Community Based-Health Management Information System (CBHMIS) is viewed as one of the processes in pursuance to the decentralisation of health services at district, rural and community level.
CBHMIS is a community focused seeking to empower communities to take control of their own health by provision of timely and accurate health information at community levels. The project has adopted the CBHIS standardised data collection tools developed by the Ministry of Public Health and Sanitation and developed special software capable of linking community health workers and health service providers at other levels to an online database for updating and retrieving health information. Target groups include: women of child bearing age, children 5 years and below in 13 community units spread over the seven districts.
Objectives
The overall objective of the project is to scale up the CB-HMIS component of the community strategy in selected districts. This will be achieved by implementing the project based on three specific objectives:
- Community Structures and Health Management Information Systems (HMIS) strengthened in 13 community health units from 5 districts
- Referral system established in 13 community health units and linked to existing health facilities
- Mechanism for targeting the poor developed and implemented in 13 community health units
Collaborating Partners: The project works in partnership with GOK structures especially Ministry of Public Health and Sanitation, Ministry of Medical Services, the provincial administration, district planning units. Other partners include community health workers, community health committees and other projects in these areas focusing on maternal and child health.
Achievements
- 13 community units are with a fully functional enhanced CBHMIS with a database containing 30,350 households with a population of 60,591
- CBHMIS software and database have been re-designed, upgraded and optimized for web access. The database has been hosted a high bandwidth server with a full-time dedicated connection to the Internet. The server is hosted with the ISP . Data can be entered from any computer with the software installed, an Internet connection and the respective permissions. This enables centralized monitoring of timeliness and accuracy of data as it is entered
- 829 community health workers have been trained on data collection, analysis and use of the information for planning. They have also been trained on the referral system from the community to health facilities and mechanisms for targeting the poorest of the poor
- 27 community health extension workers have been trained on supervision of the data collection process, data entry, analysis and sharing of information for use in developing action plans to improve health.
Sustainability
The community units are equipped with resource centers with ICT equipment which are used by community health workers to generate income through the provision of ICT-related services to the community members. Direct involvement and working hand-in-hand with the two ministries of health will ensure sustainability of the project initiative after phase-out.
Lessons Learnt
- CHWs have a vital role to play, not only in raising awareness of key health issues in the community, but also in providing basic health care in the community, especially in areas where health facilities are few and far between. In this project, they are able to follow clinician’s instructions and provide essential home-based care which reduces the number of individuals defaulting from treatment.
- There are practical, political and professional impediments to attaining quality health service delivery; A working CBHMIS offers the potential to improve the situation. This is because, practical evidence is available as to where resources should be directed to improve the health services of the communities.
- Implementing the CBHMIS gives a guide to identification of problems to be addressed, but needs goodwill from MOH to assist CHWs in implementing their actions plans
Challenges: Community Health Workers do walk long distances from one household to the other. There is completely no means of transport except a few that have been given by the Ministry of Public Health and Sanitation which are inadequate.
Future Plans: The project is seeking funds to scale up the CBHMIS at least in one community unit in each of the 47 counties of the country and a concept is being developed for mainstreaming CBHMIS as part of all AMREF projects.
