Department of Global Health, University of Washington, Seattle, Washington, USA
Department of Child, Family, & Population Health Nursing, University of Washington, Seattle, Washington, USA.
BMJ Glob Health. 2024 Aug 16;9(8):e014970. doi: 10.1136/bmjgh-2024-014970.
Routine health information systems (RHISs) are an essential source of data to inform decisions and actions around health facility performance, but RHIS data use is often limited in low and middle-income country contexts. Determinants that influence RHIS data-informed decisions and actions are not well understood, and few studies have explored the relationship between RHIS data-informed decisions and actions.
This qualitative thematic analysis study explored the determinants and characteristics of successful RHIS data-informed actions at the health facility level in Mozambique and which determinants were influenced by the Integrated District Evidence to Action (IDEAs) strategy. Two rounds of qualitative data were collected in 2019 and 2020 through 27 in-depth interviews and 7 focus group discussions with provincial, district and health facility-level managers and frontline health workers who participated in the IDEAs enhanced audit and feedback strategy. The Performance of Routine Information System Management-Act framework guided the development of the data collection tools and thematic analysis.
Key behavioural determinants of translating RHIS data into action included health worker understanding and awareness of health facility performance indicators coupled with health worker sense of ownership and responsibility to improve health facility performance. Supervision, on-the-job support and availability of financial and human resources were highlighted as essential organisational determinants in the development and implementation of action plans. The forum to regularly meet as a group to review, discuss and monitor health facility performance was emphasised as a critical determinant by study participants.
Future data-to-action interventions and research should consider contextually feasible ways to support health facility and district managers to hold regular meetings to review, discuss and monitor health facility performance as a way to promote translation of RHIS data to action.
常规卫生信息系统（RHIS）是为医疗机构绩效提供决策和行动依据的重要数据来源，但 RHIS 数据的使用在中低收入国家的情况下往往受到限制。影响 RHIS 数据驱动决策和行动的决定因素尚未得到充分理解，很少有研究探讨 RHIS 数据驱动决策和行动之间的关系。
这项定性主题分析研究探讨了莫桑比克医疗机构层面 RHIS 数据驱动行动的决定因素和特征，以及哪些决定因素受到综合区域证据到行动（IDEAs）策略的影响。在 2019 年和 2020 年，通过与参与 IDEAs 增强审计和反馈策略的省级、地区和医疗机构级管理人员以及一线卫生工作者进行 27 次深入访谈和 7 次焦点小组讨论，收集了两轮定性数据。性能常规信息系统管理-行动框架指导了数据收集工具和主题分析的制定。
将 RHIS 数据转化为行动的关键行为决定因素包括卫生工作者对医疗机构绩效指标的理解和认识，以及卫生工作者改善医疗机构绩效的主人翁意识和责任感。监督、在职支持以及财务和人力资源的可用性被强调为制定和实施行动计划的基本组织决定因素。研究参与者强调，定期作为一个小组开会审查、讨论和监测医疗机构绩效是一个关键的决定因素。
未来的数据到行动干预和研究应考虑在具体情况下支持医疗机构和地区管理人员定期开会的可行方法，以审查、讨论和监测医疗机构绩效，从而促进 RHIS 数据转化为行动。
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