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IntroductionOne of the stated reasons that Health Care Organizations in developing countries have shown very little interest in information technology up to today is the lack of skilled personnel to implement such systems. This lack of skilled personnel not only arises form the host countries but also from the lack of skilled personnel from donor countries. People is the resource that makes the organization work. Education is the key. Education is the key. Education is the key. Education is the key. Education is the key. Education is the key. Education is the key. Education is the key. The record did not get stuck...it was repeated for a reason. (see examples/human resources) Employment of New StaffAny employment should be based on clearly defined requirements based on forecasts of organization needs. Internal hiring should be attempted first. The questions to be asked during the interview should be clearly defined before the interview. It is too easy to select one applicant over another based purely on the questions that were asked during the interview. Additional questions should only be added at the end of the interview. TrainingIt is report that one of the greatest problems in International Health is the lack of trained personnel. Certifications and AccreditationGives public approval to health care training. Create incentive for health care workers to update their education Provides objective standards for promotion IncentivesToday's research projects leave little incentive for managers to be creative. Projects are designed and implemented with little authority to make changes. Allocation of ResourcesIn almost all health care systems, skilled human resources are misallocated to areas of high economic income. A human resource information system can provide the data to enable these resources be allocated more fairly. This can be carried out by having at the national level, reports for determining the concentration of physicians, nurses, and other health care workers not only by skill level buy also by location. Other statistics that can be captured to improve human resource allocations are employee turnover, salaries, reasons for entering or leaving the service, and education facilities. By knowing where resources are needed, incentives can be given to encourage additional resources to move to that area. Cost reductions can be attained by having the right number of staff, with the right skills, at the right location, during the right time. Stories
This 6 weeks of training was not enough time to teach someone how to bring up a Oracle system much less teach them how to program in SQL or how to administrate the system. Now these individuals came back to their country and worked very hard at trying to put together their system. What they did accomplish was very admirable. Yet they had no help and no funds were available for additional training. These individuals were paid an average of $3,500 per year for their dedication. Very soon afterwards, these individuals were offered jobs in several other countries at the going rate of $4,000 per month. They left. The moral to this story is that even though training is a problem in developing countries, it can be done; the shortages that occur in these countries is due to migration once their are trained. A developing country today will find it very hard to compete. Even with as much research and funding in health economics in a country such as Bangladesh, they have no health economic programs in school. Why? From the experiences of InHCc, funding organizations continue to under-estimate the training needed. Even if sufficient training is provide initially, very little, if any is provide for "continuing education."
In was soon discovered, that the NGO's staff, had very little knowledge of present day systems. In the average of the 12 years that they had been with the NGO they had not had any new training. They were still operating an old mainframe with an outdated accounting system that had been installed 12 years before. They did not know anything else. The consensus was that they "convert" the old system. The moral of the story is that if you do not have new ideas, then you have no choices to make other than what you already know. SolutionsAdditional education through the Internet can also be added where appropriated. Management training: The key to
any information system is not the collection of the data but rather the use of
that data. Training is one of the most
important contributes we can give to developing countries. Web Technology makes
possible what has never been possible before: On-line distant learning.
Applications can be built that are interactive, and teach as data is entered.
Executive information with graphs and trends can be produced in summary form,
every day, for the local manager.
Feedback from the OLAP will not
only give each local service level their information but also a comparison with
others and tips on how to improve. The ability to drill down their data will encourage higher-level managers to interact more frequency with their subordinates. This opportunity for two-way communicate encourages not only training but also the sharing of real knowledge. Change ManagementThis project calls for major
changes in the way users collect and interact with their data. In any project that changes the
way an organization functions, there will be members of the organization who do
not want the change to occur. Change management then becomes of the most
important processes in the successful implementation of the project. In any organization, the director
or the chief operating officer can set the environment for the project. Without
his support the project will fail. He must be willing to set an example for the
organization by not only living the part himself but also enforcing the proper
behavior of others. If the CEO accepts what goes on around him, then he is just
as guilty of improper attitudes as those that actually initiate the action. The biggest issues that may arise on this project will result from organization politics and will have nothing to do will technological issues. EvaluationEvaluations of health care services, and their staff, by "Monitoring and Evaluation consultants" are very often perceived negatively by the very groups that the evaluation is intended to benefit. One reason that this occurs is that often the local management has had very little chance to manage. Generally the project is established by "others" and the local administration have had few opportunities to make changes. It is no wonder that local staff get a little upset. The solution... give them the data they need and let them manage. Not only do you give them the responsibility for the results...but please give them the authority to make the needed changes. The use of moral incentives to motivate employees requires measurement. A fair and equable evaluation system must be in place for each and every staff member including managers. It is not enough to just have a "check list." Focusing on "production quotes" has been found not to work. Staffing RequirementsStaffing requirements are often complicated in developing countries because of lack of funding and skilled staff. In one BNGO the ratio of patients to nurses was 50 to 1. Governmental Regulations and CertificationGovernments must have the ability to regulate and control the licensing of health care professional. A human resource management system can provide the means to not only regulate licensing but also to enable the allocation of these resources to areas that need them the most. DiscussionA very valid reason why employees DO NOT WANT information is that this information can be used against them. For a information system to work, it must be used for the good of all. The employee must see that he made also benefit from this information. Links and Downloads to Human Resources
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It was recommended to one large NGO in a developing country that they
install a Oracle database system on a Sun Unix system. Although the physical
equipment was funded, very little money was provide for education. The
budget called for several individuals to go to a foreign country (the
country of the consultants, of course) at a cost of $1600 per week for a
period of approximately 6 weeks.