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Madebo MM, Elitro YO, Sundako BB, Anore AJ, Ashegire M, Funga ML, Lalore MT, Samuel A. Practice of district health information data for decision making and associated factors among performance monitoring team at Hadiya Zone Public Health Facilities SNNPR, Ethiopia. PLOS DIGITAL HEALTH 2024; 3:e0000552. [PMID: 39102380 PMCID: PMC11299812 DOI: 10.1371/journal.pdig.0000552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 06/18/2024] [Indexed: 08/07/2024]
Abstract
BACKGROUND Evidence based practice is a key tool to increase effectiveness and efficiency of healthcare providers worldwide and using health facility data at all levels is vital. But, it is poorly practiced in developing countries including Ethiopia. As a result, the purpose of this study was to evaluate the level of practice of District Health Information for decision making and associated factors among performance monitoring teams in Hadiya Zone public health facilities, South Nation Nationality People Republic, Ethiopia, in 2022. METHODS A facility based-cross sectional study was employed from May 3 to June 3, 2022. To obtain data, a pre-tested structured questionnaire with qualitative was employed. A multistage random sampling technique was employed to select performance monitoring team from public health facilities. Data was entered into a computer using Epi data version 4.6, and analyzed using SPSS version 25. Bivariable and multivariable analyses were used to identify determinants related to practice of district health information. For the qualitative section, thematic analysis was used. RESULTS The practice of district health information for decision making among performance monitoring team in this study was 48% (95% CI: [42.3, 54.1]). having standard sets of indicators [AOR = 4.055; 95% CI: (1.67, 9.86)], Being trained [AOR = 3.12; 95%CI: (1.385, 7.023)], having internet access [AOR = 3.23; 95% CI: (1.52, 6.9)], having positive attitudes [AOR = 2.667; 95% CI: (1.28, 5.56)], having low motivation [AOR = 0.202; 95% CI: (0.081, 0.504)], Sufficient skill [AOR = 3.239: 95%CI; (1.328, 8.164)] and having knowledge [AOR = 6.227; 95% CI: (2.12, 12.8)] were significantly associated with practice of District health information for decision making. CONCLUSION In general, this study found that the performance monitoring team at health facilities poorly practiced district health information. It requires major improvement to provide a consistent set of indicators, training, internet access, user attitudes, motivation, and necessary skills and knowledge, as well as to raise users' confidence in DHIS2.
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Affiliation(s)
| | | | | | - Adimasu Jemal Anore
- Health Informatics Technician Department, Hosanna College of Health Sciences, Hosanna, Ethiopia
| | - Muluken Ashegire
- Health Informatics Technician Department, Hosanna College of Health Sciences, Hosanna, Ethiopia
| | | | | | - Abriham Samuel
- Emergency Medical Technician Department, Hosanna College of Health Sciences, Hosanna, Ethiopia
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Taye BK, Gezie LD, Atnafu A, Mengiste SA, Kaasbøll J, Gullslett MK, Tilahun B. Effect of Performance-Based Nonfinancial Incentives on Data Quality in Individual Medical Records of Institutional Births: Quasi-Experimental Study. JMIR Med Inform 2024; 12:e54278. [PMID: 38578684 PMCID: PMC11031696 DOI: 10.2196/54278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 01/20/2024] [Accepted: 02/05/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND Despite the potential of routine health information systems in tackling persistent maternal deaths stemming from poor service quality at health facilities during and around childbirth, research has demonstrated their suboptimal performance, evident from the incomplete and inaccurate data unfit for practical use. There is a consensus that nonfinancial incentives can enhance health care providers' commitment toward achieving the desired health care quality. However, there is limited evidence regarding the effectiveness of nonfinancial incentives in improving the data quality of institutional birth services in Ethiopia. OBJECTIVE This study aimed to evaluate the effect of performance-based nonfinancial incentives on the completeness and consistency of data in the individual medical records of women who availed institutional birth services in northwest Ethiopia. METHODS We used a quasi-experimental design with a comparator group in the pre-post period, using a sample of 1969 women's medical records. The study was conducted in the "Wegera" and "Tach-armacheho" districts, which served as the intervention and comparator districts, respectively. The intervention comprised a multicomponent nonfinancial incentive, including smartphones, flash disks, power banks, certificates, and scholarships. Personal records of women who gave birth within 6 months before (April to September 2020) and after (February to July 2021) the intervention were included. Three distinct women's birth records were examined: the integrated card, integrated individual folder, and delivery register. The completeness of the data was determined by examining the presence of data elements, whereas the consistency check involved evaluating the agreement of data elements among women's birth records. The average treatment effect on the treated (ATET), with 95% CIs, was computed using a difference-in-differences model. RESULTS In the intervention district, data completeness in women's personal records was nearly 4 times higher (ATET 3.8, 95% CI 2.2-5.5; P=.02), and consistency was approximately 12 times more likely (ATET 11.6, 95% CI 4.18-19; P=.03) than in the comparator district. CONCLUSIONS This study indicates that performance-based nonfinancial incentives enhance data quality in the personal records of institutional births. Health care planners can adapt these incentives to improve the data quality of comparable medical records, particularly pregnancy-related data within health care facilities. Future research is needed to assess the effectiveness of nonfinancial incentives across diverse contexts to support successful scale-up.
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Affiliation(s)
- Biniam Kefiyalew Taye
- Department of Health Informatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Ministry of Health, The Federal Democratic Republic of Ethiopia, Addis Ababa, Ethiopia
| | - Lemma Derseh Gezie
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Asmamaw Atnafu
- Department of Health System and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | | | - Jens Kaasbøll
- Department of Informatics, University of Oslo, Oslo, Norway
| | - Monika Knudsen Gullslett
- Faculty of Health & Social Sciences, Science Center Health & Technology, University of South-Eastern Norway, Notodden, Norway
| | - Binyam Tilahun
- Department of Health Informatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Asaduzzaman M, Mekonnen Z, Rødland EK, Sahay S, Winkler AS, Gradmann C. District health information system (DHIS2) as integrated antimicrobial resistance surveillance platform: An exploratory qualitative investigation of the one health stakeholders' viewpoints in Ethiopia. Int J Med Inform 2024; 181:105268. [PMID: 37972481 DOI: 10.1016/j.ijmedinf.2023.105268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 10/16/2023] [Accepted: 10/20/2023] [Indexed: 11/19/2023]
Abstract
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.
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Affiliation(s)
- Muhammad Asaduzzaman
- Department of Community Medicine and Global Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, Norway.
| | - Zeleke Mekonnen
- School of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Ernst Kristian Rødland
- Department of Climate and Environmental Health, Norwegian Institute of Public Health, Norway
| | - Sundeep Sahay
- Department of Informatics, University of Oslo, Norway
| | - Andrea Sylvia Winkler
- Centre for Global Health, Faculty of Medicine, University of Oslo, Norway; Center for Global Health, Department of Neurology, Faculty of Medicine, Technical University of Munich, Germany
| | - Christoph Gradmann
- Department of Community Medicine and Global Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, Norway
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Abdisa AB, Hajito KW, Daka DW, Ergiba MS, Senay AB, Abdi KL, Wordofa MA. Health workers' use of routine health information and related factors at public health institutions in Illubabor Zone, Western Ethiopia. BMC Med Inform Decis Mak 2022; 22:140. [PMID: 35610716 PMCID: PMC9131521 DOI: 10.1186/s12911-022-01881-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 05/16/2022] [Indexed: 11/10/2022] Open
Abstract
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.
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Simba D, Sukums F, Kumalija C, Asiimwe SE, Pothepragada SK, Githendu PW. Perceived Usefulness, Competency, and Associated Factors in Using District Health Information System Data Among District Health Managers in Tanzania: Cross-sectional Study. JMIR Form Res 2022; 6:e29469. [PMID: 35604763 PMCID: PMC9171597 DOI: 10.2196/29469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 07/14/2021] [Accepted: 12/27/2021] [Indexed: 11/25/2022] Open
Abstract
Background Tanzania introduced District Health Information Software (version 2; DHIS2) in 2013 to support existing health management information systems and to improve data quality and use. However, to achieve these objectives, it is imperative to build human resource capabilities to address the challenges of new technologies, especially in resource-constrained countries. Objective This study aimed to determine the perceived usefulness, competency, and associated factors in using DHIS2 data among district health managers (DHMs) in Tanzania. Methods This descriptive cross-sectional study used a quantitative approach, which involved using a self-administered web-based questionnaire. This study was conducted between April and September 2019. We included all core and co-opted members of the council or district health management teams (DHMTs) from all 186 districts in the country. Frequency and bivariate analyses were conducted, and the differences among categories were measured by using a chi-square test. P values of <.05 were considered significant. Results A total of 2667 (77.96%) of the expected 3421 DHMs responded, of which 2598 (97.41%) consented and completed the questionnaires. Overall, the DHMs were satisfied with DHIS2 (2074/2596, 79.83%) because of workload reduction (2123/2598, 81.72%), the ease of learning (1953/2598, 75.17%), and enhanced data use (2239/2598, 86.18%). Although only half of the managers had user accounts (1380/2598, 53.12%) and were trained on DHIS2 data analysis (1237/2598, 47.61%), most claimed to have average to advanced skills in data validation (1774/2598, 68.28%), data visualization (1563/2598, 60.16%), and DHIS2 data use (1321/2598, 50.85%). The biggest challenges facing DHMs included the use of a paper-based system as the primary data source (1890/2598, 72.75%) and slow internet speed (1552/2598, 59.74%). Core members were more confident in using DHIS2 compared with other members (P=.004), whereas program coordinators were found to receive more training on data analysis and use (P=.001) and were more confident in using DHIS2 data compared with other DHMT members (P=.001). Conclusions This study showed that DHMs have appreciable competencies in using the DHIS2 and its data. However, their skill levels have not been commensurate with the duration of DHIS2 use. This study recommends improvements in the access to and use of DHIS2 data. More training on data use is required and should involve using cost-effective approaches to include both the core and noncore members of the DHMTs. Moreover, enhancing the culture and capacity of data use will ensure the better management and accountability of health system performance.
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Affiliation(s)
- Daudi Simba
- Department of Community Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, United Republic of Tanzania
| | - Felix Sukums
- Directorate of Information and Communication Technology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, United Republic of Tanzania
| | - Claud Kumalija
- Health Management Information System Unit, Ministry of Health, Community Development, Gender, Elderly and Children, Dodoma, United Republic of Tanzania
| | - Sarah Eden Asiimwe
- The Global Fund to Fight HIV, Tuberculosis and Malaria, Geneva, Switzerland
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