India

Building on work begun under USAID/India's Vistaar Project (led by IntraHealth), Jharkhand State partnered with CapacityPlus to scale up iHRIS Manage and ensure staff capacity for data entry, verification, and use. iHRIS now provides a comprehensive picture of the state's public health workforce, including each worker's current posting, employment and training history, specialization, and projected retirement date.

Highlights

iHRIS Manage data identified Ob/Gyn staffing shortfalls in 60% of health facilities. This finding prompted the Jharkhand principal secretary of health to redeploy 112 specialists with skills in emergency obstetric care and life-saving anesthesia skills and place them in first referral units, which are critical for saving mothers and newborns. As a result, 36 out of 52 first referral units in Jharkhand are now fully functioning, up from 18. The Department of Health and Family Welfare recruited nearly 450 new medical officers between 2012 and 2013 based on iHRIS reports. Estimating that a single medical officer covers 2,000 patients annually, these additional medical officers are increasing access to health services, including obstetric care, newborn care, a full range of family planning services, treatment of sexually transmitted infections, and referral services for 900,000 Jharkhand residents. Now iHRIS is routinely used to assess the distribution and skills of health workers in district hospitals and community health centers in the state.

The redeployment of skilled specialists and addition of new medical officers based on using iHRIS data for decision-making contributed to significant increases in the availability and utilization of maternal health services across the state. As examples, improvements in the first year included a 740% increase in women receiving three antenatal care visits (from 51,880 to 436,228), a nearly 12 times increase in facility births (from 25,557 to 303,876), and a nearly 20 times increase in Caesarean sections for women in need of them (from 369 to 7,231). The state also saw improvements in child health and family planning services and use due to a combination of strategic HR deployments and other programs (for example, between 2013 and 2015 there was a more than four-fold increase in the number of women choosing to receive a postpartum IUD—from 3,544 to 15,098).

CapacityPlus also worked with Haryana State to complete a requirements gathering exercise to define the priority needs and context for establishing and using iHRIS in that state. Initial customization of the iHRIS software for Haryana was completed and remaining work transferred to the State for them to continue with ongoing support from USAID’s Health Finance and Governance project. In addition, CapacityPlus completed a desk review to assess the state of HRIS across India. With interviews of key informants from departments of health and/or the National Rural Health Mission from 28 states and seven union territories, the study will inform a national framework and facilitate learning exchanges between states.

Photo by Trevor Snapp, courtesy of IntraHealth International