Allocating resources at an overcrowded hospital

To prioritize budgets and patient needs, a pediatrician helps health workers analyze an “overwhelming” amount of data from a new electronic system.
Dar es Salaam, Tanzania

Background

Dr. Omari Mahiza is a pediatrician at Amana Regional Referral Hospital. Situated in the Ilala District at the heart of Dar Es Salaam, Amana primarily serves young children, pregnant woman, and the elderly. While there are two other regional referral hospitals in Dar Es Salaam, Amana receives the largest number of patients daily. This is mainly because of its unique location right in the middle of the city; Amana serves not only patients in its district, but also those living in neighboring districts—including Temeke, a DREAMS priority district with high rates of HIV/AIDS prevalence. Due to this fact, quality of care has become a challenge, with low resources and high demand. Dr. Omari met the Data Zetu team during a big transition at the hospital, when a new electronic health management information system (eHMIS) was being rolled out to streamline and digitize data collection.

Problem

Dr. Omari shared several challenges with the DZ team, including lack of resources (since funds allocation is determined by the population of the hospital’s district, without considering the huge number of patients that flow into Amana from other districts) and low visibility into priority diseases to control (since diseases of Amana patients aren’t a true reflection of the diseases that are predominant in the districts the hospital is meant to serve).

The new eHMIS could in theory help address some of those challenges, such as by providing more consistent data collection and data digitization. But Dr. Omari and Data Zetu identified an even more pressing issue: Even if the eHMIS rolls out successfully, health workers still lack skills to critically analyze and engage with that data. In his words:

Solution

In 2017 Dr. Omari attended a “summer camp” organized by the School of Data, a global network committed to advancing data literacy in civil society. The summer camp connected Tanzanian Mandela Washington Fellows—a distinguished group of young leaders—with global data literacy experts, conducting practical trainings on the skills necessary to make effective use of data.

The hope of this summer camp was to provide a foundation of basic trainings that these leaders could share with their own organizations, to amplify better use of data. In Dr. Omari’s case, the solution to his challenge at Amana hospital was to share these skills with his health workers and technicians who operate the new eHMIS system.

Process

The weeklong summer camp at the Tanzania Data Lab (dLab) consisted of trainings on practical data skills, such as working with spreadsheets to analyze information and producing visuals to share key insights with decision makers. These curricula are open-source, so people like Dr. Omari can return to their institutions to reuse and share them.

More crucially, it provided networking opportunities with other young leaders and data ambassadors. This is important because data champions like Dr. Omari can feel isolated when working in complex institutions like Amana Hospital, where it can be intimidating to navigate political and technical challenges to encouraging use of data. This is partially why Data Zetu convened a meeting of young data ambassadors, as a follow-up to the summer camp, at the dLab in December 2017, which Dr. Omari attended as well.

Outcomes and Impact

Dr. Omari reports several significant changes that were sparked or supported by the summer camp and subsequent Data Zetu engagements:

• Collecting the right data: After discovering data collection examples and opportunities at the summer camp, Dr. Bakari instructed his colleagues to collect more consistent data about patients’ addresses. In his words, as a result, “The hospital was able to justify the increase in allocation of funds that it has been demanding by showing the extra load of patients it handles outside its targeted population.”
• Training data clerks: With just the short summer camp activity, Dr. Omari was equipped to share his skills with 5 other data clerks at Amana Hospital. In his words, “the knowledge acquired from the School of Data has made it possible to breakdown the large volume of data, analyze it and come out with actionable parameters.” The Hospital has already budgeted next year to cascade these trainings to other staff.
• More informed health decisions: Armed with stronger skills to engage with the eHMIS data, “it has also become possible to know the exact number of patients coming outside the targeted population for the hospital. Details such as disease predominance over certain regions and age groups accounting for most admissions or deaths are now possible to ascertain.”
• More efficient resource allocation: In his words: “The hospital now uses data as the main determinant of the allocation of very limited resources such as nurses and doctors, hospital funds and medical equipment. This has made the distribution of these resources very efficient.”

¹ https://medium.com/data-zetu/fostering-a-global-community-of-youth-data-ambassadors-e6a7edcd76a0

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