My study is part of the Health Information Systems Programme (HISP), an international effort to bring sustainable health information systems to third world countries. Two support structures for improving how health facility staff collect, use, analyze and report health data were studied. These were “Supervision” and “The Recognition Scheme”. In addition, I suggested a third, “Pair Reporting”.
My findings are based on two months of field work conducted in Malawi from August to October 2006. To approach the problem, interviews and observations were done in the two districts Chikwawa and Chiradzulu. In addition I have conducted literature reviews on relevant theory to expand my understanding of what I have observed and in turn, support my findings.
The challenges with health facility staff’s performance in working with the HMIS in Malawi is related to shortage of staff and limited resources for training. My findings conclude that intensified use of support structures can result in radical improvement in data collection and reporting performance, although with some changes in how the support structures are arranged.
Supervision is highly appreciated among staff at health facilities in Chikwawa and Chiradzulu. It is perceived as a support channel rather as surveillance of performance. My findings conclude that is increases productivity, motivation and encourages facility staff to improve performance.
The Recognition Scheme has the objective of rewarding staff at health facilities that perform well and to train those who struggles with HMIS reporting. My study shows that recognition is an effective way of motivation health workers in Malawi, and the Task Force meeting has a strong educational value and works as a structured situation of where health workers can build their self-efficacy which in turn produces personal accomplishment. The task force meeting also enables pooled knowledge and collaborative learning which results in wide sharing of knowledge.
Pair Reporting uses principles from Pair Programming in the activity of compiling HMIS15 quarterly reports. My results show that when facility staff practice Pair Programming, they produce reports with less mistakes, they have a higher confidence in their result, they are able to gain knowledge from each other which makes them able to solve difficult issues, and they have higher enjoyment in the task of compiling reports. The staff-loss risk is also reduced as multiple people are familiar with the reports.