How Donors Can Expand National Health Information Systems

Technology Salon

Vital Wave Consulting has asked my opinion a very simple, yet profound question:

What should the donor community do to expand national health information systems in the developing world?

Speaking as a technologist on a mission to change the way international development employs information and communication technology (ICT) to reach its aims of economic and social development, I am honored for the opportunity to present the key activities I believe donors need to engage in immediately to better implement national HIS.
Recognize Problems Are Human, Not High-Tech
In Washington DC, I convene the Technology Salon a monthly conversation between international and technology professionals, and recently we tackled the barriers to effective deployment of national health information systems. After a hour of debate, we came to the conclusion that the key national HIS success technology is change management.
That is deploying a national health information system successfully does not necessarily require the high-end technology resources available to richer countries. The major hurtles to successful national health information systems are human, not high-tech.
Having a clear goal of improving data quality, and a solid change management approach to achieve is the critical success factor. And this can be accomplished in countries as varied in resources as Belize, India, and Sierra Leone, regardless of what technology or technical approach is used.
So Move Beyond Shiny Flashy New Thing
If we accept that its not the information or communication technology that matters most, but old school change management, then donors need to get past their infatuation with the newest shiny, flashy gadget.

Move past mHealth (Img: DataDyne)

mHealth is a great example. While mHealth more than just mobility, and mobile phones are revolutionizing ICT in Africa, do we really need yet another program that tries to be mHealth? Is it really the answer to every health problem? You would think so by all the recent donor focus on it in lieu of the larger health initiatives that can be empowered by technology.
It even propelled Karl Brown of Rockefeller Foundation to ask, “Will mHealth eat eHealth and spit out its bones?” I sure hope not, as we should be talking about health – not focus on the letter in front, be it e, m, p, q, or z.
And Get Back to Building Human Capacity for Change
Then how can donors effect greater adoption of national health information systems, if not by focusing on the technology? By supporting a structured approach to transition Ministries of Health staff into accepting, even demanding data-driven decision making – the ultimate national HIS outcome.
This means a shift towards human capacity building across health ecosystems. Using the ADKAR Model for change, Donors and their implementing partners (consultants, NGOs, and the private sector) working together with all health stakeholders in the slow but effective community organizing process to articulate the need for data-driven decision making, and create a real desire by the stakeholder to change to it.
Then, via in-person training and workshops, give stakeholders the knowledge and ability to make the change at an individual level, and finally, ensure that Ministries of Health will reinforce the change to data-driven decision making at the organizational level through its hiring and budgeting processes.
Notice there wasn’t one mention of information and communication technologies in any of those steps. Why? Because if the donor community really wants to expand national health information systems in the developing world, it needs to recognize the inhibitors are human, not high-tech, stop focusing on the shiny toys, and build human capacity to accept change. Its only then, we’ll see any real impact from national HIS, no matter the technology.
This post was original published on Insights on Health Information