Assessment of Hmis Design and Implementation in Ethiopia: The Case of Selcted Public Health Facilities in Addis Ababa Health Bureau
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Date
2012-06
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Addis Ababa University
Abstract
Background: To facilitate informed local decision-making it is necessary to implement health management information system to timely and accurately provide each level of the health sector with the necessary information. In the interests of improving health sectors, the Ethiopian government has engaged in the sector reform, including a process of decentralizing decision-making and budgetary power to the district levels.
Objectives: The purpose of this study was to assess HMIS Design and Implementation in selected Public Health facilities of Addis Ababa Health Bureau, Ethiopia. The study attempted to determine the status of HMIS implementation and the use of HMIS generated information for health care delivery planning and decision making at different level of the health sector.
Methodology: In this study, a cross-sectional study was conducted at Addis Ababa, Ethiopia from December to June 2012. The research methods used were both qualitative and quantitative. The sample size of the study was 258. Data was collected through open and closed-ended questionnaires, observation and analysis of certain documents, and secondary data from selected reports of facilities obtained from Addis Ababa health bureau. SPSS version16 software was used to analyze quantitative data. Correlation was used as a statistical method to identify the association between selected variables and quality of HMIS data and Pearson’s correlation coefficient with two tailed test of significance was used to determine the strength of association.
Results: The general implementation of HMIS in the study area covered all (100%) of health facilities and administrative units. Availability of adequate HMIS unit staff at health facilities was not up to the need of health facilities. The use of HMIS generated information for health care delivery planning and decision making in the study area was found to be 78%.
The major identified problems related with the design of the current system used for HMIS were; Prevention Mother To Child Transmission (PMTCT) and Volunteer Counseling and Testing (VCT) for 1 to 4 age was not included, the analysis part of the existing system doesn’t include further statistical analysis it only show charts, blank space for unregistered diseases was not available, the recently included HMIS indicators for some disease were not included, and problem of registration by the professionals due to inconveniency of the HMIS formats.The study also identified the major problems of the current HMIS data collection and reporting tools. It was found that data collection tools at Outpatient Department (OPD) and Antiretroviral Therapy (ART) were not quite adequate, work burden on the professionals due to most of the tools had similar attributes, data collection using tally sheets was not suitable for professionals, and the line spacing of data collection tools was not suitable were reported as the major problems of the existing HMIS data collection and reporting tools.
Knowledge of HMIS concept, frequency of training and accountability of concerned bodies has a statistically significant association with quality of HMIS data. The finding of the study also identified that duration of supervision and availability of HMIS focal person did not have a statistically significant association with quality of HMIS data.
Conclusions: The study concludes that; health facilities need to be furnished with adequate HMIS resources, and qualified human resources required at HMIS unit. The design of the existing system used for HMIS and the data collection tools needs to be modified and customized to support the needs of the professionals by incorporating the problems identified by this research. Duration of supervision, followed by availability of HMIS focal person, did not result into a significant improvement of the quality of HMIS data, thus guideline for capacity building program of the staff have to be developed by following the strength of association identified by this and other related studies with quality of HMIS data.
Keywords
Health Management Information system, Implementation, Design, Data quality
Description
Keywords
Health Management Information system, Implementation, Design, Data quality