公共行政与管理评论

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Health Management Information System (HMIS); Whose Data is it Anyway? Contextual Challenges

Richard Muhindo, Edith Nakku Joloba and Damalie Nakanjako

In 1997 the Ministry of Health instituted the national HMIS in response to global and national call for greater accountability and results-based management. The goal being to provide timely reliable health information that would inform decision making in the sector to aid provision of better health care services to the people of Uganda. However, there are already concerns about the functionality of the system characterized by late and inadequate reporting. The purpose of this paper was to make a critical analysis of the contextual challenges to HMIS and propose a framework that would improve the collection of timely reliable data at all levels in the system. After critical analysis of the existing literature, reports and presentation at various MOH workshops and review meeting, and interactive informal talks with some personnel at the Ministry, this paper asserts that failure to use HMIS data, poor culture of accountability, lack of incentives for performance, strategic planning and vertical programs-HIV/AIDS are the strategic contextual challenges to this menace. Data utilization at all levels in the system will be the linchpin in realization of timely collection and reporting of data and to this end, a user-friendly system is at the core of any successful public health system when it will; Assist hospital managers to align health system resources with the needs of service users Link performance measurements to accountability Monitor health-related activities to help assess what works and what doesn’t Contribute to organizational development This paper proposes a framework that will see data utilization as the foundation for timely collection and reporting at all levels in the system. There will be organizational learning with the associated organizational development breeding ownership and sustained demand for data collection and reporting. Key in the implementation will be; leadership, change management, organizational embedding and capacity development.