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Learning from Each Other: Study Tour in Namibia Informs Tanzania’s Approach to Health Worker Data

Seeing success is believing in success. That sums up the response of the delegation of staff and partners IntraHealth Tanzania sent earlier this year on a study tour to learn from colleagues in Namibia about their experiences implementing a large-scale human resources information system (HRIS). What an opportune moment it was to borrow experience from Namibia, where IntraHealth is also implementing an HRIS—and one that has made decisive progress!

In both Tanzania and Namibia, long distances between towns pose challenges on financial resources and time. Like many other countries, Tanzania and Namibia historically used manual filing systems to track health worker data and therefore faced difficulties understanding and aligning their health workforces with actual needs. Because data were difficult to access, aggregate, and analyze, plans did not reflect realities.

The country contexts, however, are contrasting. In terms of population and country size, Namibia is smaller than Tanzania. The HRIS in Tanzania is implemented within a decentralized government system; in Namibia, the HRIS is implemented centrally at the Ministry of Health and Social Services (MoHSS) with 13 regional offices accessing the central HRIS.

Representatives from both countries noted the differences between the two systems.

“The government structures are very different between Namibia and Tanzania, and we are working with a smaller subset of data and only [workers in the health sector], whereas the Tanzanian project includes all public sector workers at [the] local government level," noted Rosaline Hendricks, HRIS advisor in Namibia.

Hellen Macha, assistant human resource director in Tanzania Prime Minister’s Office – Regional and Local Government (PMO-RALG) and a member of the delegation, said, “Our counterparts in Namibia have more parameters in their system. Particularly, I noted they record special skills personnel have."

The software is also different. The Tanzania HRIS is built on a customized version of IntraHealth’s open source iHRIS Manage software. The system in Namibia is built on the Human Resources Information Management System (HRIMS), developed by the Namibian Office of the Prime Minister, which is compulsory for all ministries to use.

Ultimately, it was Namibia's success regarding accuracy of data, timely updating, and willingness among decision-makers to refer to information in the HRIS for making staffing decisions that attracted the technical team from Tanzania to observe and inform their ongoing implementation of Tanzania’s Local Government Human Resource Information System (LGHRIS).

Specifically, the delegation sought to learn more about:

  1. The underlying supporting structure of Namibia’s HRIMS and the role of agencies responsible for HRIMS implementation
  2. System manuals (user operational and system administration)
  3. Data analysis, report generation, and the type of decisions made using HRIS data. 
  4. Infrastructure setup, connectivity, and information and communications technology (ICT) technical issues and support
  5. Data management processes including data collection, updating, and quality assurance

To expose their visitors to these issues, IntraHealth’s staff in Namibia guided the visitors through the MoHSS and two hospitals where the HRIMSS has been deployed. In addition to benefiting from the lessons shared below, the Tanzania delegation also saw what the hard work of implementing an HRIS can lead to. When summarizing her experience from the study tour, Macha noted, “I have learned that HRIS works.”

Major lessons the Tanzania delegation learned from Namibia include:

A viable national ICT policy provides coordination of ICT services across different ministries. Taking advantage of this policy, HRIS implementers coordinated deployment across multiple ministries using a standardized government data network. The ICT policy environment also supports a centralized approach; therefore it is possible to link up the 13 regions and the MoHSS to the main server at the Office of the Prime Minister.

A phased regional rollout is helpful. Before installing the HRIS in any region, implementers in Namibia finished all data collection. This approach allows quality assurance of the deployment process, and coverage becomes more manageable.

Attention to data quality must be rigorous. The human resources data entered in the system were compared against personnel files and payroll data. Temporarily employed dedicated staff at the MoHSS entered initial data, preventing an additional duty for busy human resources practitioners at the regional level, and an HRIS project manager and a human resources team leader supervised the data entry clerks. A rigorous process of collecting, reviewing, and keying in data aimed at a one-to-one match between data in the HRIS and data in physical files, as well as the elimination of ghost workers through comparing the data to the payroll. About 90% of this goal has been achieved in Namibia.

Defined roles are useful for accountability in updating staff data. A human resources officer is assigned individual files in alphabetical order. For example, a human resources officer is assigned files with surnames from A-D. This increases accountability and integrity of staff in keeping the data up-to-date. To distinguish roles and responsibilities of human resources professionals in the chain of command, user levels and permissions have been set within the HRIS—from the assistant human resources officer to the chief human resources officer in the MoHSS. Each level has accountability for data accuracy and completeness. The most junior human resources officers' rights in the system enable them to enter data for their seniors to review and approve.

Ongoing information technology support must be available. Namibia shared that it was essential to have a team of in-house information technology support officers in each of the offices where the HRIS is used. These officers can provide technical support during the deployment and afterwards. Namibia is currently struggling with having a shortage of information technology support in the regions, which can affect the availability of the HRIS.