Kenya's Strategic Plan for Health Information Systems

Kenya has a brand new Strategic Plan for Health Information Systems (HIS) covering the period 2009 to 2014. The new strategic plan also brings along a HIS policy to guide its implementation. The two documents attempt to deliberately address the aspirations of the National Health Strategic Plan II , the Health Sector Monitoring and Evaluation Framework and the country's Vision 2030. The documents were prepared with the technical and financial support from the Health Metrics Network (HMN) and UK's Department for International Development (DfID). Click here to access the two documents on Google Docs

Notably, among government dependent services, the health sector has been at the fore front adopting Information and Communication Technology (ICT) for improved service delivery to Kenyans. The progressiveness on the part of the health sector may be appreciated as a result of good leadership within the government. The same might also be dismissed as a mere side effect of immense donor interest especially with respect to HIV and AIDS. The extreme pessimist might dismiss the same as yet another fantastic set of paperwork that the government produces whose theory will not really be actualized in practice. The extreme pessimist will not be helped to note that whereas there is a very thin line between HIS and eHealth, another set of similar documents on the national eHealth Strategy are being finalised by a different department of the two Ministries of Health.

The strategic plan for HIS has a vision of making Kenya “a centre of excellence for quality health and health related data and information for use by all”. One of the strategic objectives in the document which should interest the local ICT industry is for 'Strengthening use and application of information and communication technology, in data management' . Cited strategies for this include enhancing data management functions with hardware and software, developing an integrated web-enabled database system, support for data flow (data connectivity), systems maintenance, data security, and developing capacity of ICT personnel. Given the plan's budget of Ksh. 1.9 billion, the above strategies if implemented will surely have a spill over effect of further nourishing the country's fledgeling ICT industry.

The plan aims to directly create jobs for 4,310 more health records and information personnel, 227 ICT officers and 221 statisticians. As meagre as these numbers may look, this should bring a little hope to the disillusioned Kenyan youth studying ICT related degree and diploma courses. Perhaps greater economic impacts will be felt in the ICT industry if affirmative action is enforced to more directly favour local entrepreneurs. Such a protectionist approach will yield even better results in the software industry if local expertise, based on widely tested, global community supported open source approaches, can be developed and tapped. Such an approach will also compare better to acquiring turnkey or off-the-shelf solutions that have dependencies on foreign software vendors with expensive licensing models.

Although it might sound fair enough for the health sector to insist that all they want is a working ICT infrastructure (software and hardware) in pursuit of the HIS strategy, it might help to look beyond an optimal solution for the short term. To gradually build capacity of the local software industry with a reasonable level of tolerance will provide optimal long term solutions in terms of Sustainability, Return On Investment (ROI to the country's economy) and the long term Total Cost of Ownership (TCO). Moreover such an approach should eventually improve the country's foreign exchange situation by exporting human resources and intellectual property developed throughout HIS implementation. The approach will also be in line with the ICT board's vision of making Kenya a top ten global ICT hub.

Lastly, of concern is the apparently dismal engagement of the ICT fraternity in developing the HIS strategic plan. Stronger participation of the ICT board, local solution providers, and associations of ICT practitioners in such an ICT related domain is called for in the future. Such involvement of the domain experts will help to address the economic dimension which exists in the bigger picture of the country's vision 2030.

Dining with your predator – the essence development dynamics

It has been said, quite often that there is by far more talk about national paperwork on everything development than actual execution of development agenda in Kenya. Such paperwork will be called national strategy, national policy, national plan of operations, national assessment, national report and everything else national that can be put on paper. Of course developing the paperwork requires consensus building, which in turn requires government officers, bi lateral partners, UN bodies, solution vendors among other stakeholders to deliberate and dine in exotic hotels.

The stakeholder meetings will be called workshops, seminars, conferences, trainings, and any other name that represents a group of privileged people who do not normally meet at their routine work places to say the same things over and over again. Needless to say, participants of such meetings also have to draw a handsome allowance to facilitate the temporary displacement from their normal work station. The stakeholders will also get a chance to share the best and worst practices across their industry while consolidating positions in exclusive clubs of globe trotting workers - increasing their tallies in the frequency tables of global workshop participants.

Now, before you get me wrong, putting our paperwork right is always important and the consensus building meetings are indeed useful. The issue that our government officials of integrity should beware of though is the need to answer a question of - Which of the stakeholders / participants is really genuine? It is also the question of who else is seeking to contribute fairly in the execution of your most well thought, noble development agenda.

Is it the multi-lateral partners?
Common wisdom has it that that UN systems are really just inefficient bureaucracies of first class world citizens. The elite bodies and their exclusive clubs inevitably have armies of globe-trotting elitists enjoying tax contributions from member countries. Needless to say these elite members themselves hardly feel the burden of heavy taxation regimes like that of Kenya. Enjoying a handsome, untaxed pay is not bad after all for the well connected, hard working elite. However beware of the less genuine UN elite who will procure and connive with a vendor or a shrewd consultant to drive the weirdest of agendas for a host country.

Is it the bi-lateral partners
Bigger countries will always want to look like they are taking care of their smaller sisters in the developing world. The US in the name of USAID, PEPFAR, CDC or whichever other vehicle fronted as a Donor agency are set up to look after America's own interests. It is easy to be flattered, that we have a big brother offering a hand of support. Watch closely and you might see that their most genuine interests will boil down to some economic value to the big brother. It may not matter whether it is the Chinese – Kenya partnership, Japan and JICA, UK and DfID. They are innocently ensuring that some modern day imperialism is propagated to the future. When the spotlight reaches the real agenda they will say it is globalisation and we shall nod our heads in helpless concurrence. Such predatory patterns might be more obscure where intellectual property such as research data, software licences and royalties are at stake. Moreover, beware of paying too much attention to some under skilled or unprofessional individuals off-loaded to Africa with strange sounding titles such as Technical Advisers.

Is it the solution vendors?
Whether it is the software company representative, the training solutions provider, the hotel salesman, the travel company executive or the storage hardware provider ranting away, they remain nothing else but businessmen. No matter how elegant they sound about the pertinent issues, all they want is some revenue stream from your development agenda. The more perpetual the revenue stream looks for them the better of course. Wanting to do business with the government is not necessarily bad – as government should not really be the solutions provider to its people. However beware of those predators who will only see a perpetual revenue stream for their business, whether or not it helps you efficiently deliver on your noble mandate of actualizing your tax financed development projects. Furthermore beware of interesting deals, recently baptised Public, Private Sector Partnerships – PPP. No matter how innocently you look at them, for graft ridden developing economies like Kenya, you need to be an angel to execute a fraud free PPP initiative.

Or is it yourself?
And lastly for the most statistically represented predator, ourselves – you and I. Have you ever prioritised the country's development agenda higher than your new investment project, your MBA, your house under construction or your junior's school fees? I need not say more about these as genuine stakeholders – lest I get arrested for presenting white lies.

 Enjoy the week!