Building Health Management Information Systems in Egypt - PHRplus

necessary at the governorate level. Also, users of facility management systems, persons filling in
and submitting forms, and persons responsible for data quality control all need training.
Permanent capacity for training 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 training in basic computing skills and commercial software. Training in proper
use and processing of forms, interpretation of results, data quality control, and other areas must be
provided by the governorate. New teams may need to be created for this. Existing personnel
cannot be expected to take on this added responsibility without added compensation.
Compensation must be independently sustainable if the training capacity is to be sustained.
Issues at MOHP headquarters are similar, though access to existing training resources is
much better. As with other information systems elements, the role of the MOHP should be to
establish basic training standards, provide a uniform training framework, help governorates put
this system in 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
Information technology should not be introduced faster than capacity is developed to use
it. Development should proceed in phases. Information technology depreciates rapidly, even in
developing countries. If introduced too far in advance of organizational and human resource
development, its value may reach zero before it can be used. System design should take this into
account; required human resources capacity can be lowered by simplifying the design. Newly
automated systems are normally run in parallel with existing manual systems while problems are
resolved, and organizational and human resource capacity is strengthened. Local technical
support and telecommunications may also improve during the program assistance effort. Careful
design and phased implementation should allow the Ministry to take advantage of these
improvements.
Annex E contains three diagrams showing ideas for gradually phasing in automation for
the Budget Tracking System being developed by DDM. The same diagrams can apply to the HIS.
In Phase 1, the system consists of a few stand-alone PCs. Information 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, information is automatically collected each
month from governorate HICs over existing telephone lines using low-cost modems and software.
If the PCs shown in the governorate HIC and general accounting office are close enough, they can
be connected in a simple peer-to-peer Local Area Network (LAN). In Phase 3, data collection by
modem is introduced at governorate and possibly district levels. PCs are introduced in district
offices and general hospitals. Introduction of information technology is coordinated with human
resource and general infrastructure development.
5.2.10 Match Operating Costs to Carrying Capacity
The Technical Assistance Element must match information technology to the needs and
carrying capacity of the MOHP. Carrying capacity is the organization's ability and willingness to
spend its own resources to keep the system running. Information technology carries significant
operating costs. These include hardware maintenance, software maintenance (corrections,
updates, licensing), consumable supplies, technical support salaries, and training. There is a direct
5.0 Strategy 39