Bridging the gaps in the Health Management Information System in the context of a changing health sector

Abstract

BackgroundThe Health Management Information System (HMIS) is crucial for evidence-based policy-making, informed decision-making during planning, implementation and evaluation of health programs; and for appropriate use of resources at all levels of the health system. This study explored the gaps and factors influencing HMIS in the context of a changing health sector in Tanzania.MethodsA cross sectional descriptive study was conducted in 11 heath facilities in Kilombero district between January and February 2008. A semi-structured questionnaire was used to interview 43 health workers on their knowledge, attitude, practice and factors for change on HMIS and HMIS booklets from these facilities were reviewed for completeness.ResultsOf all respondents, 81% had never been trained on HMIS, 65% did not properly define this system, 54% didn't know who is supposed to use the information collected and 42% did not use the collected data for planning, budgeting and evaluation of services provision. Although the attitude towards the system was positive among 91%, the reviewed HMIS booklets were never completed in 25% - 55% of the facilities. There were no significant differences in knowledge, attitude and practice on HMIS between clinicians and nurses. The most common type of HMIS booklets which were never filled were those for deliveries (55%). The gaps in the current HMIS were linked to lack of training, inactive supervision, staff workload pressure and the lengthy and laborious nature of the system.ConclusionsThis research has revealed a state of poor health data collection, lack of informed decision-making at the facility level and the factors for change in the country's HMIS. It suggests need for new innovations including incorporation of HMIS in the ongoing reviews of the curricula for all cadres of health care providers, development of more user-friendly system and use of evidence-based John Kotter's eight-step process for implementing successful changes in this system.

In Tanzania, The Many Costs Of Pay-For-Performance Leave Open To Debate Whether The Strategy Is Cost-Effective

“…However, before that implementation fewer than half of the facilities were compiling such reports, and these data were rarely reviewed or used for planning purposes. 28 Pay-for-performance served to motivate and stimulate the generation and use of data, but this process took time.When these costs were included, the total implementation costs doubled. Ideally, instead of relying on health workers to undertake data gathering and reporting, dedicated part-time staff members at lower-level facilities could be used.…”

“…However, prior to pay-for-performance, fewer than half of the facilities provided information to the HMIS. 28 The results are therefore presented with and without these data management costs.…”

Adoption of Integrated Healthcare Information System in Nairobi County: Kenyatta National Hospital versus Mater Hospital

“…At each level of the hospital organizational structure, health care information system has specific functions that require specific decisions to be made, intended ultimately to improve the health status of the patients. (Nyamtema, 2010;Locatelli, 2010).…”

Development of eHealth in Slovenia - Critical Issues and Future Directions

“…One of the fundamental tools that would allow for successful and effective tackling of challenges facing the slovenian health care system is the comprehensive informatization (Ministry of Health, 2005 and2008) representing one of the key long-term goals of public sector. Experience of the most developed countries shows that successful implementation of health care informatization projects is of immense strategic importance for further development of the health care system (chaudry et al, 2006;European commission, 2008 and but also displays important implications for the increase in social welfare (Bardhan & Thouin, 2013;WHO, 2009), economic growth (Goldzweig et al, 2009;Valeri et al, 2010) and development of information society (Nyamtema, 2010;Walsham, 2013). Majority of the existing information systems (IS) in Slovenian health care have been developed within individual health care organizations and are designed specifically to meet their own needs (Ministry of Health, 2008) while they are not adequately interoperable and do not provide complete, relevant and timely information (Ministry of Health, 2005).…”