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Mali Uses iHRIS Health Workforce Data to Improve Access to Care

Mali is partnering with the IntraHealth International-led CapacityPlus project to increase access to care for people most in need by implementing iHRIS.

IntraHealth developed iHRIS (pronounced “iris”) with support from the US Agency for International Development. The data management software helps countries track and manage their health workforce data, arming decision-makers with the information they need to better manage, deploy, and budget for their health workers.

Like many countries, Mali doesn’t have enough health workers. Eighty-three of the world’s countries (47%) fall short of the World Health Organization’s minimum threshold of 23 health workers per 10,000 people. And also like most countries, most of Mali’s health professionals choose to live and work in urban areas like Bamako. 

An equitable distribution of skilled health workers is vital to meeting the country’s demand for family planningending preventable child and maternal deaths, and achieving an AIDS-free generation. But Mali’s health leaders need reliable data to inform evidence-based recruitment, deployment, and retention of health workers in the areas with the greatest need.

CapacityPlus worked with the Directorate of Human Resources for Health at the Ministry of Health and Public Hygiene to implement a customized version of iHRIS Manage, the iHRIS product that focuses on managing health worker employment information.

The directorate piloted the software in Sikasso District of Sikasso Region, collecting and entering data on health workers posted in public, private, and community-run health facilities. Reports and data visualizations showed that the district hospital and other urban sites had disproportionately more midwives than did health centers in rural areas (where 63% of the population lives), and that no primary health center met national staffing norms.

Taking quick action, the region implemented a rotation system where midwives work one week each month in a rural health center to mentor lower-level auxiliary midwives and provide access to long-acting contraceptive methods. Sikasso Region went on to recruit and post 26 additional midwives and obstetric nurses in rural sites.

After the pilot, the directorate began expanding iHRIS to cover the rest of the districts of Sikasso Region and the other eight regions of the country, including Bamako. The national-level rollout of iHRIS is almost complete, with 14,114 health worker records entered into the system.

Decentralization of iHRIS to the regional level is enabling local leaders and managers to make evidence-based decisions on recruitment, deployment, and retention—to ensure that disadvantaged populations have access to high-quality health care.

Leaders and managers at the national level are already using iHRIS data to improve management and deployment decisions, track international commitments, and advocate for more health workers. Here are just a few examples:

Management and deployment 

  • After many health workers fled from the north during the 2012–13 coup, the directorate identified those who had been posted in Gao Region and their telephone numbers, enabling the government to offer them grants to return. This action provided much-needed care for the conflict-affected populations.
  • For the opening of a large health center in Bamako’s Kablaban Coura neighborhood, the directorate used iHRIS to select 26 qualified and experienced providers who could be transferred to supervise the new staff.
  • This month the directorate is using iHRIS data to guide the deployment of 185 newly recruited, public-sector health workers (40 doctors, 60 midwives, and 85 high-level nurses, or techniciens superior de santé, to the regions.

International commitment tracking 

  • The directorate submits the total numbers of health workers in the three northern regions of Mali (Tombouctou, Kidal, and Gao) to the Ministry of Public Health every quarter using iHRIS data and on-the-ground information in order to track Mali’s progress in honoring commitments made at the high-level Donor Conference for Development in Mali in Brussels in 2013.

Advocacy 

  • In 2014, the directorate presented iHRIS data to the prime minister’s special advisor for health, who then reported the findings to the prime minister. The prime minister recommended an increase in recruitment for 2015.

 Mali’s implementation of iHRIS Manage is also providing leaders and decision-makers with timely and accurate information about the distribution of health workers and projected needs for more workers due to transfers and retirements. By strengthening the health system, iHRIS is helping improve health outcomes and move Mali toward the country’s vision of high-quality health care for all.

Twenty countries are now using iHRIS to manage over one million health worker records. iHRIS has saved countries $177 million in licensing fees they would have incurred if they had used proprietary software instead.

The IntraHealth-led CapacityPlus project is funded by the US Agency for International Development.

This post originally appeared on the CapacityPlus website.