Department of Public Health, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon.
Challenges Initiative Solutions, Yaoundé, Cameroon.
BMC Med Inform Decis Mak. 2020 Dec 17;20(1):339. doi: 10.1186/s12911-020-01357-x.
Routine Health Information Systems (RHIS) of low-income countries function below the globally expected standard, characterised by the production and use of poor-quality data, or the non-use of good quality data for informed decision making. This has negatively influenced the health service delivery and uptake. This study focuses on identifying the factors associated with the performance of RHIS of the health facilities (HF) in Yaoundé, so as to guide targeted RHIS strengthening.
A HF-based cross-sectional study in the 6 health districts (HDs) of Yaoundé was conducted. HFs were chosen using stratified sampling with probability proportional to size per HD. Data were collected, entered into Microsoft Excel 2013 and analysed with IBM- SPSS version 25. Consistency of the questionnaire was measured using Cronbach's alpha coefficient. Pearson's chi-square (and Fisher exact where relevant) tests were used to establish relationships between qualitative variables. Associations were further quantified using unadjusted Odd ratio (OR) for univariable analysis and adjusted odds ratio (aOR) for multivariable analysis with 95% confidence interval (CI). A p-value of less than 0.05 was considered statistically significant.
Of 111 selected HFs; 16 (14.4%) were public and 95 (85.6%) private. Respondents aged 24-60 years with an average of 38.3 ± 9.3 years; 58 (52.3%) males and 53(47.7%) females. Cronbach's alpha was 0.96 (95%CI: 0.95-0.98, p < 0.001), proving that the questionnaire was reliable in measuring RHIS performances. At univariable level, the following factors were positively associated with good performances: supportive supervision (OR = 3.03 (1.1, 8.3); p = 0.02), receiving feedback from hierarchy (OR = 3.6 (0.99, 13.2); p = 0.05), having received training on health information (OR = 5.0 (1.6, 16.0); p = 0.003), and presence of a performance evaluation plan (OR = 3.3 (1.4, 8.2), p = 0.007). At multivariable level, the only significantly associated factor was having received training on health information (aOR = 3.3 (1.01, 11.1), p = 0.04).
Training of health staff in the RHIS favors RHIS good performance. Hence, emphasis should be laid on training and empowering staff, frequent and regular RHIS supervision, and frequent and regular feedback, for an efficient RHIS strengthening in Yaoundé.
低收入国家的常规卫生信息系统 (RHIS) 的运作低于全球预期标准，其特点是数据质量差，或者是无法将高质量数据用于知情决策。这对卫生服务的提供和利用产生了负面影响。本研究旨在确定与雅温得卫生设施 (HF) 的 RHIS 绩效相关的因素，以便为有针对性地加强 RHIS 提供指导。
在雅温得的 6 个卫生区 (HD) 进行了一项基于 HF 的横断面研究。使用每个 HD 按比例概率大小的分层抽样选择 HF。使用 Microsoft Excel 2013 收集数据并输入数据，然后使用 IBM-SPSS 版本 25 进行分析。使用 Cronbach's alpha 系数衡量问卷的一致性。使用 Pearson's chi-square（和相关的 Fisher 确切检验）检验来确定定性变量之间的关系。使用未调整的优势比 (OR) 进行单变量分析，并使用 95%置信区间 (CI) 进行多变量分析调整后的优势比 (aOR)。p 值小于 0.05 被认为具有统计学意义。
在选定的 111 家 HF 中；16 家（14.4%）为公立，95 家（85.6%）为私立。受访者年龄在 24-60 岁之间，平均年龄为 38.3±9.3 岁；58 名男性（52.3%）和 53 名女性（47.7%）。Cronbach's alpha 为 0.96（95%CI：0.95-0.98，p<0.001），证明该问卷在衡量 RHIS 绩效方面具有可靠性。在单变量水平上，以下因素与良好表现呈正相关：支持性监督（OR=3.03（1.1，8.3）；p=0.02）、从上级获得反馈（OR=3.6（0.99，13.2）；p=0.05）、接受过卫生信息培训（OR=5.0（1.6，16.0）；p=0.003）和有绩效评估计划（OR=3.3（1.4，8.2）；p=0.007）。在多变量水平上，唯一具有显著相关性的因素是接受过卫生信息培训（aOR=3.3（1.01，11.1）；p=0.04）。
培训卫生工作人员使用 RHIS 有利于 RHIS 的良好表现。因此，应注重培训和赋权工作人员、频繁和定期的 RHIS 监督以及频繁和定期的反馈，以加强雅温得的 RHIS。
