Routine health information utilization and associated factors among health care workers in Ethiopia: A systematic review and meta-analysis

Spatial distribution of zero-dose children in Ethiopia: evidence for a targeted intervention from a large-scale cross-sectional evaluation survey

Background

Ethiopia is the fourth leading contributor to the global total of zero-dose children (those who lack the first dose of diphtheria-tetanus-pertussis containing vaccine) and has substantial regional variations in zero-dose children. This study explored the spatial pattern of zero-dose children aged 12-35 months in Ethiopia.

Methods

A survey was conducted in pastoralist regions, developing regions, newly-established regions, conflict-affected areas, underserved urban populations, hard-to-reach areas, internally displaced populations, and refugees. Spatial autocorrelation was measured using the Global Moran'sIstatistic. Getis-Ord Gi* statistics was applied to calculate the spatial variability of the high and low prevalence rates of zero-dose children. The spatial interpolation technique was also applied to estimate unknown values that fall between known values. Inverse distance weighting interpolation method was used to predict the risk of zero-dose children. ArcGIS version 10.8 was used for the spatial analysis.

Results

A total of 3,646 children aged 12-35 months were included in the study. The spatial distribution of zero-dose children in Ethiopia was non-random (Global Moran'sI = 0.178971, p < 0.001). According to the hotspot analysis, western, eastern and northern parts of Somali and western and central parts of Afar regions had the highest load of zero-dose children (hotspot areas) followed by the Northeastern part of Amhara and southeastern part of Oromia regions. On the other hand, Southern Nations, Nationalities, and Peoples, Sidama, and the Eastern part of the Southwest Ethiopia peoples regions were identified as cold spot areas. The spatial interpolation analysis corresponded with the hotspot analysis results where western and central parts of Afar and western, eastern and northern parts of Somali regions were identified as high-risk areas for zero-dose children. However, Addis Ababa, Dire Dawa, Harari, Southern Nations, Nationalities, and Peoples, Sidama, Southwest Ethiopia Peoples, and parts of Oromia were found to be low-risk areas for zero-dose children.

Conclusion

The spatial analysis identified that zero-dose children had a significant spatial variation across the study areas. High clusters of zero-dose children were detected in Afar and Somali regions. Implementing routine and mop-up vaccination campaigns in the identified hotspot areas will help Ethiopia to improve coverage and reduce immunization inequalities.

District health information system (DHIS2) as integrated antimicrobial resistance surveillance platform: An exploratory qualitative investigation of the one health stakeholders' viewpoints in Ethiopia

INTRODUCTION

There is an unmet need for One Health (OH) surveillance and reporting systems for antimicrobial resistance (AMR) in resource poor settings. District health information system, version 2 (DHIS2), is a globally recognized digital surveillance platform which has not been widely utilized for AMR data yet. Our study aimed to understand the local stakeholders' viewpoints on DHIS2 as OH-AMR surveillance platform in Jimma, Ethiopia which will aid its further context specific establishment.

METHODS

We performed an exploratory qualitative study using semi-structured key informant interviews (KIIs) in Jimma Zone at Southwest Ethiopia. We interviewed 42 OH professionals between November 2020 and February 2021. Following verbatim transcription of the audio recordings of KIIs, we conducted thematic analysis.

RESULTS

We identified five major themes which are important for understanding the trajectory of OH-AMR surveillance in DHIS2 platform. The themes were: (1) Stakeholders' current knowledge on digital surveillance platforms including DHIS2. (2) Stakeholders' perception on digital surveillance platform including DHIS2. (3) Features suggested by stakeholders to be included in the surveillance platform. (4) Comments from stakeholders on system implementation challenges. (5) Stakeholders' perceived role in the process of implementation. Despite several barriers and challenges, most of the participants perceived and suggested DHIS2 as a suitable OH-AMR surveillance platform and were willing to contribute at their current professional roles.

CONCLUSIONS

Our study demonstrates the potential of the DHIS2 as a user friendly and acceptable interoperable platform for OH-AMR surveillance if the technology designers accommodate the stakeholders' concerns. Piloting at local level and using performance appraisal tool in all OH disciplines should be the next step before proceeding to workable format.

Utilization of health data and associated factors among department heads in public health facilities in Eastern Ethiopia: A cross-sectional study in Harari region

INTRODUCTION

Even though the information generated by routine health information systems is an essential element in the process of transforming the health sector, the information is systematically under-utilized by the health workers. Hence, this study was aimed to assess the utilization level and associated factors of routine health information system data among department heads in Eastern Ethiopia.

METHODS

The cross-sectional study design was conducted among heads of departments in the health facilities of Harari region. The source populations and the study populations were all department heads. The data were collected by standardized tools through interviews, observations, and document reviews. The data were entered into Epi Data version 3.1 and then exported to SPSS version 25 for analysis. Multivariable logistic regression was performed to identify the associated factors and P-value < 0.05 was used to declare the statistically significant association.

RESULT

Of the respondents, 51.8 % live in urban, 82.4 % participated in performance review meeting, 61.7 % received feedback, 80.6 % engage in HIS, and 91 % feel responsible to HIS. Routine health information system data utilization among department heads was 177 (79.7 %); 95 % CI: [73.8 %, 84.8 %] in the Harari region. Factors associated with data utilization were urban residence (AOR = 2.891; 95 %CI: 1.147-7.286), getting feedback (AOR = 3.136; 95 %CI: 1.311-7.499), active engagement in health information system activities (AOR = 2.560; 95 %CI: 1.010-6.490), participation in performance review meeting (AOR = 3.847; 95 %CI: 1.563-9.464), and feeling responsibility (AOR = 3.727; 95 %CI: 1.071-12.961).

CONCLUSION

Level of data use in this study was higher than the one in other studies in Ethiopia. Residence, feedback, level of engagement in health information system activities, sense of responsibility towards health information system, and performance review meeting were the determinants of data utilization. Important attention should be given by the officials at various levels to expand the information communication technology infrastructures and strengthen the feedback system.

Improving data use in decision-making and utilization of maternal healthcare services through a data-informed platform for health approaches in districts of the Gedeo Zone, southern Ethiopia, 2023: a cluster-randomized control trial

Background

In low-resource countries such as Ethiopia, the utilization of local data for planning and decision-making health systems was frequently constrained. In addition, despite several government initiatives, maternal health services were not completely utilized. On the other hand, efforts to effectively utilize the local data available to improve the utilization level of maternal healthcare services were insufficient, necessitating the need for a different approach.

Objective

This implementation study aims to test and validate the effectiveness of a data-informed platform for health (DIPH) strategies on data use for decision-making and utilization of maternal health services in districts of the Gedeo Zone, southern Ethiopia.

Methods

A two-arm parallel group, type II hybrid, cluster-randomized control trial design has been implemented to conduct the study between 1 September 2022 and 29 February 2024. Six woredas/districts have been assigned to the intervention arm and the other six to the control arm. Baseline and end-line data have been collected from 120 eligible health management staff (from both intervention arm and control arm). In the intervention arm, district health management staff have been given specialized training and continuous technical assistance as a package called the DIPH strategy by embedding it with the district's current decision-making platform such as Performance Review Team meetings. The DIPH strategy has mainly focused on five-step approaches such as situational assessment, stakeholder engagement, defining/setting priorities, planning, and follow-up. Health management staff in the control arm have performed their regular daily activities. The χ2 and t-tests have been used to check the effect of the intervention. In addition, difference-in-differences estimates have been calculated because the change may inherently occur over time. A P-value of <0.05 and a 95% confidence interval have been used to declare the significance of the intervention.

Discussion

The findings of this study were supposed to give insights into implementation strategies that improve data use in decision-making and utilization of maternal healthcare services at the woreda level and uncover contextual factors that boost the response of these strategies.

Health information use and associated factors among healthcare professionals in Ilu Aba Bor zone, Oromia region, Ethiopia: an institution-based cross-sectional study

BACKGROUND

Health information systems are essential for collecting data for planning, monitoring and evaluating health services. Using reliable information over time is an important aid in improving health outcomes, tackling disparities, enhancing efficiency and encouraging innovation. Studies on the level of health information use among health workers at the health facility level in Ethiopia are limited.

OBJECTIVES

This study was designed to assess the level of health information use and associated factors among healthcare professionals.

METHODS

An institution-based cross-sectional study was conducted among 397 health workers in health centres in the Iluababor zone of Oromia region in southwest Ethiopia, who were chosen using a simple random sampling technique. Data were collected using a pretested, self-administered questionnaire and an observation checklist. The Strengthening the Reporting of Observational Studies in Epidemiology reporting checklist was used to report the summary of the manuscript. Bivariable and multivariable binary logistic regression analysis was used to identify the determinant factors. Variables with a p value <0.05 at 95% CIs were declared significant.

RESULTS

It was found that 65.8% of the healthcare professionals had good health information usage. Use of Health Management Information System (HMIS) standard materials (adjusted OR (AOR)=8.10; 95% CI 3.51 to 16.58), training on health information (AOR=8.31; 95% CI 4.34 to 14.90), completeness of report formats (AOR=10.24; 95% CI 5.0 to 15.14) and age (AOR=0.4; 95% CI 0.2 to 0.77) were found to be significantly associated with health information use.

CONCLUSION

More than three-fifths of healthcare professionals had good health information usage. Completeness of report format, training, use of standard HMIS materials and age were significantly associated with health information usage. Ensuring the availability of standard HMIS materials and report completeness and providing training, particularly for newly recruited health workers are highly recommended to enhance health information usage.

Routine health information use among healthcare providers in Ethiopia: a systematic review and meta-analysis

INTRODUCTION

Healthcare policy formulation, programme planning, monitoring and evaluation, and healthcare service delivery as a whole are dependent on routinely generated health information in a healthcare setting. Several individual research articles on the utilisation of routine health information exist in Ethiopia; however, each of them revealed inconsistent findings.

OBJECTIVE

The main aim of this review was to combine the magnitude of routine health information use and its determinants among healthcare providers in Ethiopia.

METHODS

Databases and repositories such as PubMed, Global Health, Scopus, Embase, African journal online, Advanced Google Search and Google Scholar were searched from 20 to 26 August 2022.

RESULT

A total of 890 articles were searched but only 23 articles were included. A total of 8662 (96.3%) participants were included in the studies. The pooled prevalence of routine health information use was found to be 53.7% with 95% CI (47.45% to 59.95%). Training (adjusted OR (AOR)=1.56, 95% CI (1.12 to 2.18)), competency related to data management (AOR=1.94, 95% CI (1.35 to 2.8)), availability of standard guideline (AOR=1.66, 95% CI (1.38 to 1.99)), supportive supervision (AOR=2.07, 95% CI (1.55 to 2.76)) and feedback (AOR=2.20, 95% CI (1.30 to 3.71)) were significantly associated with routine health information use among healthcare providers at p value≤0.05 with 95% CI.

CONCLUSION

The use of routinely generated health information for evidence-based decision-making remains one of the most difficult problems in the health information system. The study's reviewers suggested that the appropriate health authorities in Ethiopia invest in enhancing the skills in using routinely generated health information.

PROSPERO REGISTRATION NUMBER

CRD42022352647.

Lessons Learned From the Capacity-Building and Mentorship Program to Improve Health Information Systems in 11 Districts of Ethiopia

Health information systems strengthening interventions, such as the capacity-building and mentorship program used, leverages the expertise of stakeholders from multiple disciplines and can help improve data quality and information use at health facilities.

Introduction:

Methods:

Results:

Discussion:

Health workers' use of routine health information and related factors at public health institutions in Illubabor Zone, Western Ethiopia

Background

Proper utilization of health data has paramount importance for health service management. However, it is less practiced in developing countries, including Ethiopia. Therefore, this study aimed to assess routine health information utilization and identify factors associated with it among health workers in the Illubabor zone, Western Ethiopia.

Methods

A facility based cross-sectional study was conducted from March to June 2021 with a total of 423 randomly selected health workers. Data were collected using an interviewer-administered questionnaire that was developed based on the performance of routine information system management (PRISM) framework. We created composite variables for health workers' knowledge, attitude, abilities, and information utilization based on existing data. Multivariate logistic regression analysis was performed and the statistical association between the outcome and independent variables was declared using 95% CI and a P < 0.05.

Results

About two-thirds or 279 health workers (66.0%, 95% CI 61.3, 70.4) had good health information utilization. Two-thirds of health workers think organizational decision-making culture (67.1%, 95% CI 62.6, 71.5) and facility managers' or supervisors' promotion of information use (65.5%, 95% CI 60.9, 69.9) are positive. Over half of health workers (57.0%, 95% CI 52.2, 61.6) have a positive attitude toward data management, and the majority (85.8%, 95% CI 82.2, 88.9) believe they are competent of performing routine data analysis and interpretation activities. Only about two-thirds of health workers (65.5%, 95% CI 60.9, 69.9) were proficient in data analysis and interpretation.

Conclusions

The use of routine health information was lower than the national target and data from other literatures. Unacceptably large number of health personnel did not use information. As a result, efforts should be made to increase health workers' data management knowledge and skills, as well as the organizational culture of data utilization.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12911-022-01881-y.

Utilisation of health management information and its determinant factors among health professionals working at public health facilities in North Wollo Zone, Northeast Ethiopia: a cross-sectional study

OBJECTIVE

The study aimed to assess health management information utilisation and associated factors among health professionals working at public health facilities in North Wollo Zone, Northeast Ethiopia.

SETTING

The study was conducted at public health facilities in the North Wollo Zone, Northeast Ethiopia.

PARTICIPANTS

A total of 664 (56.3% male and 43.7% female) health professionals participated in the study. All health professionals permanently working in North Wollo Zone were included in this study. However, health professionals who were not present during the data collection period by any means and who had less than 6 months of experience were not included in this study.

PRIMARY AND SECONDARY OUTCOME MEASURES

The main outcome measure was health management information utilisation.

RESULT

About 58.4% (n=388) (95% CI: 54.4% to 62.0%) of the study participants use health management information. The multivariable logistic regression model indicated that participants who had managerial positions are more likely to use health management information with an adjusted OR (AOR) of 3.11 and 95% CI 1.84 to 5.24. Similarly, having a good motivation level (AOR=4.42 (95% CI: 2.82 to 6.93)), perceived good culture of health information (AOR=6.17 (95% CI: 3.35 to 11.36)), a standard set of indicators (AOR=4.11 (95% CI: 2.65 to 6.38)), having good governance of health information system (AOR=1.75 (95% CI:1.13 to 2.72)) and health management information system (HMIS) training (AOR=3.10 (95% CI: 1.89 to 5.07)) were the predictors positively associated with higher utilisation of health management information.

CONCLUSION

This study revealed that utilisation of health management information was still inadequate. Enhancing motivation, building a culture of information use, having standardised indicators, strengthening the governance of health information systems and comprehensive HMIS training were measures to be taken to improve utilisation of health management information in this study setting.