Building Health Management Information Systems in Egypt - PHRplus

Another important weakness of paper and diskette transfer systems is heavy reliance on
human organization and reliability. With a good supporting and monitoring organization, they can
work quite well. The Tuberculosis Control project has been operating a paper transfer system
successfully. The Ministry of Education has been receiving data on diskettes four times a year
from all twenty-seven education mudiriyya for more than four years successfully.
Telecommunications are often seen as the solution to weaknesses of paper and diskette
systems. Data can be transmitted when necessary; no one needs to travel; data are moved from
one system to another without re-entry. The HIO system uses this method to transmit information
from polyclinics and hospitals to branch offices and HIO headquarters, as shown in Figure 1. Of
course telecommunications also relies to some extent on human organization and reliability. As
mentioned in Section 3.4, reliance on EGYPTNET may prove to be a problem due to unreliable
technical support. Also, recurrent costs for high-speed dedicated connections can be high,
exceeding the funding capacity of the organization. As with all information technology,
telecommunications technology must be matched to data volume, transmission frequency,
organizational capability, and the organization's operating budget.
4.3.3 Horizontal Flows
Horizontal flows in the governorate health directorate are particularly important. The
horizontal flows shown at the governorate level in Figure 5 do not exist. Current projects have
done little to establish them. Dr. Moharram Khalifa, June 1995, noted that HIS development in
governorate Health Information Centers had not reached governorate statistical offices. BTS
development has involved governorate planning offices, but has not involved statistical offices or
HICs. Like the central Directorate of Planning, governorate planning offices are currently
responsible for planning Chapter 3 (Bab III), capital investment projects. Yet many important
operational decisions are made at the governorate level. Increased decentralization and increased
focus on preventive and primary health care will increase the importance of decisions made by
governorate health directorates.
The roles, divisions, and relationships of information system departments at the
governorate level are not well defined. These offices include the following:
> the Health Information Center (HIC)
> the Statistical Office
> the Planning Office
No department at the governorate level is clearly responsible for training of data providers
or for data quality control. There is a direct parallel at the MOHP headquarters level, with almost
no data and information exchange among the Documentation, Information, and Decision Support
Center, the General Administration of Statistics, the Directorate of Planning, and the General
Administration of Follow-up. The horizontal flows shown at this level in Figure 5 do not exist.
An effective MIS must clearly define the functions and relationships of each governorate office
with information collection, processing, and analysis responsibilities.
28 Building Health Management MIS in Egypt: The Role of Technical Support in USAID Program Assistance