In Kenya, the health workforce data provided through the integrated human resources information system (iHRIS) is turning fortunes around.

When Kenya decentralized its health system management from one national hub to 47 individual county governments in 2013, young county departments of health found themselves struggling. They needed to identify, track, and monitor their workforces while facing looming staff shortages, labor disputes, and high recurrent expenditures in the form of salaries and allowances.

Kilifi County was no exception.

In 2013, the county relied on Excel data sheets to summarize its human resources for health (HRH) information. These data were static, unreliable, and only accessible to a few individuals, causing human resources officials to fall back on information stored haphazardly in personnel files or staff returns submitted monthly from health facilities that were not always accurate.

It wasn't until April 2017 that the county began to fully appreciate the value of iHRIS.

This constrained the county’s planning, budgeting, and forecasting for its health workforce.

Four years later, things are different in Kilifi, thanks to iHRIS, open source software built by IntraHealth International to manage health workforce data.

Kilifi County adopted the system as a result of over three years of collaboration with IntraHealth, led by our USAID-funded Human Resources for Health Capacity Bridge project and Human Resources for Health Kenya Mechanism. We’ve worked together to provide training and technical assistance, and to form a technical working group that implements the system. We’ve also helped Kilifi County to participate in quarterly intercounty coordination forums, where they can continuously benchmark themselves against other counties.

This peer-to-peer learning and collaboration has encouraged the county to sustain regular updates, troubleshoot problems, and build the team’s ability to mentor other counties, such as TaitaTaveta.

But it was not until April 2017 that the county began to fully appreciate the value of iHRIS.

Millions in annual savings

While grappling with a bloated wage bill, Dr. Timothy Malingi, Kilifi County chief officer of health, saw discrepancies in the data stored in iHRIS and those in the payroll system, the Integrated Payroll & Personnel Database (IPPD).

So the county facilitated a four-day workshop with the iHRIS technical working group. Together with the county human resources director and payroll manager, the group inspected, sorted, cleaned, and updated 1,460 staff records in both iHRIS and the IPPD.

The county is now saving $150,765 per year.

They found that while payroll data had 1,460 workers listed, iHRIS data mined from staff returns had only 1,429—a difference of 31 health workers. On further inspection, they used iHRIS data to identify 25 staff members that should be expunged from the payroll, as they no longer merited drawing salaries from the health department.

As a result, the county is now saving KES 1,256,383 per month, or US$150,765 per year—significantly reducing the department’s annual spending on recurrent expenditure.

In October 2017, the county became the first in its cluster to generate and disseminate a second version of its HRH information dashboard. This dashboard compares HRH data with HIV service delivery data, providing a clearer picture of the impact of the health workforce on service delivery, and it is available publicly to stakeholders.

And due to the accuracy and completeness of the records in both iHRIS and the IPPD, Kenya is now using these data to inform its health workforce forecasting.

Kilifi County’s experience with iHRIS illustrates how data not only drive effective health workforce management, but also help counties optimize their limited resources.