IST-Africa 2011 Conference Proceedings
Paul Cunningham and Miriam Cunningham (Eds)
IIMC International Information Management Corporation, 2011
ISBN: 978-1-905824-24-3
Health Information Systems Integration in
Tanzania: Tapping the Contextual Advantages
Masoud MAHUNDI
1
, Jens KAASBØLL
2
, Hashim TWAAKYONDO
3
University of Dar es Salaam, P.O Box 35062, Dar es Salaam, Tanzania
1
Tel: +255 71 258337, Email: mmahundi@cs.udsm.ac.tz
3
Tel: +255 75 4386261, Email: hmtwaaky@yahoo.com
2
Department of Informatics, University of Oslo, P.O.Box 1080 Blindern, N - 0316 Oslo, Norway
Tel: +47 22852429, Fax: +47 22852401, Email: jens.kaasboll@ifi.uio.no
Abstract: Fragmentation has for long been a characteristic of Health Information
Systems (HIS) in the developing countries with many studies expounding about a
variety of drawbacks brought by the same. There have been, so far, many academic
fronts through which fragmentation has been addressed and this study addresses
fragmentation and eventually integration through the Vertical Health Programmes
(VHP) which, more than once, proved difficult in Tanzania. This work argues that
most of the initiatives towards integration did not optimally tape the contextual
advantages. Empirical data for this study have been extracted from an on-going
implementation of the project to strengthen Health Management Information System
in Tanzania, in which this qualitative study was involved in the three regions of
implementation. Data have been collected through supervision visits, meetings,
discussions, structured and unstructured interviews and observations. It was found
out that of the advantages is the existence of several shared elements across
programmes which only require streamlining to achieve integration. Reproductive
and Child Health programme, for example, shares 19 data elements with Malaria and
17 with Expanded Programme of Immunisation. There are also shared procedures
and routines and even donors. This work goes further into suggesting an approach
towards Integration
Keywords: integration, health information system, vertical health programmes
1. Introduction
There has been, for a while, a growing concern to the strengthening of Health Information
Systems (HIS) in Tanzania. This concern, however, has been relatively more pronounced
within intervention specific programmes (dubbed Vertical Health Programmes, VHP) than
outside. Revisions of Data collection tools for the Expanded Programme of Immunisation
(EPI) and the Reproductive and Child Health (RCH) services, and the M&E strengthening
for VCT and STI are some of the examples.
Initiatives to strengthen the HIS have therefore, for long, impliedly meant strengthening
the VHP’s information systems. Eventually, the HIS in Tanzania has been left fragmented,
leaving individual VHPs decide what kind of data they would like to collect, what are the
procedures to manage such information, the indicators to respond to, staff to process,
frequencies and the related affairs. The situation turned chaotic and the integration of these
programmes has, therefore, been deemed paramount by stakeholders.
Initiatives to integrate the health information systems in Tanzania are historic, and
because the Health Management Information System (HMIS) in Tanzania has been meant
to provide such integration, then the HMIS history suffices the background of integration
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