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Health Management Information System (HMIS); Whose Data is it Anyway?

Contextual Challenges

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 Review of Public Administration and Muhindo, et al., Review Pub Administration Manag

Management 2016, 4:2

http://dx.doi.org/10.4172/2315-7844.1000190

Research Article Open Access

Health Management Information System (HMIS); Whose Data is it

Anyway? Contextual Challenges
Richard Muhindo1*, Edith Nakku Joloba2 and Damalie Nakanjako3
1Department of Nursing, Makerere University College of Health Sciences, Uganda.
2School of Public Health, Makererere University, Uganda.
3Associate Professor, School of Medicine, Makerere University, Uganda.
*Corresponding author: Richard Muhindo, Lecturer, Department of Nursing, Makerere University College of Health Sciences, Uganda, Tel: +256782146111; E-mail:
[email protected], [email protected]
Rec date: April 18, 2016, Acc date: June 29, 2016, Pub date: July 2, 2016
Copyright: © 2016 Muhindo R, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted
use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

In 1997 the Ministry of Health instituted the national HMIS in response to global and national call for greater
accountability and results-based management. The goal being to provide timely reliable health information that
would inform decision making in the sector to aid provision of better health care services to the people of Uganda.
However, there are already concerns about the functionality of the system characterized by late and inadequate
reporting.

The purpose of this paper was to make a critical analysis of the contextual challenges to HMIS and propose a
framework that would improve the collection of timely reliable data at all levels in the system.

After critical analysis of the existing literature, reports and presentation at various MOH workshops and review
meeting, and interactive informal talks with some personnel at the Ministry, this paper asserts that failure to use
HMIS data, poor culture of accountability, lack of incentives for performance, strategic planning and vertical
programs-HIV/AIDS are the strategic contextual challenges to this menace.

Data utilization at all levels in the system will be the linchpin in realization of timely collection and reporting of data
and to this end, a user-friendly system is at the core of any successful public health system when it will;

Assist hospital managers to align health system resources with the needs of service users

Link performance measurements to accountability

Monitor health-related activities to help assess what works and what doesn’t

Contribute to organizational development

This paper proposes a framework that will see data utilization as the foundation for timely collection and reporting
at all levels in the system. There will be organizational learning with the associated organizational development
breeding ownership and sustained demand for data collection and reporting. Key in the implementation will be;
leadership, change management, organizational embedding and capacity development.

Keywords: Provision; Critical analysis; Literature; Accountability; Others being; strategic planning, operational planning and budgeting
Strategic contextual challenges for results, public financial management, programme and project
management [7]. The primary goal of M&E in Uganda is to improve
Background the performance of the public sector through the strengthening of the
operational, coordinated, and cost-effective production and use of
Over the last three decades there has been increased global and objective information on implementation and results of national
national demand for greater accountability and results-based strategies, policies, programmes and projects [7].
management [1-3]. This demand has necessitated the need for
designing of useful and useable monitoring and evaluation systems Result-based M&E systems designed successfully are said to
(M&E) that support programming and design of evidence based monitor and evaluate projects, programs and policies at all levels
policies and work plans [4-6]. According to the Uganda National [8-10]. Information collected and analyzed at any phase of project
policy on Public sector on Monitoring and evaluation, M&E is cycle provides feedback that can better inform key decision-makers
recognized as one of the five pillars of results-based management [7]. and other stakeholders. A functional M&E system should provide a
continuous flow of information that is useful internally as a

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ISSN:2315-7844 RPAM, an open access
Citation: Muhindo R, Joloba EN, Nakanjako D (2016) Health Management Information System (HMIS); Whose Data is it Anyway? Contextual
Challenges. Review Pub Administration Manag 4: 190. doi:10.4172/2315-7844.1000190

Page 2 of 7

management tool and externally as evidence to those who demand organized [20]. The HMIS has of recent been revised to harmonize
discernible impacts [11-13]. reporting systems and cater for emerging information needs of the
MOH and other stakeholder in the areas of HIV/AIDS, TB and
The Health Information Management System (HMIS) Malaria care programs [19,21].
in Uganda However, findings of a study on the quality of Uganda’s health
facility data collected through the HMIS revealed that overall, the data
An HMIS is a database system in which “raw data” are stored and
quality in 2010/2011 was somewhat lower than in 2008/09; with only
transformed into information, as a system is said to be composed of
71 of the 112 districts (63%) meeting the quality criteria [22]. The
interrelating components that can be grouped into two entities [14-16].
study shows that Completeness of district reporting is poor in 9% of
At the first level, the process is to ensure the collection of data from
districts and completeness of health facility reporting is problematic
lower levels to the central level that transforms data into information.
for one-third of the districts. Accuracy of reporting is only partly
The conceptual level concerns itself with analysis and feedback
adequate, with 18% of the district reports zero or missing, 7% of the
mechanisms aiding the transformation of data into knowledge to
districts having extreme outliers, and 9% of the districts having major
inform decision making [17]. The functionality of the HMIS varies
differences between the annual total and the sum of the monthly
from organization to organization but generally in the ministry of
reports. District population projections for the denominators in
health it is used to collect routine data and information on patients,
2010/2011 are estimated to be off by more than one-third for 22% of
costs, performance of personnel, specific diseases, medical conditions,
districts [22].
their management, use of medicines and other medical supplies [18].
Generally routine data collection provides most of the data used for Similar observations on lack of timely reliable data have been noted
M&E, making the HMIS and other reporting tools, a major component in other studies and national HIV/AIDS coordination meetings [23].
of the M&E system at the MOH. The tools exist in both electronic and In the MOH technical review meeting held in July, 2011, lack of
manual to cater for the differences in technology built at various health reliable data due to failure by some health facilities and districts to
facilities in the country [19]. At the health facilities there are a number report was highlighted as a major challenge of the M&E unit of the
of registers (specific diseases/conditions), client data cards that are AIDS control Program (ACP). For example data from the national
supposedly filled on a daily basis and data compiled on a monthly basis HIV counseling and testing ( HCT) unit indicated that 49%, 33% and
into HMIS report forms either manually or electronically and send to 53% of the districts in the country registered 100% reporting in 2008,
the next reporting level in the health care system; mainly from health 2009 and 2010 respectively. This observation cuts across all the
facility to the district health office and eventually to the MOH. programmatic areas of the ACP unit according to the M&E program
officer. This raises a concern of whether planning at all levels in the
In Uganda, a health information system (HIS) was first designed in
system is informed by reliable up to information. Informal talks with
1985 to capture and analyze morbidity data for selected communicable
MOH officials at the ACP program indicate that there is already
and non-communicable diseases and other services like immunization
fatigue at some facilities that even certain indicators in the tools are
and family planning.
not reported on. For example during the ART adherence framework
Information was collected in health facilities, summarized at district formulation workshop, it was observed that some indicator questions
level and later forwarded to the ministry of health. In 1992, a review on the HIV care/ART card are never reported on or even filled by
was commissioned after realization that vital management information health workers.
on staffing levels, infrastructure, health facility management, medical
This in itself raises a concern of the utilization and relevancy of data
equipment availability, drug and financial management were left out.
at the service delivery points. The Minister of state for primary health
Based on the findings of the review and modifications, a national wide
at the HIV/AIDS coordination meeting held 30th June-1st July, 2011
HMIS was initiated in 1997. The core functions of the Ugandan HMIS
said despite achievements made in sector over time, the public
are to establish and maintain a comprehensive of health and
perception of the sector is negative. He attributed this largely on the
management information for planning, monitoring and evaluation of
use of old un-updated data and lack of dissemination mechanisms. If
the health sector strategic plan. The major focus being improving and
this assertion is true then one would wonder whether planning and
strengthening; Data collection and compilation of health events,
decision making including setting programmatic targets is informed by
timelessness, completeness and accuracy of reported data, analysis,
reliable data at the MOH. A number of factors including limited
interpretation and utilization for evidence based decision making and
number of staff and skills, low motivation, combined with lack of
action, regular dissemination and feedback to all stake holders among
incentives and tools have been pointed out by some scholars and actors
others [20].
to be responsible for this gloomy face [23,24]. While this could be true,
The 1997 model of the Uganda HMIS was based on a multitude of this paper contends that this is just a tip of the iceberg. Thus, the goal
paper tools (reporting forms, registers, databases, and manuals), each of this paper was to attempt to make a critical analysis of the contextual
containing a specific set of programme information. Health workers at challenges to HMIS to decipher the true face of this problem and
lower levels were supposed to record and compile separately a number thereafter propose a framework that would improve the collection of
of forms. Due to the big number of forms and registers, health workers timely reliable data/information at all levels of the health care system.
spent lots of time on tallying and summarizing the information. This
labor intensive activity is said to have somehow affected the accuracy Methods
of reports and reporting itself at all levels of the system [21]. Thus in
2000-2001, a review of the HMIS data collection and reporting tool This is a personal analytical opinion based on my personal
was conducted with the aim of integrating the major aspects of the observations and interaction with the M&E Unit of the ministry of
health and management information. In July 2001, a national health during my attachment as a fellow trainee in global health
dissemination workshop to launch the revised HMIS tools was leadership in 2011. After a careful review of existing literature,
presentations at workshops, reports and interactive informal talks with

Review Pub Administration Manag Volume 4 • Issue 2 • 1000190

ISSN:2315-7844 RPAM, an open access
Citation: Muhindo R, Joloba EN, Nakanjako D (2016) Health Management Information System (HMIS); Whose Data is it Anyway? Contextual
Challenges. Review Pub Administration Manag 4: 190. doi:10.4172/2315-7844.1000190

Page 3 of 7

some personnel at the AIDS control program (ACP), MOH that This paper argues that improving data utilization in the system
focused on characteristics of the HMIS (data collection processes, including lower levels will require transformation of health facilities
utilization at all levels), strength and weakness, we observed that and the system into learning organizations, key in this aspiration will
inadequate number of personnel, in addition to limited financial and be change management. The use and learning will lead to alignment of
other material resources are some of the critical factors pointed to by health systems resources to the needs of service users, linkage of
many to be responsible for lack of reliable and timely data. However, performance measurements to accountability, monitor health related
below are the critical contextual challenges I consider antecedents to activities to assess what works and what doesn’t and contribute to
this menace. organizational development (improved quality of service and visibility
in the eyes of the public).
Utilization of HMIS Data Learning, organizational development and ownership will generate
In the health sector, HMIS is being more and more used to fulfill the demand for timely reliable data that will see commitment from the
often very demanding reporting requirements of higher institutional system at all levels in terms of resource (finance and human) allocation
levels such as the District, Ministry of Health or donor; that one can for HMIS related processes. Organizational learning can be
conclude that the HMIS is basically keeping track of the main outputs encouraged through introduction of hospital journals where best
in a health organization. This emphasis on reporting disconnects the practices and innovations at different hospitals in country are
lower (collecting) facilities from data as it’s perceived to be a need of compiled on annual basis. Such an approach can provide not only an
higher institutional levels. This translates into lack of ownership at the opportunity for hospital to learn from each other but also motivate
very collection level, the problem continues along the reporting chain. hospitals to value collection of timely and reliable data. Hospitals in
This observation was re-affirmed by the data officer at ACP unit, who this case are the only role models for their counter parts.
said many times facilities are not even aware of their own data and that
they are made aware during the support supervision visits. it is said Culture of Accountability
that at times facilities refuse to acknowledge their own reports
Understanding this problem in the total context of the country is
claiming that wrong data should have been submitted especially if the
imperative. It has been observed that the culture of accountability and
report reflects low or bad performance on certain programmatic
evidence-based management is still relatively new and not yet well
indicators. This raises the concern of whether the reported data is
established and widespread in the public sector [4,33,34]. Observations
reliable or just reported to fulfill the obligation. The other concern is
indicate that several policy makers do not understand the value added
whether data is analyzed, disseminated and utilized at the collection
by M&E tools to guide future policies, programs and budgets for better
facility. It has been observed that HMIS can be used as an
result [6]. This could also be true for the health sector. Despite the
organizational development tool if data is transformed into
implementation of result based management initiatives and tools like
information for organizational service delivery improvement.
the HMIS in Uganda, demand for accountability mostly focuses on
Organizations or facilities can only be motivated to continually collect
monitoring information related to budget preparation, execution and
and report reliable and timely data if they find it useful or learn from it
reporting. There is still a culture of “consuming budgets” versus
to improve the performance of their own organization [25-27].
reaching results and performance is mostly measured in terms of
The general observation is that data utilization at all levels in the activities and outputs rather than outcomes [4,35,36]. Planning and
health care system is low except at some few centers (learning setting programs targets may not necessarily be based on evidence or
organizations) of excellence [28,29]. Some technical staff at ACP unit reliable data; many at the MOH will tell you that the problem is not
concurs with this observation that many times data has not be used, lack or absence of data but rather use of the available data/information.
activities including planning seem to continue in a more or less Furthermore budgets are allocated to health facilities in accordance to
predicted manner. This status quo is less likely going to create demand the national strategic plan, which at times doesn’t reflect the situation
for commitment to HMIS related activities. HMIS should be seen as a on the ground in terms of data. There are situations where budget
major fundamental policy reform in the health sector that requires a allocations are guided by politics rather than evidence in form of data.
new mind set, in particular the use of data.
Scholar like Duco and Resodihardjo have pointed out that
Organizational aspects like vision, programmes, people, structure institutional socialization may result into policy lock-in that leads to
and procedures and organizational processes; thinking and learning, path-dependence, for example the culture of planning not based on
doing, being and relating all have implications on policy reliable data itself is a barrier to organizational behavior of collecting
implementation [30-32]. People are likely to buy-in policy change if and reporting timely reliable data [37]. A culture that raises the
they think it positively impacts on their core business. For example do concern of whose data is it anyway? This context makes commitment
structures and procedures support the core business of the to HMIS goals including data collection, human and financial resource
organization in terms of program planning, doing or being in terms of allocation limited among key policy manager, program managers and
administration, structure modification. While the HMIS keeps track of staff at service delivery points.
the main outputs in the health sector using it solely for this purpose
This paper argues that the daunting challenge facing HMIS is not
creates fatigue among those involved as little if any is seen between the
inadequate staff and limited finances as pointed out by many but
process and the core business of the health facility. It’s not therefore
failure by the system to use the available data. Collecting data that is
surprising that most health workers see themselves as care provider
not used in the system breeds fatigue among those involved in data
(their core business) and thus have no business in data collection.
collection and compilation. There is no evidence that availing the
HMIS should be seen as an organizational tool with an objective of
necessary staff with financial resources will necessarily improve
tracking outputs, relate them to inputs and thus monitor the effects of
collection and reporting of timely and reliable data. This hypothesis
managerial decisions.
holds if we compare with NGOs and other centers of excellence, while

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ISSN:2315-7844 RPAM, an open access
Citation: Muhindo R, Joloba EN, Nakanjako D (2016) Health Management Information System (HMIS); Whose Data is it Anyway? Contextual
Challenges. Review Pub Administration Manag 4: 190. doi:10.4172/2315-7844.1000190

Page 4 of 7

this paper is not trying to contend that NGOs are more effective and with little or no attention to existing evidence [6]. Such scenarios don’t
efficient than government, but rather because their survival in terms of provide an environment for commitment to HMIS and its related
funding depends on demonstration of evidence in terms of data/ processes. This also furthers the argument that data utilization is the
information to their funders, they have put in place structures to daunting challenge of HMIS. This paper asserts that only when
ensure that timely reliable data is available [38]. organizations in the system see how data collected influences their
organizational processes; thinking and learning, planning, managerial
Thus it’s not the inadequate staff but the value we attach to data.
decisions and performance; that commitment to the HMIS will be
This paper thus recommends that the MOH should demonstrate to
achieved. It’s hoped that when the above is realized more resources in
those engaged in data collection how data collected in the system has
terms of human and finances will be allocated for the same cause.
been used and mechanisms to disseminate data utilization. However,
data utilization at the very source of generation should be the priority
if the hunger to collect and report timely reliable data is to be HIV/AIDS
sustained. Like any other policy change, a favorable environment is While HIV/AIDS still poses one of the most formidable public
necessary for its success and this may call for other reforms in the health problems to the health care sector, the same is true for M&E and
sector for example financing. thus HMIS. The disease has not only led to enormous donor funds
being pumped into system but also proliferation of numerous
Incentives for Performance Measurement international, national and local NGOs, each implementing HIV/AID
related interventions. The emergence of bilateral agencies like global
The HMIS operates in an environment where the incentive system
fund and Bill-gates with specific interest in HIV, Malaria and TB has
of rewards and sanctions itself is non-functional. Some scholars have
almost seen most new infrastructure development in health care in
pointed out that the system has no “bite” as both institutions and
Uganda focus on these three diseases. Most of the HIV/AIDS
individuals do not bear the positive or negative costs of their actions,
interventions are implemented in form of projects with a lot of data/
results or lack of [6]. For example what happens if a facility doesn’t
information demands most probably as donor requirement that a
report or report late? We observed that reporting or not seem not to
number of parallel reporting systems emerged [40,41].
affect the facilities. For example they will continue to receive their
drugs, since even the drugs are supplied by another party, employees One observes a number of detailed data collection tools including
will continue getting their pay and probably institutional budgets, as client registers and cards; for example the ART cards, Pre-ART and
the culture is preoccupation with activities. From this observation one ART initiation register, ART dispensing log books and others each
would conclude that there seem to be no practical incentives for data with a number of variables in areas of HIV/AIDS and TB and few, if
collection, compilation and reporting at the facility level, given that any in other disease areas. For example it was noted during the chronic
planning and setting target can be done without necessarily using data. care model workshop that during the pre-implementation assessment,
there were no registers and cards for other chronic condition like
Performance assessment has been implemented for staff with
diabetes, hypertension and cancer at health facilities in the pilot
guidelines to be linked to a system of rewards and recognition [39].
district. Members concurred that this true for most health facilities in
There is lack of incentives for performance probably due to the fact the
the country and that data/information on these conditions is therefore
resources to offer incentives to adhere to results-oriented management
scanty.
and related integrated performance framework like HMIS are not
available. In light of this reality (lack of resources to incentivize data This is probably not surprising as HIV/AIDS has over time
collection and reporting in the health sector), data utilization through, fascinated donors that one observes a lot of projects and funds in this
documentation and sharing of individual hospital best practices and area and few if any other disease areas. Today if one visited and found
experiences, introduction of hospital journals, newsletters presents an a new tool like computer, microscope or even a table at a health facility,
opportunity to leverage on. you would be surprised if you are told that it was procured or donated
not through an HIV/AIDS project. The system has almost become
Such initiatives will create demand for timely and reliable data/
synonymous with HIV/AIDS.
information at the center of generation; more importantly such
intervention will enable hospitals in country to share and learn from The fact that HIV/AIDS related interventions are implemented in
each other challenges, lessons, innovations and best practices. We form of individual projects has ultimately led to development of
ought to appreciate that these facilities are centers for innovations that different registers and reporting tools; for example ART, HCT, PMTCT,
many of us are unaware of. This paper asserts that such an approach each with its own data collection and reporting demands. Generally
will transform our health facilities into learning organization and it’s one would hypothesize that HIV/AIDS interventions have seen more
the learning, documentation and sharing best practices with other data being demanded from health facilities than never before. This
hospitals that will provide the incentive for timely data collection, could probably be due to the very nature of their implementation;
compilation and reporting. “project like” and also being implemented by various partners who
must demonstrate to their funds their outputs. It’s surprising that many
Strategic Planning are of the view that data collection in such a manner is straining the
already constrained workforce in the sector. Also this paper doubts the
Despite existence of strategic plans at national and lower levels like sustainability of such an approach when mainstreamed the public
hospitals, many times they are not always based on a good diagnosis sector.
resulting from a solid analysis of baseline data and use of evaluation
information from previous plans and interventions. Everybody seems While the new framework to integrate HIV/AIDS data into the
to say there is lack of information or data while on the other side data national HMIS presents a new ray of hope, there is a need to recognize
lies unutilized sometimes. According to Idea international, 2010, some that unless culture of timely reporting is addressed, lack of data in
strategic plans are based on personal judgments and at times politics form outputs may stiff efforts to mobilize resources from the donor

Review Pub Administration Manag Volume 4 • Issue 2 • 1000190

ISSN:2315-7844 RPAM, an open access
Citation: Muhindo R, Joloba EN, Nakanjako D (2016) Health Management Information System (HMIS); Whose Data is it Anyway? Contextual
Challenges. Review Pub Administration Manag 4: 190. doi:10.4172/2315-7844.1000190

Page 5 of 7

community; as such efforts to stamp out the epidemic may be This paper contends that understanding these contextual challenges;
undermined. Secondly most of the time different partners implement use of HMIS data, the culture of accountability, incentives for
different HIV/AIDS interventions, presenting coordination challenge. performance management, strategic planning and HIV/AIDS will be
imperative in planning interventions to strengthen HMIS and M&E
To the HMIS, the different HIV/AIDS interventions employ data
frameworks in the health care sector.
tools with a number of variables, if integration means reducing the
workload at the collection point, then the question is whether
integration doesn’t mean addition or if it means reduction then which The Framework for Timely Collection and Reporting of
variables must be lost without missing out important data for Reliable Data
planning. Integrating the reporting mechanisms for HIV/AIDS service
This paper proposes the framework below as a tool to create
related indicators (ART, PMTCT, and HCT) may offer another
demand for timely collection and reporting of data at all levels in the
alternative. There is need to balance data collection and reporting on
health care system.
HIV/AIDS and other health related diseases if system is to be
responsive to the health care needs of all Ugandans.

Figure 1: Framework for timely data collection and reporting.

According to this framework, data utilization at all levels of the Critical to realize the goal of data utilization will be leadership,
system will be the key in generating momentum for timely collection Institutionalized strategies on how data generated at each level will be
and reporting of reliable data, more so at the collection points. Data/ utilized should be designed.
information must been seen to be the basis of managerial decisions
Furthermore, data utilization will transform these institutions into
including strategic planning, planning and allocation of resources,
learning organizations that will see them not only effectively plan,
organizational and staff performance appraisal. Facilities may be
efficiently mobilize, allocate and utilize the resources available but also
encouraged and empowered to use data/information to mobilize own
provide quality and responsive care to the Public. Learning that is
resources. Generally data/information must be seen to influence the
linked to planning, resource allocation and use will generate and
dynamic processes of these facilities (thinking and learning, doing,
sustain demand for data collection, analysis and reporting.
being and relating). To this end therefore, there is need to incentivize
the use of data at all levels of system. While transforming these To incentivize learning at health facilities we propose that
institutions into learning organizations presents one opportunity, documentation of best practices and innovations that utilize data
policy reforms may be necessary including financing, drug supply, generated be encouraged. To this end, we propose the introduction of
Human resources and performance based contract employment. hospital newsletters, journals and websites where possible. The

Review Pub Administration Manag Volume 4 • Issue 2 • 1000190

ISSN:2315-7844 RPAM, an open access
Citation: Muhindo R, Joloba EN, Nakanjako D (2016) Health Management Information System (HMIS); Whose Data is it Anyway? Contextual
Challenges. Review Pub Administration Manag 4: 190. doi:10.4172/2315-7844.1000190

Page 6 of 7

dissemination of such information will not only allow hospitals to • Link performance measurements to accountability
learn from each other but also increase their public visibility; this could • Monitor health-related activities to help assess what works and
go a long way to fascinate young professionals. Critical to this however, what doesn’t
will be strategic leadership, change management, organizational • Contribute to organizational development
embedding and capacity development. To enhance the analysis and use
of data/information, there may be need to upgrade the position of The new framework emphasizes the integration of HIV/AIDS data
hospital records officers to strategic information officer with abilities to into the national HMIS, there is a need to recognize that unless culture
analyze and interpret data. of timely reporting is addressed, lack of data may stiff efforts to
mobilize resources from the donor community; as such efforts to
Data utilization with the associated organizational learning will lead stamp out the epidemic may be undermined.
to organizational development that will see these organizations
become evidence-based in their routines. It’s hypothesized that This paper recommends a framework (Figure 1) for timely
capacity development in data analysis and use, resource planning and collection and reporting of data that will emphasis a cyclic cycle of data
use, attraction and retention of skilled human resource for health will utilization at all levels in the health care system, data use that
accrue with resultant improvement in quality services to the public. transforms facilities into learning organizations, data use and learning
The improved quality of services will improve public satisfaction. leading to organizational development at all levels. The organizational
transformation through data utilization will breed ownership that will
Data utilization combined organization learning and organizational see organizational commitment in form of resource allocation. This
development will lead to data/information ownership that will create will create and sustain demand for timely data collection and reporting
and sustain demand for timely collection of reliable data. Critical to of reliable data. To enhance the analysis and use of data/information,
timely collection of reliable data is data ownership and use. To this end there may be need to upgrade the position of hospital records officers
therefore, there will be a need to adopt user friendly tools, to strategic information officer with abilities to analyze and interpret
organizational embedding and capacity development. data.
In a nutshell, according to this framework, data utilization at all Key factors in the implementation of the framework are leadership,
levels in the health care system will be the linchpin in realization of change management, organizational embedding and capacity
timely collection and reporting of data. The collected data must be development.
seen to influence the processes that make an organization dynamic
(thinking and learning, doing, being and relating) to all stakeholders in
the system. Data utilized in this way will see commitment in terms of
Acknowledgements
financial, human and other material resources from the system. The National Program Manager AIDS/STI Control Program
However, it may also be very imperative to ascertain from the facilities
themselves how they can utilize data. Site mentor: Dr. Elizabeth Namagala
Primary Mentor: Dr. Damalie Nakanjako
Limitations Staff of ACP Unit, MOH
This was a desk review with some informal interviews with some Afya Bora consortium
MOH personnel. The period of stay being short (2.5 months), it was
not possible to access and review all the policy documents, frameworks
and report neither interview all key stakeholders. However, the analysis
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Citation: Muhindo R, Joloba EN, Nakanjako D (2016) Health Management Information System (HMIS); Whose Data is it Anyway? Contextual
Challenges. Review Pub Administration Manag 4: 190. doi:10.4172/2315-7844.1000190

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