Challenges on RHIS

As we are closing the second semester for S.Y. 2016-2017, students of MI239 (Primary Health Care), we were given a task to contribute in identifying one challenge in Routine Health Information System (RHIS) in the country and how will we be able to change it to make the existing RHIS stronger, more effective, and sustainable.

Guided by the Theory of Change, I focused on BEHAVIORAL DETERMINANTS.

In the Philippines, only few of the facilities or RHUs are using computerized systems in collection of medical data of the community and rely on the collection using pen and paper records. One may say that this contribute to non-standard, inconsistent, and inaccurate collection since the collector may include in the record any data according to his/her preference. Over time, one may exclude details that are not needed at the moment but may be needed in the future. Furthermore, there is always a lack of manpower in the facilities and the high attrition rate that affects the operations and fulfillment of the tasks at hand.

While in reality, people movement across organizations and facilities are inevitable, the management and governance of the facility can improve the process and develop contingency plans when the need arises. The people spearheading such development should be able to focus on the following as well:

1. Establishment of a training group that can provide the quality data collection and skills development teaching in the facility-level. Not only that it will only focus on the training on the data collection skills but as well personal development of the workers. It would help as well if the teaching techniques be designed in layman terms that are easily understood by the workers (such as BHWs) since not all of them have the educational attainment and skills needed. However, that doesn’t mean that they will not be involved in the data collection, even they have a role to participate. We must be mindful that these people may be resistant, or feel discouraged or useless if such lack of skills be emphasized to them. What is needed is to help them understand the purpose and importance of their role in the tasks at hand, and that skills according to their abilities can be developed and taught. In case there would be people leaving, there is always someone capable in teaching how the system works.
2. Reward System and incentives to the workers is not necessarily need to be in monetary value but can be in other form of recognition of hard work, compliance to standard, involvement, meeting established KPIs may motivate the workers. This is to at least lower the chance of having the workers leave in pursuit of greener pastures.
3. Emphasis on Data Demand and Need and developing Information Culture. Some people do not find routinary things interesting. It should be emphasized to the workers the benefits of the data they collect and analyze.
4. Involvement of the collectors and users of data in the planning. It should be noted that everyone involved has an important role to play. With identified skills and learning they have, they would feel valuable in contributing their ideas and thoughts in the planning, implementing, improving, and maintaining the RHIS.
5. Standard indicators and data collection system establishment by using tools such as MEASURE or PRISM may work but what is needed is agreement among them is essential.
6. Development of ICT-based solutions may be a long shot but it should be part of the planning and improvement.
7. Resources (Manpower, Finance, Infrastructure and commodities) should be well provided.

If you would notice, I am more into empowering the workers in the facility-level. I believe that supporting and acknowledging them is crucial in maintaining the RHIS because frontliners are drivers for change and implementation of RHIS.