The HMIS in Zambia: a trace on the implementation steps

This document, published by the Central Board of Health of Zambia, describes the implementation of the country’s health management information system (HMIS) during 1995 to 2003, and considers the system’s achievements and the challenges facing it. The new HMIS was a response to weaknesses of the previous system, which was highly fragmented but with centralised data management. The aim was to establish a self sustaining monitoring and evaluation system that would improve decision making at all levels of the health care system with timely, valid and appropriate information.

Achievements of the new system included institutionalising data usage in district management; improved reporting timelines; and improved data quality. However, there were also a number of ongoing challenges. The design of the system was unfinished when implementation began; reporting systems were fragmented; and a review that was supposed to be carried out after two years never happened. Senior officials appeared too busy to undergo orientation on data use for decision-making, and it appeared difficult for some people to change the way they do business in order to make greater use of data. Other challenges included human resources problems, the lack of a clear monitoring and evaluation framework, and inadequate documentation.