iHRIS Health Workforce Information System Helps India Improve Health Service Delivery

India, like many countries, is embracing the goal of universal health coverage—that all people can affordably access the health services they need. Health workers are vital to these efforts, of course, since health services don’t deliver themselves. Using data for decision-making, too, is critical.

Health worker and client in IndiaIndia needs accurate data on its health workforce in order to improve the population’s access to care and move closer to universal health coverage. What skills and qualifications do the current health workers have? Where are they posted? Are they deployed to the areas of greatest need—and if so, are they being retained? And to recruit more health workers and deploy them strategically, India needs data on where vacancies exist and which cadres are in greatest demand. This information is vital for public health decision-making and planning.

While several states in India maintain health worker data in paper-based systems, some states have initiated efforts to computerize their data. A functional web-based human resources information system (HRIS) can provide a full picture of a country’s health workforce. The Government of India prioritized the development of web-based HRIS in its five-year strategic plan (2012–2017).

Jharkhand State is partnering with the USAID-funded CapacityPlus project, led by IntraHealth International, to strengthen and support statewide scale-up of its HRIS. Working closely with the Department of Health and Family Welfare and the State Health Mission, CapacityPlus helped the State to develop data entry protocols and build staff capacity for data entry, data verification, data use, and iHRIS software customization to meet the State’s needs.

Powerful set of tools

“Together with IntraHealth, our team has developed a very good system, and we should use it for rational deployment as well as for other HR-related decisions. Everything is available at one place.”

    —Jharkhand Principal Secretary of Health

iHRIS is the world’s leading open source software for health workforce information systems. Nineteen countries are using it to manage over one million staff records. iHRIS is used by governments, employers, professional associations, and universities to maintain and analyze accurate, up-to-date information on their employees, members, or students. IntraHealth, through the USAID-funded Capacity Project, launched the first version of iHRIS in 2007. CapacityPlus continues to enhance the software and partner with countries to roll out iHRIS and provide training.

With iHRIS, countries have access to accurate data to address health workforce shortages and solve other challenges across the health sector. Using iHRIS helps countries place health workers where they are most needed. And because iHRIS is free and open source, it is an affordable and customizable option for countries to meet their specific needs. iHRIS has saved countries $177 million in licensing fees they would have incurred if they had used proprietary software instead.

A comprehensive picture

Today Jharkhand’s customized iHRIS provides a comprehensive picture of the State’s public health workforce, including each worker’s current posting, employment and training history, specialization, and projected retirement date.

“Together with IntraHealth, our team has developed a very good system, and we should use it for rational deployment as well as for other HR-related decisions,” said Jharkhand’s principal secretary of health. “Everything is available at one place.”

Strategic redeployment

Health-sector leaders in Jharkhand are enthusiastic about iHRIS because it has improved their ability to recruit and effectively deploy health workers, especially doctors.

As one example, obstetricians and anesthesiologists are in great demand at community health centers. Jharkhand’s principal secretary of health reviewed iHRIS reports showing the placement of these specialists and, based on these data, redeployed an estimated 112 medical officers (physicians) to ensure more equitable availability of health workers with skills in emergency obstetric care and life-saving anesthetic skills. These medical officers were placed in community health centers that were designated as first referral units.

Impact of iHRIS in Jharkhand State:   A Few Examples

  • 112 medical officers redeployed to community health centers designated as first referral units
  • 36 first referral units are now fully functioning, up from 18
  • 450 new medical officers recruited (34% increase) and posted in high-vacancy districts
  • 900,000 additional people can now access health services

To date there are 36 out of 52 fully-functioning first referral units in Jharkhand, up from approximately 18 in 2011. These facilities are critical for saving the lives of mothers and newborns.

Recruiting more medical officers

In another example, the Department of Health and Family Welfare in Jharkhand recruited nearly 450 new medical officers between 2012 and 2013 (a 34% increase), addressing a need revealed in iHRIS reports, and posted them in high-vacancy districts. With medical officers covering an annual patient panel of 2,000 patients, this will provide 900,000 additional Jharkhand residents with health services. Now iHRIS is routinely used to assess the distribution and skills of health workers in district hospitals and community health centers. Many medical officers and other health workers who were posted in the same districts for years have been transferred to other areas where the need is greater.

Commitment to improving the well-being of all

Jharkhand’s experience illustrates the important role that HR information systems play in moving toward India’s goal of universal health coverage. According to the WHO, information systems are a crucial part of building the strong health system necessary for reaching universal health coverage.

CapacityPlus is proud to support the Government in India in this laudable goal. “Making basic health services available to all is a tall order,” said IntraHealth CEO Pape Gaye, “but it’s the right thing to do.”

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Photo by Trevor Snapp, courtesy of IntraHealth International (a nurse speaks with a client at the district hospital in Hazaribagh, Jharkhand State)