To assess the improvement in the health information system in the district Nowshera by integrating the data reporting of the Expanded Program on Immunization (EPI) and Lady Health Worker (LHW) programs in the existing system. Methodology The study was conducted at district Nowshera and Swabi, Pakistan between May 2015 and May 2016 for a duration of one year. The data collection instruments used in the study were adapted from the Performance of Routine Information System Management (PRISM) tool package. The study was conducted in three phases during a period of one year. The first three months were utilized for baseline assessment. The next six months were being used for implementing the integration of the EPI and LHW, and the next three months were being used for the post-intervention evaluation. Microsoft Excel software was used to enter and analyze the data. A p < 0.05 was considered as the cutoff value for significance. Results The results indicated that the integration of data from the EPI and LHW with that of the existing Health Information System (HIS) is possible and has the potential for improving the existing system. The least significant results were produced by the use of information, which depicts that the utilization of data in decision making or policy making is still needed to be improved. Moreover, we reported a lack of enforcement and regulation by the authorities in monitoring the feedback system in the HIS. Conclusion The current study revealed significant improvements in the use of information, data quality, and behavior of staff. It is essential to properly train the team on how to operate the District Health Information System (DHIS) to gain adequate and timely data on health status and determinants. Additionally, the integration would benefit in managing the data at not only the national level but at the district level too.
BackgroundAdolescents and providers can benefit from practical tools targeting lifestyle modification for obesity prevention and management. We created Conversation Cards for Adolescents© (CCAs), a patient-centered communication and behavior change tool for adolescents and providers to use in clinical practice. The purpose of our study is to (i) assess the feasibility of CCAs in a real-world, practice setting to inform full-scale trial procedures, (ii) assess user experiences of CCAs, and (iii) determine the preliminary effect of CCAs on changing behavioral and affective-cognitive outcomes among adolescents.MethodsStarting in early 2019, this prospective study is a nested mixed-methods, theory-driven, and pragmatic pilot randomized controlled trial with a goal to enroll 50 adolescents (13–17 years old) and 9 physicians practicing at the Northeast Community Health Centre in Edmonton, Alberta, Canada. Adolescents will collaboratively set one S.M.A.R.T. (specific, measurable, attainable, realistic, timely) goal with their physician to implement over a 3-week period; however, only those randomized to the experimental group will use CCAs to inform their goal. Outcome assessments at baseline and follow-up (3 weeks post-baseline) will include behavioral, affective-cognitive, and process-related outcomes.DiscussionIn examining the feasibility, user experiences, and preliminary effect of CCAs, our study will add contributions to the obesity literature on lifestyle modifications among adolescents in a real-world, practice setting as well as inform the scalability of our approach for a full-scale effectiveness randomized controlled trial on behavior change.Trial registrationClinicalTrials.gov Identifier: NCT03821896.
Objective: To evaluate the general status and functioning of health information system (HIS) in district Nowshera. Methodology: An observational study was conducted in district Nowshera Khyber Pakhtunkhwa, Pakistan between June 2015-2016.The study population included all districts, health information system (HIS) health workers in Khyber Pakhtunkhwa. District Nowshera was selected for the purpose on non probability sampling technique. The data collection instruments used in this study was adapted from the PRISM tool package that was modified for the purpose of this study. Results: A total of 30 health facilities of District Nowshera were assessed for Quality of Data and Use of Information through DHIS Diagnostic Tool. 60% of the health facilities compile DHIS data and 93% do not get feedback from DHO office. 94% of the health facilities have not displayed map of their catchment areas. 87% of the health facilities do not arrange meetings regarding the managerial issues. Regarding the use of information, no documentation is available in any health facility of the district. The DHIS workers were assessed and interpreted according to the scale of Mann-Whitney-U method. The organizational and behavioral assessment was done which was statically insignificant. Conclusion: There is an immediate need to install the system wide up gradation of technology and software. The manageable data would help the health personnel and managers to formulate the policies that would be helpful in up grading the standard of HIS and a universal HIS should be operated throughout the province.
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