Good Leadership for Successful Health Information Systems in Ethiopia
Leadership is critical to creating an enabling environment for health information system (HIS) strengthening. At the woreda level in Ethiopia, this leadership involves developing and implementing a costed plan; promoting the development of HIS and use of data; facilitating collaboration and partnership between different HIS stakeholders; and ensuring compliance with HIS legislation, policies, standards, and guidelines.
The Jarso Woreda Health Office leadership recognized the value of a strong HIS to improve the performance of other components of the health system, including service delivery. Recently, the woreda health office, in collaboration with USAID’s Digital Health Activity (DHA), conducted mentorship in its five health centers and selected health posts (HPs) with the aim of building the capacity of staff on data quality verification, analysis, and use. Thereafter, the joint woreda and DHA mentorship team provided written feedback and a tailored action plan for each facility based on the gaps identified through the mentorship process. The woreda leadership demonstrated its commitment for improvement by immediately starting implementation of the recommendations and the action plan, conducting cluster review meetings with catchment HEWs and staff at all five health centers to discuss findings of the mentorship exercise and the planned interventions to strengthen HIS.
The leadership has been focusing attention on the use of standardized HIS tools and providing services per national guidelines and protocols. The woreda encourages health facilities whenever there is an opportunity to record and report by using standard recording and reporting manuals. The woreda is also taking advantage of national initiatives that are being cascaded to the woreda through the Information Revolution (IR) agenda. Jarso is one of the early adopters of an electronic community health information system (eCHIS), which is being implemented in all kebeles in the woreda to support health extension workers (HEWs) during routine recording of activities like household registration. eCHIS helped not only to standardize service delivery, recording, and reporting, it also enabled the woreda to capture baseline population data for planning.
Although eCHIS implementation in Jarso Woreda has faced multiple challenges, including connectivity, the woreda has taken various measures including allocating resources for eCHIS implementation strengthening and providing airtime from their personal finances for HEWs in areas where connectivity is a major challenge.
Besides eCHIS implementation, the woreda conducts other HIS strengthening activities to monitor program activity progress. The woreda conducts quarterly routine data quality assessments with a proper feedback loop with health facilities. Ato Ibsa Jemal, Jarso Woreda Health Office Head, said, “Listening to the feedback of stakeholders and implementing it is crucial.”
Over the past year, the health managers in Jarso showed that ownership and leadership are crucial to sustainably strengthen HIS and optimize its contribution to other components of the systems. The 1st Round Assessment of the woreda in the information revolution (IR) pathway revealed the status of the woreda health office as ‘emerging’. The 4th round assessment ranked them as a ‘model’ woreda health office. DHA will continue supporting the health centers until they become a model in the IR.