The availability of an accurate and complete health facility list is fundamental in producing quality and timely data that is sufficient to aid evidence-based decisions, resource allocation, and planning within the healthcare ecosystem.
The Health Management Information System (HMIS) ecosystem in Mozambique comprises several subsystems. As part of MOH eHealth Strategy, the HMIS team played a central role toward the development of the interoperability layer with the aim of facilitating information sharing and exchange across these subsystems. One of the very first steps of this process was the need to align the lists of health facilities that were handled by these subsystems.
In Mozambique, there were data sharing and access issues that led to a need for creating a master list of all facilities. These challenges included having multiple versions of facility lists in circulation, each with varying information including; different health facility unique identifiers, non-standardized coding, incomplete or inaccurate data. There were also difficulties in accessing and using facility list data. Additionally, there were needs for a categorization of health services. Mozambique knew that they not only needed an accurate and accessible list, but there was a need to ensure that the data could be shared across different systems (interoperability).
The development of the Master Facility List (MFL) aims to organize the health units by the area where they are located, but fundamentally, to show the type of services they are providing to the target population. The existence of numerous health facilities does not necessarily mean that they are all providing certain health services. Hence, the existence of a Master Facility List helps decision-makers to:
- know exactly what services the health unit provides;
- know the performance of each health unit on the different health programs;
- know the coverage of services in relation to the target population.
Saudigitus (HISP Mozambique)
University of Oslo
Availability & Interoperability
A national MFL has been in place and available to the general public. An API that allows access to the MFL is also available and the HMIS unit has been providing access to it to several organizations that are working within the interoperability projects.
There are future plans to work with the University of Oslo to explore this process with other countries. Each country is unique and will need to identify their current situation and prioritize their needs for facility data. This means that there is more to learn from this process in how other countries operate currently and what the pathway to success looks like. It’s most important to explore the environment in each country in order to build the best system.
The goal in establishing a national Master Facility List (MFL) was to compile a complete, up-to-date, authoritative list of the health facilities in the country and include details about services at the facility. Ownership of this list was also an important item to define. Having an owner of this list is what categorizes it as a “master” list. One authority was needed to maintain it to standard mechanisms for updates and validations.
Two user roles were defined for the creation of the MFL: The Provincial Level Administrators who captures and edits the details of the facility site; and the National Level Administrators who review, confirm, and approve the data and how it holds up to the standards.
To address registration requests of the facilities, a Subnational Level Administration Module was created to help manage requests for the creation of an organizational structure in the system. A similar system, the National Level Administration Module, was created to allow system administrators for approval of requests.
To manage access and availability of data in the MFL, separate roles and access were created for “Internal Users” and “External Users”. Internal Users can view the facility and facility site data, have an extended view, and can export facility data into excel – all of which requires authentication by this user. External Users have more limitations in the MFL. The public portal was developed to expose that approved MFL to the external users who have the possibility of exporting to excel and use it in their systems.
- Facility planning and management, including unique identification of facilities
Health Issues Addressed
- Healthcare Administration – Facilities
- Query health worker and/or facility records workflow