Table 3 Human Resource Development Doma<strong>in</strong>s 38 <strong>Build<strong>in</strong>g</strong> <strong>Health</strong> <strong>Management</strong> MIS <strong>in</strong> <strong>Egypt</strong>: The Role of Technical Support <strong>in</strong> USAID Program Assistance
necessary at the governorate level. Also, users of facility management systems, persons fill<strong>in</strong>g <strong>in</strong> and submitt<strong>in</strong>g forms, and persons responsible for data quality control all need tra<strong>in</strong><strong>in</strong>g. Permanent capacity for tra<strong>in</strong><strong>in</strong>g data providers, processors, and quality control personnel, must be developed at the governorate level. Good private sector resources and some public sector resources exist for tra<strong>in</strong><strong>in</strong>g <strong>in</strong> basic comput<strong>in</strong>g skills and commercial software. Tra<strong>in</strong><strong>in</strong>g <strong>in</strong> proper use and process<strong>in</strong>g of forms, <strong>in</strong>terpretation of results, data quality control, and other areas must be provided by the governorate. New teams may need to be created for this. Exist<strong>in</strong>g personnel cannot be expected to take on this added responsibility without added compensation. Compensation must be <strong>in</strong>dependently susta<strong>in</strong>able if the tra<strong>in</strong><strong>in</strong>g capacity is to be susta<strong>in</strong>ed. Issues at MOHP headquarters are similar, though access to exist<strong>in</strong>g tra<strong>in</strong><strong>in</strong>g resources is much better. As with other <strong>in</strong>formation systems elements, the role of the MOHP should be to establish basic tra<strong>in</strong><strong>in</strong>g standards, provide a uniform tra<strong>in</strong><strong>in</strong>g framework, help governorates put this system <strong>in</strong> place, monitor governorate efforts, and provide help where necessary. The Technical Assistance Element should help the MOHP to establish this system. 5.2.9 Do not Exceed Absorptive Capacity <strong>Information</strong> technology should not be <strong>in</strong>troduced faster than capacity is developed to use it. Development should proceed <strong>in</strong> phases. <strong>Information</strong> technology depreciates rapidly, even <strong>in</strong> develop<strong>in</strong>g countries. If <strong>in</strong>troduced too far <strong>in</strong> advance of organizational and human resource development, its value may reach zero before it can be used. System design should take this <strong>in</strong>to account; required human resources capacity can be lowered by simplify<strong>in</strong>g the design. Newly automated systems are normally run <strong>in</strong> parallel with exist<strong>in</strong>g manual systems while problems are resolved, and organizational and human resource capacity is strengthened. Local technical support and telecommunications may also improve dur<strong>in</strong>g the program assistance effort. Careful design and phased implementation should allow the M<strong>in</strong>istry to take advantage of these improvements. Annex E conta<strong>in</strong>s three diagrams show<strong>in</strong>g ideas for gradually phas<strong>in</strong>g <strong>in</strong> automation for the Budget Track<strong>in</strong>g System be<strong>in</strong>g developed by DDM. The same diagrams can apply to the HIS. In Phase 1, the system consists of a few stand-alone PCs. <strong>Information</strong> is transferred between PCs on diskettes. Paper forms are still used to collect data from all facilities and from district pharmaceutical supply centers. In Phase 2, <strong>in</strong>formation is automatically collected each month from governorate HICs over exist<strong>in</strong>g telephone l<strong>in</strong>es us<strong>in</strong>g low-cost modems and software. If the PCs shown <strong>in</strong> the governorate HIC and general account<strong>in</strong>g office are close enough, they can be connected <strong>in</strong> a simple peer-to-peer Local Area Network (LAN). In Phase 3, data collection by modem is <strong>in</strong>troduced at governorate and possibly district levels. PCs are <strong>in</strong>troduced <strong>in</strong> district offices and general hospitals. Introduction of <strong>in</strong>formation technology is coord<strong>in</strong>ated with human resource and general <strong>in</strong>frastructure development. 5.2.10 Match Operat<strong>in</strong>g Costs to Carry<strong>in</strong>g Capacity The Technical Assistance Element must match <strong>in</strong>formation technology to the needs and carry<strong>in</strong>g capacity of the MOHP. Carry<strong>in</strong>g capacity is the organization's ability and will<strong>in</strong>gness to spend its own resources to keep the system runn<strong>in</strong>g. <strong>Information</strong> technology carries significant operat<strong>in</strong>g costs. These <strong>in</strong>clude hardware ma<strong>in</strong>tenance, software ma<strong>in</strong>tenance (corrections, updates, licens<strong>in</strong>g), consumable supplies, technical support salaries, and tra<strong>in</strong><strong>in</strong>g. There is a direct 5.0 Strategy 39