Jul 04, 2016
The Human Resource Information System (HRIS) helps in rationalising health staff deployment and cope with the challenges of a large population, tiered government health facilities and budgetary constraints in the state.
Vaishali/ Nalanda/ Patna: The quality of delivering services in the health sector depends to a large extent on healthcare professionals, who form the core of public health care system. Better management of healthcare professionals like doctors, nurses and other allied staff yields not only better results, but also patient satisfaction.
The challenge of human resource management and deployment is all the more important in a state like Bihar, which has an estimated population of 103,804,637 (Census 2011) and is sub divided into 9 divisions, 38 districts and 533 blocks, having 11,702 government health facilities. The health facilities comprise 36 Sadar Hospitals (District Hospitals), 67 Referral Hospitals, 533 Primary Health Centres, 1,330 Additional Primary Health Centres and 9,696 Health Sub Centres.
With such a large population base, different tiers of government health facilities and budgetary constraints, keeping track of and managing health staff across the state remains a major challenge to achieve the desired level of health services in the state.
Over the years Bihar has progressed along a gradual development trajectory by building its infrastructure and resources. One of the significant achievements of the State Health Society Bihar (SHSB) along this trajectory is its initiative to develop an online human resource database –the Human Resource Information Systems (HRIS). All the old manual records were decided to be computerised for ease of management and decision-making. With application support from IntraHealth International and Bihar Technical Assistance Support Team (BTAST), under the Sector Wide Approach to Strengthening Health (SWASTH) programme, HRIS was introduced in 2014. Apart from being a database with details of all the health care providers working in the public health facilities, HRIS also acts a tool for managing a comprehensive human resources strategy.
While BTAST supports SHSB at the strategic level, IntraHealth works as the implementing agency for state wide implementation of HRIS at all levels. IntraHealth started working on the HRIS since July 2014 and in first phase, 38 consultants were employed to collect primary data for all districts. With progress in the development of HRIS, this was subsequently managed through 9 regional consultants. An HRIS cell was also established at the SHSB and it’s being managed by three IT consultants.
HRIS is built on an open-source-software which is easily customisable according to the government’s requirement. Information captured through HRIS includes data about health care providers such as the medical officers, general nurses, auxiliary-nurse-midwives (ANMs), and others. It has information on their educational qualification, contact addresses, current posting, service history, deputation, training history, specialisation, and family details including that of parents, spouse and nominees.
One immediate use of this database has been through the linking of HRIS with payment order generation (pay slip generation) and transfer orders of health personnel. As personnel profiles on HRIS are now linked with monthly payments, it encourages and ensures that HRIS cell as well as the accounts departments of the health facility regularly update the information. The provision launched in the beginning of this year has brought efficiency and accuracy in regular updates. To ensure accuracy, updates about exiting employees are made at the state level after a primary verification at the facility level. BTAST has supported the data collection as well as data quality monitoring.
HRIS database is reported to be helping the health department in matching the needs of healthcare facilities with the available trained healthcare staff. For example, there could be a health facility with four surgeons, but not many patients. On the other hand, there are facilities over-subscribed with patients, but not enough trained personnel. The information system helps to identify such issues and thereby rationalise deployment of human resources. The database also has information about promotions and career progression. When such data is uploaded on the website, the Department of Health becomes aware of the kind of skilled resource available and makes decisions about the responsibilities that could be assigned to the available staff.
As Animesh Sinha, one of the three consultants at the HRIS cell says, the main purpose of HRIS is to identify critical HR details required for administrative decisions. He says, “The base work of data collection happens at facility levels. HRIS today has a standing ready reference of nearly 50, 000 profiles. We have strengthened HRIS by tracing manpower deployment status from available manual records through regular reviews and analysis.”
Ranjan Kumar, Software Developer-cum-System Administrator, SHSB, Patna, elaborates that the health HR profiles spread across 12,000 government health facilities are available on HRIS, which holds data for all categories including contractual, regular and tenure-based employees. Seniority and cadre details of regular employees are also being maintained on the HRIS website, which helps in rational transfers and postings. Rajesh Kumar Singh, State Programme Coordinator, IntraHealth, Patna, reports that plans for rational deployment and trained-staff at the facilities have been drawn up with the support of HRIS.
Since the time HRIS has come into use, deployment of specialists at FRU and above level has been showing an increasing trend. The software is reported to have brought in efficiency in HR management at all levels including SHSB, Regional Programme Management Unit, District Programme Management Unit and Block Programme Management Unit. Amit Kumar of Monitoring and Evaluation (M&E), District Health Society, Nalanda, says, “Based on the analysis obtained through HRIS, the Civil Surgeon takes rational decisions to deploy staff according to the requirements. Online information is handy for enabling quick decisions as there is systematic classification of the health staff at various levels,”
Infrastructure, both software and hardware, for running the HRIS system in Bihar has been provided by the State government. The internet services at all levels including block, district and state level, too, are supported by the state government. Internet connectivity can be a challenge in effective functioning of HRIS, especially in rural areas and SHSB is in the process of developing an offline module to ensure these problems, too, are overcome.
As Satyajit Chowdhury, Director, Health, BTAST, succinctly puts it, “HRIS has helped to map the number of service personnel at health facilities at various levels and is now an easy resource for practical decisions. In future it may well be used for further analysis to track trends that would enable strategic policy decisions on human resources for health.”