Voices from the Capacity Project

Kautoo Mutirua lives in a large country with a widespread population. “Namibia in terms of population is a small country, but in terms of geographic size it’s quite a big country,” she says. Connecting residents to health care—and connecting regions to each other—can be a challenge. “The demand is quite huge.”

Mutirua is the former director of human resources planning and development in the Ministry of Health and Social Services. Namibia “has been struggling with the issue of shortages and skills in human resources for health,” she says, complicated by vast distances between facilities and difficulties linking information between regions and the capital. Now a technical advisor with I-TECH and seconded to the Ministry of Health, Mutirua is a leader on key health sector issues, including the deployment of HR information systems (HRIS).

Information on a country’s health workers is essential for planning and decision-making. When quality data and effective reporting are in place, leaders can better understand the current workforce and plan for recruitment, training and retention. They can help deploy the right people in the right places to provide quality care.

To help, the Capacity Project met with key decision-makers in Namibia to assess their information needs. The Project helped to strengthen the Namibia HRIS Stakeholder Leadership Group, chaired by Mutirua; the group determined that a stepped approach was the best solution to quickly improve existing systems. “Start small,” Mutirua advises. “Don’t try to do everything at once. You have to take your own country’s context into consideration and do it slowly but sure.”

The Ministry’s 18 HR management offices in 13 regions were sending health worker data to the head office for the information system currently in use. Since the system was only located at the head office and the regions couldn’t share data, the Stakeholder Leadership Group decided to pilot the system in three regions (Erongo, Hardap, Khomas). Constraints ranged from infrastructure to staff’s limited skills with computers and information systems.

Guided by the Project’s local HRIS advisor Laticha Walters, the team linked the pilot sites to the central system, installed equipment and trained staff on computer literacy and the use of the system. The pilot project went live in March 2009 as planned. All the networks are up and running, and 15 types of reports—such as staff due for salary increments and a summary of post status—can now be obtained.

The Stakeholder Leadership Group helped to ensure that the pilot stayed on track. “The way we started with just three regions and five hospitals, it gave us the opportunity to look at how things are progressing and I think we learned a lot of lessons,” Mutirua notes.

Ninety-seven percent of the Ministry’s core HR information is now automated. This means that any HR movements, such as resignations and new appointments, are updated in real time for these three regions. This enables the Ministry to make evidence-based decisions, drawing on data and presenting it in a clear format.

Mutirua points to “the linkage of the Stakeholder Leadership Group to the HR Management Directorate, and the efforts made by the group to keep the Ministry leadership well informed and involved in the milestones of this project. That has been quite successful,” she says, “and the project is fully owned by the Ministry of Health”—crucial to sustainability.

In December 2008, IntraHealth International received a five-year Capacity Project Associate Award; the Namibia HIV Prevention, Care and Support Program is supported by USAID/Namibia. This furthers the Project’s successful HRIS work, in addition to strengthening a network of organizations to offer comprehensive HIV/AIDS services. The connectivity initiative is expanding to six additional regions this year and to all 13 by 2010. A high-profile ceremony in April marked the official handover of HRIS equipment to the Ministry. Minister of Health Dr. Richard Kamwi said that this important work will help achieve the country’s Vision 2030 and Millennium Development Goals.

“I would like to thank the Capacity Project for having responded so positively to the Namibian call to assist in this initiative,” says Mutirua. “I think the Ministry of Health and all the Namibians are quite happy that this is working, and I’m sure in the next probably two years we might show a whole complete pie of success—a big one!”

[July 2009. Print a PDF version.]

The Capacity Project, funded by the United States Agency for International Development (USAID) and implemented by IntraHealth International and partners (IMA, Jhpiego, LATH, MSH, PATH, TRG), helps developing countries strengthen human resources for health to better respond to the challenges of implementing and sustaining quality health programs.

The Voices from the Capacity Project series is made possible by the support of the American people through USAID. The contents are the responsibility of IntraHealth International and do not necessarily reflect the views of USAID or the United States Government.