Adoption of integrated human resources for health information system (iHRIS) tool at district level to improve health care workers’ planning and distribution in Malawi

Background: Lack of evidence to inform Human Resources for Health (HRH) decisions contributes to inequitable HRH planning and distribution globally, affecting countries’ progress towards universal health coverage and sustainable development. Adoption of HRH models and information systems to address this has been slow in developing countries with partially decentralized health systems. Malawi also plans to roll out integrated Human Resources Information System (iHRIS) at district level to enhance availability of HRH information, as evidence for equitable HRH decisions, improved HRH density and Universal Health Coverage (UHC). This review discussed the applicability of iHRIS adoption in Malawi; and how and whether its use can address the inequitable HRH planning and distribution in Malawi context.Methods: A total of 363 international and local literatures from 2010 to 2022 were identified using a broad range of engines including Thammasat online library and Academic ultimate search. 53 were finally included in this systematic review, through a defined selection criterion.Findings: Districts have limited influence over data use and HRH decisions in partially decentralized health systems such as Malawi. Inequitable HRH planning and distribution is contributed by not only lack of evidence but also lack of corresponding models for responsive HRH projections. additionally, varying data management support and capacity across public and non-public health institutions; more focus on data entry than use; and inefficient data coordination at sub-national levels would limit quality and interoperability of iHRIS data and would defeat the whole purpose for iHRIS.Conclusion: Inequitable HRH planning and distribution of HRH is as a result of factors beyond just the unavailability of HRH information. Comprehensive HRH data should be considered as one of the means and not the single needed solution for inequitable HRH distribution. To achieve equitable HRH for UHC, other strategies such as responsive HRH projection models, substantial devolvement of authority for decision making in decentralized health systems like Malawi, development of Community Health Workers, and sustained support for HRH, would also be useful, along iHRIS.