Department of Health Informatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
BMC Med Inform Decis Mak. 2021 Dec 31;21(1):373. doi: 10.1186/s12911-021-01741-1.
The health management information system has been implemented at all levels of healthcare delivery to ensure quality data production and information use in Ethiopia. Including the capacity-building activities and provision of infrastructure, various efforts have been made to improve the production and use of quality health data though the result is still unsatisfactory. This study aimed to examine the quality of health data and use in Wogera and Tach-Armacheho districts and understand its barriers and facilitators.
The study utilized a mixed-method; for the quantitative approach, institution-based cross-sectional study was conducted to determine the quality of health data and use by 95 departments in the two districts. The qualitative approach involved 16 in-depth interviewees from Wogera district. A descriptive Phenomenological design was used to explore factors influencing the quality and use of health data. The quantitative data were expressed descriptively with tables, graphs, and percent whereas the qualitative data were analyzed with content analysis guided by the social-ecological model framework.
The average levels of information use for Wogera and Tach-Armacheho districts were estimated at 29 and 35.9, respectively. The overall average level of accuracy of reports for six different health services in the HCs of Wogera and Tach Armacheho districts were 0.95 and 0.86, respectively. The qualitatively identified factors that influence the production and use of quality health data include valuing data, getting staff training, being a patriotic staff, and getting supportive supervision, were identified from individual-level characteristics; similarly, coaching, supportive supervision, and peer-to-peer learning from relational/interpersonal level characteristics, and organizational culture, incentive, infrastructure establishing accountability, and staff turnover, were identified from organizational level characteristics.
The quality of data and routine information utilization was low and were influenced by a number of actors presented in and around the health system including individual, interpersonal, and organizational characteristics. Incentive affects data quality and information use directly or indirectly after modifying factors at all levels of the social-ecological model. Therefore, interventions should gear towards addressing multiple social-ecological factors of the health system concomitantly or intervene on incentive which has a multifaceted effect on the outcome.
健康管理信息系统已在各级医疗服务中实施,以确保在埃塞俄比亚生成高质量的数据并使用信息。包括能力建设活动和基础设施的提供,已经做出了各种努力来提高高质量卫生数据的生成和使用,但结果仍不尽如人意。本研究旨在检查沃格拉和塔查-阿姆拉赫霍地区的卫生数据质量和使用情况,并了解其障碍和促进因素。
本研究采用混合方法;在定量方法方面,对两个地区的 95 个部门进行了基于机构的横断面研究,以确定卫生数据的质量和使用情况。定性方法包括来自沃格拉区的 16 名深入访谈者。采用描述性现象学设计来探讨影响卫生数据质量和使用的因素。定量数据用表格、图表和百分比进行描述性表示,而定性数据则根据社会生态模型框架进行内容分析。
沃格拉和塔查-阿姆拉赫霍地区的信息使用平均水平分别估计为 29%和 35.9%。沃格拉和塔查阿姆拉赫霍地区卫生中心的六种不同卫生服务报告的总体准确性平均水平分别为 0.95 和 0.86。从个体特征中确定了影响卫生数据质量生成和使用的因素,包括重视数据、获得员工培训、成为爱国员工和获得支持性监督;同样,从人际关系/人际层面的特征中确定了辅导、支持性监督和同伴学习,以及从组织层面的特征中确定了组织文化、激励、基础设施建立问责制和员工流动。
数据质量和常规信息利用程度较低,受到卫生系统内外的多个因素的影响,包括个人、人际关系和组织特征。激励通过修改社会生态模型各层次的因素,直接或间接地影响数据质量和信息利用。因此,干预措施应针对卫生系统的多个社会生态因素同时进行,或针对激励因素进行干预,激励因素对结果有多方影响。