebhardt</a>, <a href="/people/claire-viadro" hreflang="und">Claire Viadro</a>, <a href="/people/leah-mcmanus" hreflang="und">Leah McManus</a>, <a href="/people/emily-nicholson" hreflang="und">Emily Nicholson</a>, <a href="/people/amanda-puckett-bendor" hreflang="und">Amanda Puckett BenDor</a>, <a href="/people/carl-leitner" hreflang="und">Carl Leitner</a> Tue, 21 Apr 2020 13:56:31 +0000 kseaton 5009 at https://www.intrahealth.org Getting to Zero: Lessons on Ebola and Global Health Security https://www.intrahealth.org/vital/getting-zero-lessons-ebola-and-global-health-security <span>Getting to Zero: Lessons on Ebola and Global Health Security</span> <span><span lang="" about="/users/mnathe" typeof="schema:Person" property="schema:name" datatype="">mnathe</span></span> <span><time datetime="2018-11-16T18:04:30-05:00" title="November 16, 2018 18:04 PM">November 16, 2018</time> </span> <div class="field field-name-field-publish-datetime field-type-datetime field-label-hidden field--name-field-publish-datetime field--type-datetime field--label-hidden field__items"> <div class="field__item"><time datetime="2018-11-20T12:00:00Z">November 20, 2018</time> </div> </div><div class="intro"> <p>We sat down with Oliver Johnson to find out how West Africa's 2014 outbreak is informing DRC's today.</p> </div> <hr> <div class="field field-name-body field-type-text-with-summary field-label-hidden field--name-body field--type-text-with-summary field--label-hidden field__items"> <div class="field__item"><p>As news from the epicenter of the Ebola outbreak in the Democratic Republic of Congo (DRC) <a href="https://www.washingtonpost.com/health/2018/11/05/cdc-director-warns-that-congos-ebola-outbreak-may-not-be-containable/?utm_term=.3b5c3773580e">worsens</a>, how can the lessons from the 2014-2016 West Africa Ebola outbreak help?</p> <p>I sat down with Dr. Oliver Johnson, coauthor of <a href="https://www.gettingtozerobook.org/">Getting to Zero: A Doctor and a Diplomat on the Ebola Frontline</a>, who worked on the frontlines of the West Africa outbreak, to find out. He stressed that while we’ve learned a lot about Ebola, most of it has involved technical aspects, such as the <a href="https://www.reuters.com/article/us-health-ebola-congo/ebola-fight-has-new-science-but-faces-old-hurdles-in-restive-congo-idUSKCN1LQ0HZ">medical innovations</a> and treatment practices we’re now seeing in the DRC—but we haven’t yet learned to navigate the damage caused by political complexities, which vary by country and context.</p> <blockquote> <p>We often respond to exactly what has come before, rather than being ready for the uncertain.</p> </blockquote> <p><strong>Earlier today you said that rather than focusing on preparing for the next Ebola outbreak, we should instead be preparing for the unexpected. What does this look like in practice, and how can policy-makers act on this?</strong></p> <p>We need to maintain flexibility in our systems and our responses. We often respond to exactly what has come before, rather than being ready for the uncertain. After the West Africa Ebola outbreak, organizations developed the perfect personal protective equipment (PPE) suit, and they wanted to stock these around the world. But this would reduce their flexibility and leave them unprepared if the next disease, for example, were airborne.</p> <p>Headquarters need to ask themselves what their appetite for risk is. They need to have a breadth of resources at the ready, and they need to be comfortable with uncertainty, choosing to trust their teams in the field and support them as needed.</p> <p><strong>You spoke earlier of the lack of trust at all levels during the West Africa outbreak. What can be done to restore trust between governments, health workers, and individual communities?</strong></p> <p>The question is partly how to create a government that is accountable to the people, and perceived as such, but also how to restore the trust between health workers and the public. In countries like Sierra Leone, health workers sometimes have a bad reputation for mistreating patients and demanding additional payments.</p> <blockquote> <p>We must always remember to ask ourselves “What would I do if this were me?”</p> </blockquote> <p>While much of this work should be done domestically, the international community does have a role to play in heightening accountability and improving trust, by:</p> <ul style="list-style-type:circle"><li>Investing in initiatives that boost accountability, supporting ministries and the health workforce, and ensuring staff are paid on time.</li> <li>Not inadvertently encouraging absenteeism, bribery, or corruption through our programming.</li> <li>Being accountable with salaries and ensuring that all national health workers are paid in emergencies.</li> </ul></div> </div> <hr /> <div class="field field-name-field-slideshow field-type-entity-reference-revisions field-label-hidden field--name-field-slideshow field--type-entity-reference-revisions field--label-hidden content-slideshow field__items"> <div class="swipe"> <div class="swipe-wrap"> <div class="slide"> <div class="img"> <img loading="lazy" src="/sites/default/files/styles/max_width_800/public/oliver_johnson2.jpg?itok=XpYcyAKd" width="800" height="533" typeof="foaf:Image" /> </div> <div class="caption"> <p> While international staff received their salaries during the 2014-2016 Ebola outbreak, many health workers here in Sierra Leone have still never received their full pay. Photo of Dr. Oliver Johnson assisting a colleague courtesy of King's College London. </p> </div> </div> <div class="slide"> <div class="img"> <img loading="lazy" src="/sites/default/files/styles/max_width_800/public/connaught_hospital.jpg?itok=7-zwlogq" width="800" height="450" typeof="foaf:Image" /> </div> <div class="caption"> <p> It’s easy to think there is not time to listen, but what we discovered is that we didn’t have time not to listen. Photo of Connaught Hospital in Freetown, Sierra Leone. Photo courtesy of King's College London. </p> </div> </div> </div> </div> </div> <span class='field-name-body'> <div class="field field-name-field-panel-text field-type-text-long field-label-hidden field--name-field-panel-text field--type-text-long field--label-hidden field__items"> <div class="field__item"><p><strong>Your book highlights the failure to engage communities in the Ebola response in West Africa. How can those responding to an outbreak ensure true community engagement while also operating at scale?</strong></p> <p>We need to listen more. We should not go in with a megaphone, but instead go to community meetings and wait until everyone has had a chance to speak. It’s easy to think there is not time to listen, but what we discovered is that we didn’t have time <em>not</em> to listen. We should have employed people in community engagement, precisely for their listening skills, not for their shouting skills. </p> <p>We must always remember to ask ourselves “What would I do if this were me?” During the West Africa outbreak, clinicians would become exasperated when parents avoided the official advice not to touch their sick children, but we should have realized that if this were our child, <em>of course</em> we would touch them!</p> <p>We were far too focused on a medical response, rather than trying to understand the people who were affected and remembering to empathize. Anthropologists and human rights organizations should have an active presence during crises, participating in key meetings and helping us design better responses from the beginning.</p> <p><strong>Could you highlight some of the disparities between international and national frontline health workers during the response?</strong></p> <p>While international staff were employed by international organizations responsible for their salaries, many Sierra Leonean health workers have still never received their full pay. We need an organization that specializes in setting up rapid and secure payment schemes to ensure local staff are fairly paid in emergency settings.</p> <p>The biggest inequity was with quality of care. International staff would be medically evacuated when they fell ill, but not local staff. There was a double standard. We should have invested more in improving the standard of care that all national responders could access. The local staff felt betrayed by this, and they were angry a lot of the time.</p> <p>We didn’t do enough to recognize the stigma faced by national staff. We had nurses who were kicked out of their family homes because their relatives were terrified they would bring Ebola home. The trauma faced by international staff was real, but it was nothing compared to that faced by national staff.</p> <p><strong>As Sierra Leone, Liberia, and Guinea rebuild their health systems, what should they prioritize?</strong></p> <p>A health system is made up of people. We need to invest in health workers and improve their working conditions. This should include investing in community health worker models, as they—along with nurses—are the backbone of primary care.</p> <p>We need to recognize that strengthening health systems is a political process as well as a technical one. Accountability and transparency from national ministries as well as NGOs and donors are vital in building mutual trust. Improving these would encourage donors to invest in government health systems, rather than in parallel programs. Then a virtuous cycle would begin, where the capacity of the ministry and the health workforce would grow. The core shift must occur here, and everything else will follow.</p> <blockquote> <p>We have a responsibility to learn these lessons.</p> </blockquote> <h2>Top lessons from West Africa</h2> <p>In their new book, Johnson and coauthor Sinead Walsh, the former Irish Ambassador to Sierra Leone and Liberia, highlight some of the core failings of the response to the West Africa Ebola outbreak. Their book explores these top lessons from West Africa:</p> <ul><li>Community engagement and a people-centered response were crucial.</li> <li>Strong leadership and coordination are essential.</li> <li>Response efforts at all levels must be transparent and accountable.</li> <li>We must work within government health systems, and keep government health workers front and center.</li> </ul><p>As an international community, we have a responsibility to learn these lessons, and urge investment in and support for frontline health workers around the world. We must remember the damaging impact that politics can have on response efforts and encourage all parties to prioritize health and human life over their own agendas.</p> <p>The fragile security setting, and presence of armed groups, remains the biggest threat to containing the current Ebola outbreak in the DRC. </p> </div> </div> </span> <div class="author"> By <div class="author "> <a href="/people/jessica-turner"> <div class="img"> <div class="image" style="padding-bottom: 100%;"> <div class="field field-name-field-thumbnail field-type-image field-label-hidden field--name-field-thumbnail field--type-image field--label-hidden field__items"> <img loading="lazy" src="/sites/default/files/styles/large/public/person-thumbnail-images/img0274.jpg?itok=0uK2v1JL" width="480" height="480" alt="Jessica Turner" title="Jessica Turner" typeof="foaf:Image" /> </div> </div> </div> <div class="by">By <strong>Jessica Turner</strong></div> <span class="title"><div class="field field-name-field-job-title field-type-string field-label-hidden field--name-field-job-title field--type-string field--label-hidden field__items"> <div class="field__item">Former Global Health Corps fellow, IntraHealth International</div> </div></span> </a> </div> </div> <a href="/topics/ebola" hreflang="en">Ebola</a> <a href="/topics/policy-advocacy" hreflang="en">Policy &amp; Advocacy</a> <a href="/topics/global-health-security" hreflang="en">Global health security</a> <a href="/topics/health-conflict" hreflang="en">Health in Conflict</a><a href="/countries/democratic-republic-congo" hreflang="en">Democratic Republic of the Congo</a><a href="/countries/sierra-leone" hreflang="en">Sierra Leone</a><div class=" image-caption"> </div> <div class="field field-name-field-thumbnail field-type-image field-label-above field--name-field-thumbnail field--type-image field--label-above field__items"> <div class="field__label">Vital Thumbnail Image</div> /sites/default/files/article-thumbnail-images/commonthumbnailinfectiousdiseases.png </div> Fri, 16 Nov 2018 23:04:30 +0000 mnathe 4534 at https://www.intrahealth.org Current Events Our Work Q&A Safety for Frontline Health Workers Paramount to Ebola Response and Global Health Security https://www.intrahealth.org/vital/safety-frontline-health-workers-paramount-ebola-response-and-global-health-security <span>Safety for Frontline Health Workers Paramount to Ebola Response and Global Health Security</span> <span><span lang="" about="/users/mnathe" typeof="schema:Person" property="schema:name" datatype="">mnathe</span></span> <span><time datetime="2018-11-09T13:23:56-05:00" title="November 09, 2018 13:23 PM">November 09, 2018</time> </span> <div class="field field-name-field-publish-datetime field-type-datetime field-label-hidden field--name-field-publish-datetime field--type-datetime field--label-hidden field__items"> <div class="field__item"><time datetime="2018-11-09T12:00:00Z">November 09, 2018</time> </div> </div><div class="intro"> <p>The threat in DRC may no longer be containable and could become endemic.</p> </div> <hr> <div class="field field-name-body field-type-text-with-summary field-label-hidden field--name-body field--type-text-with-summary field--label-hidden field__items"> <div class="field__item"><p><a href="https://www.washingtonpost.com/health/2018/11/05/cdc-director-warns-that-congos-ebola-outbreak-may-not-be-containable/?utm_term=.2606ad53e7fb">US Centers for Disease Control and Prevention</a> (CDC) director Robert Redfield came to Capitol Hill in Washington Monday with an ominous warning:</p> <p>The current Ebola outbreak in northeastern Democratic Republic of Congo (DRC) is now so serious that it might not be containable and could become endemic.</p> <p>The <a href="http://apps.who.int/iris/bitstream/handle/10665/275757/SITREP_EVD_DRC_20181106-eng.pdf?ua=1">World Health Organization (WHO) reports</a> this week that there are now 300 cases of the virus and 186 deaths since the outbreak was declared four months ago. Twenty-seven health workers have been infected and three have died.</p> <p>Key to ending the current outbreak in the DRC and any future global health security threat, Redfield said, is foundational training in infectious disease control for frontline health workers in the world’s most remote and fragile communities—which should not be done “<a href="http://www.centerforhealthsecurity.org/about-the-center/pressroom/press_releases/2018-11-06_redfield-ebola-hill-event.html">on the run</a>.”</p> <blockquote> <p>Right now in the DRC, health workers are being attacked.</p> </blockquote> <p>We at <a href="https://www.intrahealth.org/">IntraHealth International</a>, as well as at the <a href="https://www.frontlinehealthworkers.org/">Frontline Health Workers Coalition</a> and the <a href="https://www.safeguardinghealth.org/">Safeguarding Health in Conflict Coalition</a>, have made and heard this plea before, at the same office building no less, during a <a href="https://www.foreign.senate.gov/imo/media/doc/Gaye_Testimony.pdf">2014 Senate hearing</a> at the height of the Ebola epidemic in West Africa. That epidemic <a href="https://www.cdc.gov/vhf/ebola/history/2014-2016-outbreak/index.html">infected more than 28,000 people</a>—including four in the United States—killed more than 11,000 people and cost $4.3 billion to contain. </p> <p>Sinead Walsh, Ireland’s Ambassador to Sierra Leone during the 2014 epidemic, <a href="https://www.independent.ie/life/health-wellbeing/health-workers-were-dying-left-right-and-centre-it-was-one-of-the-most-difficult-things-irelands-ambassador-to-sierra-leone-during-the-ebola-epidemic-37124354.html">described the situation</a> this way to the <em>Independent</em>: “Health workers were dying left, right, and center. They didn't have proper protection. This, for me, was one of the most difficult things. We had all these health workers dying and they were still there.”</p> <p>There is evidence that focusing on the frontline health workforce works. More than 75% of the responders to an <a href="http://apps.who.int/iris/bitstream/handle/10665/273348/SITREP_EVD_DRC_20180725-eng.pdf?ua=1">earlier Ebola outbreak</a>, declared in May in northwestern DRC, came from within the region. These frontline health workers had a strong understanding of the disease, thanks in part to support from US global health programs, and a new trial vaccine helped them feel safer.</p> <p>On July 25, the WHO declared that outbreak contained—in just 16 weeks.</p> <p>Fortunately, the <a href="https://www.youtube.com/watch?v=MxEZT_wFGCc&amp;feature=youtu.be">United States</a> joined leaders from around the world this week to agree on <a href="http://5thghsa2018.org/about">a new framework</a> for the second five-year phase of the <a href="https://www.ghsagenda.org/">Global Health Security Agenda (GHSA)</a>—a growing partnership of 64 countries, international organizations, and nongovernmental stakeholders that aims to boost the prevention, detection, and response to infectious disease threats.</p> <p>The local and global threat posed by the current Ebola outbreak in the DRC brings immediate urgency for the new <a href="http://5thghsa2018.org/uploads/GHSA%202024%20Framework%20-%20Final%20Version%20(November%202018).pdf">GHSA 2024 framework</a> to mitigate infectious disease threats.</p> <p>Unfortunately, right now in northeastern DRC, frontline health workers’ heroic efforts are being made near-impossible by war in the region. Health workers and others <a href="https://www.npr.org/sections/goatsandsoda/2018/10/30/661010437/an-angry-crowd-a-burial-teams-escape-scenes-from-the-ebola-outbreak">are being attacked</a> and armed militias, too many to count, are complicating their efforts to trace those who’ve come into contact with Ebola and care for the sick.</p> <blockquote> <p>Active shooting is common. I cannot access entire villages.</p> </blockquote> <p>Erik Mukama, a doctor working for CARE in Beni, at the center of the outbreak, <a href="https://www.theguardian.com/global-development/2018/nov/06/doctor-fear-of-armed-attack-ebola-patients-congo-drc?CMP=share_btn_tw">told the <em>Guardian</em></a>: “I have been responding to different disease outbreaks in the DRC for 18 years, yet I have never seen anything as challenging as containing Ebola in an armed-conflict zone… Active shooting is common. I cannot access entire villages. Not because of the unequipped terrain and unpaved dirt roads but because these villages act as front lines between the different armed groups.”</p> <p>We commend the actions of the United Nations, the WHO, and leaders around the world to improve the security situation in the DRC, as cease-fires are critical for frontline health workers to quash this outbreak. But <a href="https://www.safeguardinghealth.org/sites/shcc/files/SHCC2018final.pdf">attacks on health workers and facilities are far from confined to the DRC</a> and are occurring in at least 23 countries in conflict around the world. Far greater action for monitoring and accountability of attacks on health workers is paramount for GHSA’s efforts to be successful.</p> <p>Unlocking the massive <a href="http://www.frontlinehealthworkers.org/their-amazing-impact/">humanitarian</a>, <a href="http://apps.who.int/iris/bitstream/10665/250047/1/9789241511308-eng.pdf?ua=1">economic</a>, and <a href="https://www.frontlinehealthworkers.org/wp-content/uploads/2017/04/Global-Health-Security.pdf">safeguarding</a> potential of frontline health workers could be the key to a safer and more prosperous world. To do so, we must listen to the <a href="https://www.frontlinehealthworkers.org/blog/more-story-takeaways-health-heroes-plus-social-good-summit">stories of frontline health workers</a> who put their lives on the line to save their communities.</p> <p>And we must couple their heroic action with policies and investments that ensure they are connected to the <a href="https://usaidlearninglab.org/lab-notes/mhero-story-adapting-mobile-technology-support-health-systems-strengthening-amid-ebola">information</a>, training, and equipment they need; that they are able to safely perform their work and are protected from violence in conflict areas; and that their lifesaving services are available to the most neglected communities.</p> </div> </div> <div class="author"> By <div class="author "> <a href="/people/carol-bales"> <div class="img"> <div class="image" style="padding-bottom: 100%;"> <div class="field field-name-field-thumbnail field-type-image field-label-hidden field--name-field-thumbnail field--type-image field--label-hidden field__items"> <img loading="lazy" src="/sites/default/files/styles/large/public/person-thumbnail-images/carol-profile-2023.jpg?itok=4JI25eon" width="480" height="480" alt="" typeof="foaf:Image" /> </div> </div> </div> <div class="by">By <strong>Carol Bales</strong></div> <span class="title"><div class="field field-name-field-job-title field-type-string field-label-hidden field--name-field-job-title field--type-string field--label-hidden field__items"> <div class="field__item">Strategic communications manager</div> </div></span> </a> </div> , <div class="author "> <a href="/people/vince-blaser"> <div class="img"> <div class="image" style="padding-bottom: 100%;"> <div class="field field-name-field-thumbnail field-type-image field-label-hidden field--name-field-thumbnail field--type-image field--label-hidden field__items"> <img loading="lazy" src="/sites/default/files/styles/large/public/event-participant-images/vinceblaser.jpg?itok=CddJdk8q" width="480" height="480" alt="Vince Blaser" title="Vince Blaser" typeof="foaf:Image" /> </div> </div> </div> <div class="by">By <strong>Vince Blaser</strong></div> <span class="title"><div class="field field-name-field-job-title field-type-string field-label-hidden field--name-field-job-title field--type-string field--label-hidden field__items"> <div class="field__item">Former senior advocacy &amp; policy advisor, IntraHealth International, and director, Frontline Health Workers Coalition</div> </div></span> </a> </div> </div> <a href="/topics/ebola" hreflang="en">Ebola</a> <a href="/topics/policy-advocacy" hreflang="en">Policy &amp; Advocacy</a> <a href="/topics/global-health-security" hreflang="en">Global health security</a> <a href="/topics/safety-and-conflict" hreflang="en">Safety and Conflict</a><a href="/countries/democratic-republic-congo" hreflang="en">Democratic Republic of the Congo</a><div class=" image-caption"> </div> <div class="field field-name-field-vital-top-of-post-caption field-type-string-long field-label-hidden field--name-field-vital-top-of-post-caption field--type-string-long field--label-hidden field__items"> <div class="field__item">&quot;Being a nurse is like being a soldier,&quot; Wislyne S. Yarh Sieh said after working on the front lines of the 2014-2015 Ebola outbreak in Liberia. &quot;You cannot take your uniform off when there is battle.&quot; Photo by Sarah Grile for USAID.</div> </div><div class="field field-name-field-thumbnail field-type-image field-label-above field--name-field-thumbnail field--type-image field--label-above field__items"> <div class="field__label">Vital Thumbnail Image</div> /sites/default/files/article-thumbnail-images/thumbnail_4.jpg </div> Fri, 09 Nov 2018 18:23:56 +0000 mnathe 4523 at https://www.intrahealth.org Opinion Current Events Our Work How the Introduction of a Human Resources Information System Helped the Democratic Republic of Congo to Mobilise Domestic Resources for an Improved Health Workforce https://www.intrahealth.org/resources/how-introduction-human-resources-information-system-helped-democratic-republic-congo <span>How the Introduction of a Human Resources Information System Helped the Democratic Republic of Congo to Mobilise Domestic Resources for an Improved Health Workforce</span> <time datetime="2017-11-11T12:00:00Z">2017</time> <span><span lang="" about="/users/intrahealth" typeof="schema:Person" property="schema:name" datatype="">intrahealth</span></span> <span><time datetime="2017-12-13T15:28:35-05:00" title="December 13, 2017 15:28 PM">December 13, 2017</time> </span> <div class="field field-name-body field-type-text-with-summary field-label-hidden field--name-body field--type-text-with-summary field--label-hidden field__items"> <div class="field__item"><p>This <em>Health Policy and Planning</em> article describes how the Democratic Republic of the Congo used data from iHRIS, a human resource information system developed by IntraHealth International, to conduct a payroll analysis in two large provinces, identify ghost workers, and reinvest the savings in paying health workers like nurses and midwives who had previously been underpaid or uncompensated.</p> </div> </div><div class="field field-name-field-thumbnail field-type-image field-label-hidden field--name-field-thumbnail field--type-image field--label-hidden field__items"> <img loading="lazy" src="/sites/default/files/styles/resource_thumbnail/public/resource-thumbnail-images/articlethumb.png?itok=IyaQCzPl" width="150" height="194" alt="article thumbnail" title="article thumbnail" typeof="foaf:Image" /> </div><div class="field field-name-field-link field-type-link field-label-hidden field--name-field-link field--type-link field--label-hidden field__items"> <div class="field__item"><a href="https://academic.oup.com/heapol/article/32/suppl_3/iii25/4621477">https://academic.oup.com/heapol/article/32/suppl_3/iii25/4621477</a></div> </div><div class="field field-name-field-countries field-type-entity-reference field-label-above field--name-field-countries field--type-entity-reference field--label-above field__items"> <strong class="field__label">Countries</strong> <a href="/countries/democratic-republic-congo" hreflang="en">Democratic Republic of the Congo</a></div><div class="term-list field field-name-field-projects field-type-entity-reference field-label-above field--name-field-projects field--type-entity-reference field--label-above field__items"> <strong class="field__label">Projects</strong> <a href="/projects/acces-aux-soins-de-sante-primaires-access-primary-health-care" hreflang="en">Accès Aux Soins de Santé Primaires (Access to Primary Health Care)</a></div><div class="field field-name-field-topics field-type-entity-reference field-label-above field--name-field-topics field--type-entity-reference field--label-above field__items"> <strong class="field__label">Topics</strong> <a href="/topics/digital-health" hreflang="en">Digital Health</a><a href="/topics/measurement-analytics" hreflang="en">Measurement &amp; Analytics</a><a href="/topics/health-workforce-systems" hreflang="en">Health Workforce &amp; Systems</a></div><div class="field field-name-field-series field-type-string field-label-above field--name-field-series field--type-string field--label-above field__items"> <strong class="field__label">Series</strong> Health Policy and Planning, volume 32, issue suppl 3, 1 </div>By <a href="/people/jean-robert-likofata" hreflang="en">Jean Robert Likofata</a>, <a href="/people/claire-viadro" hreflang="und">Claire Viadro</a>, <a href="/people/leah-mcmanus" hreflang="und">Leah McManus</a>, <a href="/people/jennifer-wesson" hreflang="und">Jennifer Wesson</a>, <a href="/people/nicaise-matoko" hreflang="en">Nicaise Matoko</a>, <a href="/people/epiphane-ngumbu" hreflang="en">Epiphane Ngumbu</a>, <a href="/people/kate-gilroy" hreflang="en">Kate Gilroy</a>, <a href="/people/daren-trudeau" hreflang="und">Daren Trudeau</a> Wed, 13 Dec 2017 20:28:35 +0000 intrahealth 4290 at https://www.intrahealth.org Democratic Republic of the Congo Tackles Ghost Workers, Mobilizes Resources for Real Health Workers https://www.intrahealth.org/news/democratic-republic-congo-tackles-ghost-workers-mobilizes-resources-real-health-workers <span>Democratic Republic of the Congo Tackles Ghost Workers, Mobilizes Resources for Real Health Workers</span> <span><span lang="" about="/users/intrahealth" typeof="schema:Person" property="schema:name" datatype="">intrahealth</span></span> <span><time datetime="2017-12-13T15:06:22-05:00" title="December 13, 2017 15:06 PM">December 13, 2017</time> </span> <img loading="lazy" src="/sites/default/files/styles/max_width_800/public/news-article-images/182495149831b1682fbech.jpg?itok=ULtAxpFu" width="800" height="450" alt="Health worker in DRC" typeof="foaf:Image" /> <time datetime="2017-12-13T12:00:00Z">December 13, 2017</time> <p>Thanks to the power of data, government officials in the Democratic Republic of the Congo (DRC) discovered that 27% of health workers receiving government salaries and 42% of those receiving risk allowances in two large provinces—Kasaï Central and Kasaï—were ghost workers. In response, the Ministry of Public Health rapidly reallocated funds to cover 781 salaries and 2,613 risk allowances for real health workers, such as nurses and midwives who had previously been underpaid or uncompensated.</p> <p>Scarce resources make it challenging for the DRC to pay its public-sector health workers regular salaries. About half receive monthly stipends called “risk allowances” instead. And some subsist on informal means of compensation.</p> <p>Ghost workers—individuals who are on the payroll but don’t show up for work, or may not even exist—are making the situation worse. The <a href="http://www.who.int/hrh/documents/15-295Strategy_Report-04_24_2015.pdf">problem of ghost workers</a> in low-income countries represents a longstanding blight on health workforce budgets, and a drain on limited domestic resources.</p> <p>The DRC is taking action—and improving overall management of its health workforce—by rolling out the <a href="https://www.ihris.org/">iHRIS</a> human resources information system, with help from <a href="https://www.intrahealth.org/">IntraHealth International</a>. Officials can compare iHRIS data on actual health workers—including contact information, photos, and job statuses—with data from the Ministry of Finance’s electronic payroll management system to identify potential ghost workers.</p> <p>The dramatic results of the DRC’s first payroll analysis were published last month in the journal <a href="https://academic.oup.com/heapol/article/32/suppl_3/iii25/4621477"><em>Health Policy and Planning</em></a> and presented at the <a href="http://hrhforum2017.ie/">Fourth Global Forum on Human Resources for Health</a>.</p> <p>Having the iHRIS data and seeing them used to rationalize spending on health workers motivates provincial health officials, who are on the lookout for practical ways to take on greater ownership of human resources management and provincial-level budgetary decisions.</p> <p>The Ministry of Public Health has expanded iHRIS into two additional provinces (of the country’s 26) and the government is committed to a national rollout. While the DRC suffers from a severe shortage of health workers, having accurate data on those that are serving—and further addressing the scourge of ghost workers—will go a long way toward making best use of domestic resources for health.</p> <hr /> <h3>Resources</h3> <div class="resource-list"> <div about="/resources/how-introduction-human-resources-information-system-helped-democratic-republic-congo" class="node node-resource resource node-teaser"> <a href="/resources/how-introduction-human-resources-information-system-helped-democratic-republic-congo"> <div class="img"> <div class="image" style="padding-bottom: 129.41176470588235%;"> <img loading="lazy" src="/sites/default/files/styles/resource_thumbnail/public/resource-thumbnail-images/articlethumb.png?itok=IyaQCzPl" width="150" height="194" alt="article thumbnail" title="article thumbnail" typeof="foaf:Image" /> </div> </div> <h5> <span>How the Introduction of a Human Resources Information System Helped the Democratic Republic of Congo to Mobilise Domestic Resources for an Improved Health Workforce</span> </h5> </a> </div> </div> <span class='field-name-body'> <div class="field field-name-field-panel-text field-type-text-long field-label-hidden field--name-field-panel-text field--type-text-long field--label-hidden field__items"> <div class="field__item"><hr /><p><strong>Read more: </strong></p> <ul><li><a href="https://www.intrahealth.org/vital/ghost-workers-aren%E2%80%99t-spooky%E2%80%94they%E2%80%99re-expensive">Ghost Workers Aren’t Spooky—They’re Expensive</a></li> <li><a href="https://www.intrahealth.org/news/dominican-republics-health-sector-reinvests-savings-from-ghost-workers-to-improve-care">Dominican Republic's Health Sector Reinvests Savings from Ghost Workers to Improve Care</a></li> </ul><p><em>The funding for iHRIS in the DRC is supported by the Department for International Development-funded project, </em><a href="https://www.intrahealth.org/projects/acc%C3%A8s-aux-soins-de-sant%C3%A9-primaires-access-primary-health-care"><em>Access to Primary Health Care</em></a><em>, led by IMA World Health. IntraHealth developed </em><a href="https://www.ihris.org/"><em>iHRIS</em></a><em> with funding from the US Agency for International Development.</em> <em>Establishing national health workforce registries such as iHRIS and ensuring the most effective use of limited resources by eliminating ghost workers and other unnecessary costs are both policy options recommended by the World Health Organization in its first </em><a href="http://apps.who.int/iris/bitstream/10665/250368/1/9789241511131-eng.pdf"><em>Global Strategy on Human Resources for Health: Workforce 2030</em></a><em>.</em></p> </div> </div> </span> <a href="/countries/democratic-republic-congo" hreflang="en">Democratic Republic of the Congo</a><a href="/topics/digital-health" hreflang="en">Digital Health</a><a href="/topics/health-financing" hreflang="en">Health Financing</a><a href="/topics/health-workforce-systems" hreflang="en">Health Workforce &amp; Systems</a>Photo by Morgana Wingard for USAID (CC BY-NC 2.0) <a href="/projects/acces-aux-soins-de-sante-primaires-access-primary-health-care" hreflang="en">Accès Aux Soins de Santé Primaires (Access to Primary Health Care)</a> Wed, 13 Dec 2017 20:06:22 +0000 intrahealth 4286 at https://www.intrahealth.org Ghost Workers Aren’t Spooky—They’re Expensive https://www.intrahealth.org/vital/ghost-workers-arent-spooky-theyre-expensive <span>Ghost Workers Aren’t Spooky—They’re Expensive </span> <span><span lang="" about="/users/mnathe" typeof="schema:Person" property="schema:name" datatype="">mnathe</span></span> <span><time datetime="2017-11-06T14:01:23-05:00" title="November 06, 2017 14:01 PM">November 06, 2017</time> </span> <div class="field field-name-field-publish-datetime field-type-datetime field-label-hidden field--name-field-publish-datetime field--type-datetime field--label-hidden field__items"> <div class="field__item"><time datetime="2017-11-20T12:00:00Z">November 20, 2017</time> </div> </div><div class="intro"> <p>The Democratic Republic of the Congo found $2 million in savings when they used data to uncover absent health workers.</p> </div> <hr> <div class="field field-name-body field-type-text-with-summary field-label-hidden field--name-body field--type-text-with-summary field--label-hidden field__items"> <div class="field__item"><p>When a country uses the <a href="https://www.ihris.org/">iHRIS software</a> to manage their human resources for health, they sometimes get a bonus.</p> <p>iHRIS can provide data connections that offer unexpected benefits for the managers and leaders of a health care system. Sometimes, just comparing data between iHRIS and another system can save money—a lot of money.</p> <p>But it takes some detective work.</p> <p>Oh, not the kind that involves trench coats and fedoras. The kind that takes patience and persistence. Like what the Ministry of Public Health just did in the Democratic Republic of the Congo (DRC) last year.</p> <blockquote> <p>In the DRC, over half of health workers do not receive regular government pay of any kind.</p> </blockquote> <p>The country implemented <a href="https://www.ihris.org/ihris-suite/health-workforce-software/ihris-manage/">iHRIS Manage</a>—with technical assistance from <a href="http://www.intrahealth.org">IntraHealth International</a>, which developed the iHRIS software—in four of the country’s 26 provinces. But in two provinces, Kasaï Central and Kasaï, they did something extra. These provinces sit on the southern border with Angola and make up 10% of the DRC’s population of 80 million.</p> <p>The Ministry of Public Health conducted a census of its health workers followed by an in-depth payroll analysis. To begin, they deployed six trained four-person teams of ministry and IntraHealth personnel that used a two-stage process to interview health workers in each health zone.</p> <p>The first pass required each health worker to bring their credentials for identification, education, and employment. Those entries were immediately entered into the national iHRIS data system. In a second stage, the teams returned to each zone and repeated the process for those who missed the first session or needed to bring any document they had not provided earlier. An appeals panel heard the cases of  health workers denied entry into the system due to paperwork issues or other irregularities.</p> <p>The Ministry of Public Health then took this new data a step further. Through a complex set of steps, the teams were able to enter data and verify information of over 11,000 workers out of a total of 14,000 personnel records spread across iHRIS and the payroll system.  </p> <p>Why the difference? In part, ghosts!</p> <p>During the data collection, the Ministry of Public Health noticed a problem and mobilized a special interministerial committee to match each entry with the government payroll records system. Led by the Ministry of Public Health, the effort required representatives from the Ministry of Finance and the Ministry of Public Service, along with technical support from IntraHealth, to combine and analyze the records. They used computer queries to compare iHRIS entries with payroll entries, matching names and other identifying data, sometimes even resorting to matching them manually.</p> <blockquote> <p>Over 25% of salaried health workers in the payroll system were ghost workers.</p> </blockquote> <p>But let’s halt our detective story for an important note. In the DRC, over half of health workers do not receive regular government pay of any kind, neither salaries nor risk allowances. Many people receive facility-generated user fees or other locally generated revenues. Part of the reason that these revenue sources exist is the lack of funding at the national level to support health workers’ salaries. Keep that in mind. Back to our story.</p> <p>The analysis revealed that over 25% of salaried health workers in the payroll system were “ghost workers” who drew a salary but did not actually work, as were 42% of workers being compensated through risk allowances—781 of the former and 2,613 of the latter.</p> <p>As a result, the Ministry of Public Health reallocated nearly US$2 million away from these ghost workers to cover the salaries and risk allowances for real health workers who had not previously received any civil service compensation. That was enough funding to cover every previously unsalaried worker in these two provinces.  </p> <p>The Ministry of Health recognized a problem and when armed with the data to fix it, took action that will have lasting and positive effects on the health system of the DRC.</p> <p>While not very glamorous, this detective work helped strengthen the DRC health system by redirecting funds to the people who support its work, the health workers. And as a result, more DRC citizens will have access to the health care they need.</p> <p>That’s the power of iHRIS, and the power of data.</p> <p><strong>Join us at the </strong><strong><a href="http://www.globaldigitalhealthforum.org/washington/2017">Global Digital Health Forum</a></strong><strong> next month to learn more about iHRIS and IntraHealth’s digital health work around the world. </strong>More details on this work are also available in the latest issue of <a href="https://academic.oup.com/heapol/article/32/suppl_3/iii25/4621477?guestAccessKey=ab53846e-9981-41db-a3fe-38eb2c869a18">Health Policy and Planning</a> and were presented last week at the <a href="https://www.intrahealth.org/events/fourth-global-forum-human-resources-health">Fourth Annual Global Forum on Human Resources for Health</a>.</p> <p><em>This post refers to the great work of my colleagues, Dr. Jean-Robert Likofata, IntraHealth’s senior human resources for health advisor and Pierre Kasongo, IntraHealth’s iHRIS manager in the Democratic Republic of the Congo. This work would not have been possible without the motivation and leadership of the Ministry of Public Health, Ministry of Finance, and Ministry of Public Service who  joined forces to resolve this problem of ghost workers in the DRC. The funding for iHRIS in the DRC is supported by the DFID-funded project, </em><a href="https://www.intrahealth.org/projects/acc%C3%A8s-aux-soins-de-sant%C3%A9-primaires-access-primary-health-care"><em>Access to Primary Health Care</em></a><em>, led by IMA World Health. IntraHealth developed </em><a href="https://www.ihris.org/"><em>iHRIS</em></a><em> with funding from the US Agency for International Development.</em></p> </div> </div> <div class="author"> By <div class="author "> <a href="/people/david-potenziani"> <div class="img"> <div class="image" style="padding-bottom: 100%;"> <div class="field field-name-field-thumbnail field-type-image field-label-hidden field--name-field-thumbnail field--type-image field--label-hidden field__items"> <img loading="lazy" src="/sites/default/files/styles/large/public/person-thumbnail-images/dave2cropped.jpg?itok=pAlc24BZ" width="480" height="480" alt="Dave Potenziani" title="Dave Potenziani" typeof="foaf:Image" /> </div> </div> </div> <div class="by">By <strong>David Potenziani</strong></div> <span class="title"><div class="field field-name-field-job-title field-type-string field-label-hidden field--name-field-job-title field--type-string field--label-hidden field__items"> <div class="field__item">Former senior informatics advisor, IntraHealth International</div> </div></span> </a> </div> </div> <a href="/topics/hris" hreflang="en">HRIS</a> <a href="/topics/leadership-and-governance" hreflang="en">Leadership and Governance</a> <a href="/topics/global-digital-health-forum" hreflang="en">Global Digital Health Forum</a> <a href="/topics/health-financing" hreflang="en">Health Financing</a> <a href="/topics/health-workforce-systems" hreflang="en">Health Workforce &amp; Systems</a><a href="/countries/democratic-republic-congo" hreflang="en">Democratic Republic of the Congo</a><div class=" image-caption"> </div> <div class="field field-name-field-thumbnail field-type-image field-label-above field--name-field-thumbnail field--type-image field--label-above field__items"> <div class="field__label">Vital Thumbnail Image</div> /sites/default/files/news-article-thumbnail-images/savings-thumb.png </div> Mon, 06 Nov 2017 19:01:23 +0000 mnathe 4182 at https://www.intrahealth.org Current Events Our Work Strengthening Health Workforce Information in the Democratic Republic of the Congo: Implementing iHRIS in Kasai and Kasai Central Provinces https://www.intrahealth.org/resources/strengthening-health-workforce-information-democratic-republic-congo-implementing-ihris <span>Strengthening Health Workforce Information in the Democratic Republic of the Congo: Implementing iHRIS in Kasai and Kasai Central Provinces</span> <time datetime="2016-01-01T12:00:00Z">2016</time> <span><span lang="" typeof="schema:Person" property="schema:name" datatype="">Anonymous (not verified)</span></span> <span><time datetime="2016-10-06T15:02:47-04:00" title="October 06, 2016 15:02 PM">October 06, 2016</time> </span> <div class="field field-name-body field-type-text-with-summary field-label-hidden field--name-body field--type-text-with-summary field--label-hidden field__items"> <div class="field__item"><div> <p>This brief provides an overview of IntraHealth's work helping the Democratic Republic of the Congo's Ministry of Health imlement iHRIS--IntraHealth's free, open source human resource information system software--and strengthen its health workforce data collection and use.</p> <p> </p> </div> </div> </div> <a href="/sites/default/files/attachment-files/DRC_iHRIS_brief.pdf" class="resource-button">Download</a> <select class="fancy"> <option value="">Download in Another Language</option> <option value="/sites/default/files/attachment-files/DRC_iHRIS_brief_French.pdf">French</option> </select> <div class="field field-name-field-thumbnail field-type-image field-label-hidden field--name-field-thumbnail field--type-image field--label-hidden field__items"> <img loading="lazy" src="/sites/default/files/styles/resource_thumbnail/public/resource-thumbnail-images/screenshot2016-10-26at110910pm.png?itok=QB3MuaJW" width="150" height="194" alt="" typeof="foaf:Image" /> </div><div class="field field-name-field-countries field-type-entity-reference field-label-above field--name-field-countries field--type-entity-reference field--label-above field__items"> <strong class="field__label">Countries</strong> <a href="/countries/democratic-republic-congo" hreflang="en">Democratic Republic of the Congo</a></div><div class="field field-name-field-topics field-type-entity-reference field-label-above field--name-field-topics field--type-entity-reference field--label-above field__items"> <strong class="field__label">Topics</strong> <a href="/topics/technology" hreflang="en">Technology</a><a href="/topics/elearning" hreflang="en">eLearning</a><a href="/topics/health-workforce-systems" hreflang="en">Health Workforce &amp; Systems</a></div><div class="field field-name-field-publisher field-type-string field-label-above field--name-field-publisher field--type-string field--label-above field__items"> <strong class="field__label">Publisher</strong> IntraHealth International</div> Thu, 06 Oct 2016 19:02:47 +0000 Anonymous 2983 at https://www.intrahealth.org