HMIS reform (3)
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Hi Bruce
No, you haven't misread the AFRO-NETS target audience. It may be that you
have overwhelmed us with your very topical questions! I for one am strugg-
ling with many of these questions (as I have said before I am heading
Health Information Services in Mpumalanga Province in South Africa, and am
also working with Arthur Heywood in training our 21 District Information
Officers, while we are also attempting to restructure the current health
information system at district level).
This district level exercise is such a slow process with hiccups along the
way. At this stage I am encouraging (instead of trying to force anything)
sub-regional initiatives (a number of districts grouping together), e.g.
piloting a new clinic register, or discussing what should be contained in a
clinic-based patient record, etc., while at the same time hoping that the
district information officers will start reporting on the minimum list of
indicators we workshopped with Arthur.
However, I also am under pressure from the national Department of Health to
go out on tender for (a very sophisticated) hospital information system for
all our hospitals.
In the light of these two tracks I have to follow, how does one arrive at
an integrated Health Information System?
To respond more directly to what you have said: What does the term HMIS
encompass? Would this sophisticated (also hugely costly), and really com-
prehensive hospital information system I have to implement fit in with the
definition?
What about Bill's approach in Haiti? There the hospital information system
appears to be truly part of the rest of the system, and not so sophisti-
cated, but still delivers what is important! Why can't I pursue such an
approach? One response that I had to this question (from somebody outside
of the public sector), is that South Africa wouldn't like to learn from
Haiti, or other African countries for that matter!
It appears to me that in our surroundings (e.g. poor public hospital
management practices, no culture of information utilisation for decision
making, etc.) we should rather develop our information systems
incrementally, and iteratively.
I would love to have comments.
Arie
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Dr Arie Verburgh
Department of Health
Private Bag X11285
1200 Nelspruit
Mpumalanga
South Africa
Tel: +27-13-7552291
Fax: +27-13-7553546
Cell: 083-229-1107
mailto:ariev@social.mpu.gov.za
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