HISP (Health information Systems Program) is a global network of people, entities and organisations that design, implement and sustain Health Information Systems.  As a network, HISP globally follows a participatory approach to support local management of healthcare delivery and information flows, and was established by the Department of Informatics at the University of Oslo.

HISP South Africa is a Section 21 not-for-profit non-governmental organisation (NPO/NGO) that specialises in the development and maintenance of health information systems – a member of the global HISP network. While we use computers and databases to capture and analyse information, we recognise that good paper-based data collection forms are the backbone for most computerised systems. Since our establishment in 2003, we have been innovating and implementing both paper-based and computerised systems for primary health care (PHC) and hospitals mainly in resource constrained settings.  We believe that health care data must be used for management purposes.  We support people who work at all levels in the health system hierarchy from data collectors in clinics and hospitals, to information managers and decision/policy makers at health district and national levels.

While our team is based across numerous centres in South Africa, we also support health information systems development in other countries in Africa. We have partnered with local organisations, universities, and ministries of health in Namibia, Botswana, Nigeria, Southern Sudan, Malawi, Zimbabwe, Zambia, Liberia, Uganda, DRC (in French) and in South East Asia (India and Myanmar), and through these partnerships have developed local teams of health information practitioners.

We have a staff compliment of more than 50 full time staff: – this interalia includes a software development team of 9, a database management team of 10, a health information systems support- and training team of 27 full time staff members. We are supported by a competent administrative team of 6 who oversee project budget allocations and funding.

Our staff have expertise in many facets of information systems and health care.  We have medical doctors, nurses, social scientists, computer experts and informatics staff who all work together in a team approach. The qualifications in our team include PHDs, Masters, Honours, and bachelor degrees in Informatics, computer programming, and nursing science.  Our team is led by a Medical Specialist who also holds a PhD in Information Management, and HISP management reports to a board of directors.

The Early Years

HISP(P) (then called the Health Information Systems Pilot Project, or HISPP) started as a Research and Development Pilot Project, in three health districts in Cape Town in 1994: Khayelitsha, Mitchells Plain, and Blaauwberg (South Peninsula was added 3 years later).   Key actors were the School of Public Health (University of the Western Cape), Department of Community Health (University of Cape Town), and the Norwegian Computing Centre (affiliated to Institute of Informatics, University of Oslo) – with general support from the Western Cape Department of Health and the National Department of Health.  Political and personal relations established between Norway and South Africa during the struggle against apartheid played a key role in initiating and shaping the project – several of the key players on the South African side had been in exile.  It was a new dawn for South Africa, and HISPP aimed to assist with designing efficient information systems that would support democratisation, decentralisation, and access to better health care for all in the spirit of the Alma Ata declaration.

HISP(P) initially focused on Community Information Systems and grassroots health committees, but after the upsets caused by local elections in 1995 focus shifted to integration processes and information systems within the Department of Health.  HISPP was involved in several successful projects and tool developments during the next 2-3 years – most importantly the District Health Information Software (DHIS) version 1.0 in early 1997.  The DHIS was adopted by the Western Cape Province in mid-97, by the Eastern Cape Province in Oct-98, and finally, as a national system in Feb-99 with rollout completed during 1999 and 2000 (now as version 1.3).  From late 2000 it was also piloted or adopted by other countries. The completely re-designed DHIS 1.4 was developed during 2003-04, which in turn formed the basis for the first version of the web-based DHIS2 from 2005-06.

NORAD (the Norwegian Agency for International Development) provided funding for the pilot phase (1994-98).  The USAID-funded EQUITY project under Management Sciences for Health (MSH) provided funding from 1999-2003 to what was now called the Health Information Systems Programme (HISP).  UCT was the administrative anchor from 1994-98 and UWC from 1999-2003.  The academic environment was vital for the HISP team of 6-10 people in those years, due to a number of related education and research programmes providing synergy as well as protection against bureaucratic interference from the government.  For several years UWC’s School of Public Health has hosted short courses in health information conducted by HISP facilitators; these have been attended by several hundred health information officers and health staff involved in management.  These courses arose as part of the educational aspect of the collaboration with UWC as well as need to provide training to the many people who were interested in DHIS and health information systems.

While the HISP team from the start formed alliances with the “movers and the shakers” within the Department of Health, it was frequently under attack from others who wanted more centralised control of DHIS development.

The HISP team re-organised itself as a not-for-profit company in 2003 (HISP-SA), mainly because their primary focus increasingly was software development and technical support (“consulting”) whereas UWC naturally prioritises education and research.  Tight links to UWC and other universities continued around training and research, though, and HISP nodes in a number of other DHIS-using countries are still university-based (the UiO DHIS2 core development team being the best known example).  After a hand-to-mouth existence during 2004-2007, HISP-SA stabilised through 2-3 year long Service Level Agreements with the National Department of Health from 2008 onwards.