Amref Health Africa International Conference

24-26 November, 2014

Nairobi, Kenya

04/19/23 1

Assessment of Health Management Information System (HMIS) Performance at Health Facilities

of Afar Region, 2013

Presenter: Mesfin Ayeta

 

04/19/23 2

Presentation Outline

1. Background

2. Methods

3. Result and Discussion

4. Conclusion

5. Recommendation

04/19/23 3

In developing countries, the collection, compilation, analysis and utilization of health data remains to be practically major problem.

In Ethiopia, the HMIS is characterized by burdensome data collection and inadequate staff skill and also the information flow is fragmented (WHO, 2007).

This resulted in redundant and conflicting reports and poor quality of data in terms of accuracy and timelines.

04/19/23 4

Background

In Afar region, despite some improvements were observed; the problems on HMIS performance is still there.

However, there are not scientific evidences showing the possible determinants of HMIS performance in the region.

04/19/23 5

General Objective To assess the status of HMIS performance at health

facilities level and identify its determinant factors.

Specific Objectives To assess the status of HMIS performance at health

facilities

To find out challenges and best lessons of HMIS performance in health facilities

04/19/23 6

Objectives

Methods

Study Design A cross-sectional study design was carried out.

Data Source

Study Unit Health facilities

Service providers

Patients/Clients records

04/19/23 7

Sample Size Determination

The Sample size is calculated based on the study unit:

Health facility: Rule of thumb sampling method was used. The rule

states, if the number of units are less than 50, take a 30-50% sample.

Record Review: Single Population Proportion formula was used. 384

Individual records were reviewed.

Health Professionals: All the selected health facilities health workers. 04/19/23 8

Data collection instrument/Tools Interview using questionnaire

Observation using checklist Record review

Self-administrative Questionnaires

In-depth Interview

04/19/23 9

Data analysis SPSS version 20 was used to analyze quantitative data.

Tables, figures and frequencies

Logistic regression Thematic analysis for qualitative data

04/19/23 10

Results and Discussion

Description of Respondents

04/19/23

Variables Frequency

Respondent’s qualificationMD/HOclinical nurse/midwifePara medicals

4 (3.2%)80 (63.5%)42 (33.3%)

Responsibilities of RespondentsHead of facility and unitsClinical health service providersPara medicals

15 (11.9%)79 (62.7%)32(25.4%)

HIMIS Training Received Not received

40 (31.7%)86 (68.3%)

11

Existence of Performance Monitoring Team (PMT) and HMIS guideline

04/19/23

Present0%

20%

40%

60%

80%

PMTHMIS guideline

31%31%

69% 69%

12

Presence of HMIS focal person and Supervision at health facilities

04/19/23

Exist

Not exist

0%

20%

40%

60%

80%

HMIS focal person Supervision

71%65%

29% 35%

13

HMIS process and practice at Health facilities

04/19/23

Variables Frequency

Yes No I do not Know

Checking reports before sending to the next level?

Use standardized set of indicator

Send HMIS Report based on scheduled

Health facilities received written feedback on HMIS performance

41.7%

29.2%

12.5%

20.8%

35.4%

41.7%

87.5%

39.6%

22.9%

29.2%

37.5%

14

Knowledge, attitude, practice and motivation of the health personnel on HMIS performance

04/19/23

14.3%

85.7%

Knowledge

Adequate knowledge

Inadequate knowledge

15

Knowledge, attitude, practice and motivation of the health personnel in HMIS performance

04/19/23

11.1%

88.9%

Motivation

Better Motivated

Not motivated

16

04/19/23 17

Data quality of patent’s record

04/19/23 18

Health professionals culture of information use was found to be 37.3%.

Study in Jimma (2011) shows that utilization of health information was 32.9%.

In Tanzania (2011), 42% did not use the collected data for decision making process.

Study in Malawi (2005) revealed that that data is incomplete as there are gaps in the data collection tools.

04/19/23 19

Factors associated with information use for decision making process

Health professionals who work in Health facilities which established PMT were 2.83 times more likely to use information.

Health care providers who had positive attitude were 2.79 times more likely to use information.

Motivated Health professionals were 3.5 times more likely to use information than not motivated.

04/19/23 20

Study conducted in Nigeria (2012) shows motivated health professionals were more likely to use information for decision making process.

Similarly, India in 2007 shows establishment of PMT had showed significant association with health professional information use.

04/19/23 21

Conclusion

Data quality of HMIS tools were found to be very poor.

Information use habit of health workers for decision making were found to be very low.

Establishment of performance monitoring team, motivation and attitude health care providers were found to be significantly associated with information use.

04/19/23 22

Recommendation

The regional health bureau needs to design in-service trainings on information use culture and data quality.

The regional and district health offices should regularly give supportive supervision and technical assistants to health facilities

Regional and district health offices shall encourage, train and follow up health care providers to establish performance monitoring team.

Motivating health care providers and providing training on moral and ethical issues is recommended to improve information use for decision making.

04/19/23 23

THANK YOU!

04/19/23 24