The Effect of Community Health Information System on Health Care Services Utilization in Rural Ethiopia

BACKGROUND: The Health Extension Program (HEP) was introduced in 2003 to extend primary health care services by institutionalizing the former volunteer-based village health services. However, this program is not comprehensively evaluated. MATERIALS AND METHODS: The 2019 comprehensive national assessment of HEP involved (1) assessment through quantitative and qualitative primary data, (2) a thorough systematic review of the HEP literature, and (3) a synthesis of evidence from the two sources. The assessment included household survey(n=7122), a survey of health extension workers (HEWs) (n=584) _, and an assessment of health posts (HPs)(n=343) and their supervising health centers (HCs)(n=179) from 62 randomly selected woredas. As part of the comprehensive assessment. OUTPUT AND RESULTS: The outputs were (a) full and abridged reports, (b) 40 posters, (c) seven published, three under review scientific papers and (d) seven papers in this special issue. During the one-year period preceding the study, 54.8% of women, 32.1% of men, and 21.9% of female youths had at least a one-time interaction with HEWs. HPs and HEWs were universally available. There were critical gaps in the skills and motivation of HEWs and fulfillment of HP standards: 57.3% of HEWs were certified, average satisfaction score of HEWs was 48.6%, and 5.4% of HPs fulfilled equipment standards. CONCLUSIONS: The findings informed policy and program decisions of the Ministry of Health, including the design of the HEP Optimization Roadmap 2020­2035 and the development Health Sector Transformation Plan II. It is also shared with global community through published papers.

Communication model enhancement using electronic health record standard for tertiary hospital

Background: Communication of patient information in a healthcare setting in previous years was based on documented information on paper records carried from one location to another. However, with the introduction of electronic health records (EHRs), communications are now conducted electronically via installed and connected computer systems that are networked together. Inadequate communication of patients' information can deter patients' health and threaten their lives, putting them in unnecessary danger. Objective: The objective of this study was to design a standard EHR template model of communication for tertiary hospital that can be used in communicating patients' information between various departments involved in the management of patients without carrying papers around or tossing Patients or their relatives up and down. Method: The research adopts soft system methodology (SSM) with communication concepts from knowledge management, combining observations with various practical information to make a conclusion based on past experiences through a process of inductive reasoning, a communication model was developed that can be used as a template for hospitals to upgrade/integrate paper-based patient information management to electronic based in a bid to enhance patient care and information management. Results: The developed communication template model has been designed to be adopted for use in a bid to manage patients' information electronically in all tertiary hospitals and other hospitals that may so desire its use. Conclusion: It is observed from this article that communication in hospitals through EHR template is user friendly, safe and possible within the hospital and to outside facilities for effective paperless management of patients.

Health workers with good self-perceived competency have lower actual competency levels on HIS in Eastern Ethiopia: A cross-sectional study

Introduction: Utilization of health information is critical to meeting service performance goals and for making informed decisions. However, in resource limited countries, health data is rarely used in decisions around program improvements. This study aimed to assess the determinants of competency levels for health workers who utilized data from health information systems in Eastern Ethiopia. Methods:A cross-sectional study was carried out from April -May 2021 at selected public health facilities in the Dire Dawacityand Harar regions. A total of 129 health professionals were included in the study and simple random sampling techniques were used to select health facilities. Data was collected using face-to-face interviews and competency levels were measured using a tool adapted from the Performance of Routine Information Systems Management (PRISM) framework. STATA version 16 was used for data analysis. A linear regression model was applied to determine the linear relationship between self-perceived competency and the actual competency levels of the healthcare workers.Adjusted beta (ß) along with a 95% confidence interval (CI) was used to measure the strength of the association with a p-value < 0.05. Results:The overall mean for the actual competency levels of health workers who utilized data was 20.45 [95% CI: 16.71, 24.19]. Being head of a hospital/health center (ß: 19.24, 95% CI: 4.42, 34.06), perusing HIS training (ß: 14.38, 95% CI: 6.10, 22.67) and good perceived competency to perform RHIS tasks (ß: -12.96, 95% CI: -25.49, -0.43) were significantly associated with actual competency levels.Conclusion:The Health workers with high perceivedcompetency levels were found to have actual competency levels that were low. Health information systemfocused trainings were found to be positively associated with actual competency levels and being a hospital or health center head was found to be associated negatively to the actual competency levels of health workers. This research has found that providing health information system training for health workers could prove to be beneficial. There is also a need for initiatives aimed at enhancing competency in order to improve the health information systems related competency levels and data use.[Ethiop. J. Health Dev. 2022;36(SI-1)]

Atlas of African health statistics 2022: Health situation analysis of the WHO African Region

The population of the World Health Organization's (WHO) African Region was estimated to be 1 120 161 000 in 2020 and about 14.4% of the world's population of 7 758 157 000. It was 8 billion in 20211 . It is the third largest population among the WHO regions after South-East Asia and the Western Pacific. Between 2019 and 2020, the population differential was equivalent to that of a state of more than 28 million inhabitants. The five most populated countries account for more than 45% of the Region's population. Among these, Nigeria and the Democratic Republic of the Congo represent about 50% of the population of the West African and Central African subregions, respectively, and Ethiopia represents about 20% of the population of the East and Southern Africa subregions. The average annual population growth in Africa was 2.5% in 2020. If the heterogeneity of the population growth between the regions of the world and between countries in the same subregion is considered, countries from and East and Southern Africa subregions seem to have lower population growth rates than countries in other large subregions, which show significantly higher increases. The current population density of Africa is low, estimated to be 36 inhabitants per km2 for the whole continent. However, many areas are uninhabitable and some countries have relatively large populations. High population density is a concern that must be addressed through policies, because it could generate surges and high concentrations of populations in mega cities and urban slums, which can be an issue when it comes to accessing various qualitative services. Gross domestic product (GDP) reflects a country's resources and therefore its potential to provide access to services to its people, particularly health services. This dynamic creates a circle, with healthier people going to work and contributing to the production of wealth for the benefit of the country. The most vulnerable people live from agriculture in rural areas, or in conflict-affected states. Difficulties in accessing health services, low education and inequalities between men and women are additional obstacles to poverty reduction. The population of sub-Saharan Africa is expected to almost double over the next three decades, growing from 1.15 billion in 2022 to 2.09 billion in 2050. The world's population is expected to grow from 7.94 billion at present to 8.51 billion in 2030 and 9.68 billion in 2050. The demographic dividend2 for African countries will emanate from the acceleration of economic growth following a de crease in fertility with a change in the structure of the age pyramid where the active population, that is those aged 18­65 years, will be more important, reaching a certain optimum to make positive the ratio between the population able to finance health and education systems and the population that benefits from these systems. This is the human capital for development at a given moment. The demographic dividend appears to be an opportunity and an invitation to action, but it is also a real challenge, that of creating sustainable jobs to generate the development to activate the economic growth lever.

Atlas of African Health Statistics 2022: Health situation analysis of the WHO African Region - Country profiles

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Atlas des statistiques sanitaires africaines 2022: Analyse de la situation sanitaire de la Région africaine ­ Profils Pays

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Accelerating implementation of district health information systems: perspectives from healthcare workers from KwaZulu-Natal, South Africa

Background: Although electronic health record systems are critical for healthcare management, there has been genuine concern about the quantity and quality of data generated by these systems inhibiting its full implementation. Objectives: The purpose of this article was to explore the experiences of healthcare workers (HCWs) and challenges facing the acceleration of the District Health Information System (DHIS) in the KwaZulu-Natal (KZN) province of South Africa. Methods: In this study, an interpretive research paradigm was followed to explore the current state of electronic health in South Africa from the experiences of HCWs in the KZN province. Semi-structured focus group interviews conducted with 20 participants drawn from the district office, clinical nurse practitioners and data capturers allowed thematic analysis of data using a systems approach to link the perspectives HCWs to the design of the DHIS. Results: The participants held the view that e-health is crucial for monitoring disease trends, policy development, planning and allocation of infrastructure, information technology (IT), financial and human resources. Nevertheless, the participants highlighted a concern surrounding e-health regulations, ethics and data confidentiality; data quality and lack of interoperability of Health Information Systems (HIS). This concern was attributed to data fragmentation, internal politics and lack of coordination of the data system. Conclusions: The study suggests that good quality data ­ from an integrated DHIS, is highly critical for the effective utilisation, implementation and acceleration of e-health systems in the province to support epidemiological surveillance and modelling of outbreaks, such as the COVID-19 pandemic.

Building a COVID-19 repository website for healthcare professionals in Ethiopia

Health professionals dealing with the COVID-19, both in clinical care and in the public health domain, require up-to-date and relevant scientific information. The Diaspora and Ethiopian Advisory Councils on the COVID-19 pandemic in Ethiopia joined forces with the Ethiopian Medical Association to create a local repository of compre-hensive peer-screened information on COVID-19. We describe the motivating factors for such a repository, the process of creating the website, and the utilization of this information resource for Ethiopian healthcare professionals.

Information needs of men for early detection of prostate cancer in IDEMILI-north local government area, Anambra state, Nigeria

The research is a study of information needs of men for early detection of prostate cancer. This study adopted descriptive survey research design. The sample for the study comprised two hundred (200) men drawn from ten Catholic Churches in ten towns of Idemili-North, Anambra State. The instrument for data collection was structured questionnaire. The data obtained were analyzed using percentages and mean ratings. The major findings include that men have a serious need for information on early detection measures, particularly on knowledge of possible warning signs of prostate cancer. Men access information on prostate cancer mainly through television programmes and health centres. Men prefer certain media for effective propagation of prostate cancer such as Health centres, Town hall meetings, church meetings and men's group meetings. The hindrance factors on access to prostate cancer information are all related to absence of functional library services as well as lack of adequate information mechanisms. The study recommends that the government should make prostate cancer information propagation an enforceable integral part of the healthcare delivery system as well as set up awareness campaign committee to strategically implement it.

Resources, indicators, data management, dissemination and use in health information systems in Sub-Saharan Africa: results of a questionnaire-based survey

OBJECTIVE:To describe the status of health information systems in 14 sub-Saharan African countries of the World Health Organization African Region.DESIGN:A questionnaire-based survey.SETTING:Fourteen sub-Saharan African countries of the African Region.PARTICIPANTS:Key informants in the ministries of health, national statistics offices, health programmes, donors and technical agencies.MAIN OUTCOME MEASURES:State of resources, indicators, data sources, data management, information products, dissemination and use of health information.RESULTS:The highest average score was in the identification and harmonisation of indicators (73%), reflecting successful efforts to identify priority indicators and reach international consensus on indicators for several diseases. This was followed by information products (63%), which indicated the availability of accurate and reliable data. The lowest score (41%) was in data management, the ability to collect, store, analyse and distribute data, followed by resources - policy and planning, human and financial resources, and infrastructure (53%). Data sources (e.g. censuses, surveys) were on average inadequate with a score of 56%. The average score for dissemination and use of health information was 57%, which indicated limited or inadequate use of data for advocacy, planning and decision-making. CONCLUSIONS:National health information systems are weak in the surveyed countries and much more needs to be done to improve the quality and relevance of data, and their management, sharing and use for policy-making and decision-making

Health information systems in Africa: descriptive analysis of data sources, information products and health statistics

Objective To identify key data sources of health information and describe their availability in countries of the World Health Organization (WHO) African Region. Methods An analytical review on the availability and quality of health information data sources in countries; from experience; observations; literature and contributions from countries. Setting Forty-six Member States of the WHO African Region. Participants No participants. Main outcome measures The state of data sources; including censuses; surveys; vital registration and health care facility-based sources. Results In almost all countries of the Region; there is a heavy reliance on household surveys for most indicators; with more than 121 household surveys having been conducted in the Region since 2000. Few countries have civil registration systems that permit adequate and regular tracking of mortality and causes of death. Demographic surveillance sites function in several countries; but the data generated are not integrated into the national health information system because of concerns about representativeness. Health management information systems generate considerable data; but the information is rarely used because of concerns about bias; quality and timeliness. To date; 43 countries in the Region have initiated Integrated Disease Surveillance and Response. Conclusions A multitude of data sources are used to track progress towards health-related goals in the Region; with heavy reliance on household surveys for most indicators. Countries need to develop comprehensive national plans for health information that address the full range of data needs and data sources and that include provision for building national capacities for data generation; analysis; dissemination and use

Information systems for monitoring the burden of chronic diseases in public reference health facilities in Rwanda; Burundi and Eastern DRC

Chronic diseases are an increasingly important cause of death in sub-Saharan Africa. Diseases such as cancer; diabetes and arterial hypertension remained for years in the background; in the shadow of pandemics such as malaria; HIV / AIDS and tuberculosis. In the past 6 years; 4 reference hospitals of Kisangani; Bukavu; Kigali and Bujumbura implemented hospital information systems enabling sophisticated analysis of the diagnostic variance of out-patient visits and in-patient admissions. Important volumes of chronic disease data have been collected in a period between 2006 and 2012; demonstrating that the problem of chronic diseases also grows rapidly in the Great Lakes region and therefore urgent steps must be taken; both by governments (Rwanda; DRC and Burundi); by the international donor community and by local hospital boards

How Effective is the 2012 Maternal; Newborn and Child Health Week (MNCHW) in River State?

Nigeria is one of the countries noted to have made insufficient progress towards the attainment of the health-related MDGs. Experience has however shown that a few cost-effective interventions that can be delivered in resource poor settings; through family/community-level action and schedulable population-oriented services; are able to rapidly attain these goals. This was the basis of the Maternal; Newborn and Child Health Week (MNCHW) in Nigeria; designed to achieve rapid population coverage of chosen interventions; within the one week period of the programme. This study assessed the effectiveness of the week held in Rivers State; in June 2012. of the LGAs; while iron and folate tablets were given to just 2.86Materials and Methods: The data for the assessment was collected through on-the- spot observations; three semi-structured questionnaires; and the final summaries of the week; provided by the State Ministry of Health. The questionnaires were administered in nine health centers; in three randomly selected LGAs. The first questionnaire was used to assess the extent of the social mobilization carried out for the week; the second was an exit interview of clients of the health facilities; and used to assess the success of the social mobilization campaign; while the third questionnaire was used to assess the availability of the intervention commodities; and the quality of care given to the clients.Results: The social mobilization campaign for the week was poorly funded and did not have much effect; as only 28.57 of the clients of the health facilities were aware of the week. Most of the commodities for the week; except the NPI vaccines and vitamin A; were not available in the required quantities. Long Lasting Insecticide-treated Nets (LLINs) and Sulphadoxine-Pyrimethamine (SP) were not available in 65.22 of the LGAs; family planning commodities were not available in 30.43 of the LGAs; family planning commodities were not available in 30.43 of the LGAs; while iron and folate tablets were given to just 2.86 of the LGAs; while iron and folate tablets were given to just 2.86 of the targeted total. The coverage rate of the vaccines ranged from 1.29 recorded with the measles vaccine; to the 14.85; for the DPT vaccine. The coverage with vitamin A of 43.41; for the DPT vaccine. The coverage with vitamin A of 43.41 was the highest of all the interventions; while the 0.36 coverage for family planning commodities was the least.Conclusions: The MNCHW in Rivers State did not meet the stated objectives. Efforts should be made to leverage on the political will of the current government of the State for health programmes

Application of the Information; Motivation and Behavioural Skills Model for Targeting HIV Risk Behaviour amongst Adolescent Learners in South Africa

This paper discusses the application of an information; motivation and behavioural skills (IMB) model in a school-based programme for the reduction of HIV risk behaviour among 259 Grade 11 learners in two high schools in Alexandra township; Johannesburg. School 1 was the Experimental group; while School 2 was the Control group. After a baseline study (Time 1) at both schools; a 3-week intervention programme was conducted at School 1. A post-test (Time 2) was conducted at both schools. The intervention was repeated at School 2; followed by another post-test (Time 3) at both schools. A final test (Time 4) was conducted at both schools. While there were positive changes in the levels of HIVetAIDS IMB in learner participants; these changes may not be entirely attributed to the intervention. If an IMB model-based intervention is to be maximally effective in reducing HIV-risk behaviour among adolescents; it must focus on the behavioural; structural and socio-cultural contexts in which adolescents live

Sensitivity of hospital-based surveillance for severe disease: a geographic information system analysis of access to care in Kilifi district, Kenya

Objective To explore the relationship between homestead distance to hospital and access to care and to estimate the sensitivity of hospital-based surveillance in Kilifi district; Kenya. Methods In 2002-2006; clinical information was obtained from all children admitted to Kilifi District Hospital and linked to demographic surveillance data. Travel times to the hospital were calculated using geographic information systems and regression models were constructed to examine the relationships between travel time; cause-specific hospitalization rates and probability of death in hospital. Access to care ratios relating hospitalization rates to community mortality rates were computed and used to estimate surveillance sensitivity. Findings The analysis included 7200 admissions (64 per 1000 child-years). Median pedestrian and vehicular travel times to hospital were 237 and 61 minutes; respectively. Hospitalization rates decreased by 21per hour of travel by foot and 28per half hour of travel by vehicle. Distance decay was steeper for meningitis than for pneumonia; for females than for males; and for areas where mothers had less education on average. Distance was positively associated with the probability of dying in hospital. Overall access to care ratios; which represent the probability that a child in need of hospitalization will have access to care at the hospital; were 51-58for pneumonia and 66-70for meningitis. Conclusion In this setting; hospital utilization rates decreased and the severity of cases admitted to hospital increased as distance between homestead and hospital increased. Access to hospital care for children living in remote areas was low; particularly for those with less severe conditions. Distance decay was attenuated by increased levels of maternal education. Hospital-based surveillance underestimated pneumonia and meningitis incidence by more than 45and 30; respectively

HIV/AIDS Knowledge; Behaviour and Beliefs Among South African University Students

Globally; South Africa has the highest prevalence of HIV/AIDS. In the absence of cure; prevention is the only available method to reduce HIV prevalence rates. This can only be obtained through behavioural change; which is associated with a good knowledge about HIV. The study aims to determine the knowledge; beliefs; behaviours and sources of HIV and AIDS information among university students at two tertiary institutions in South Africa. The study was a quantitative; cross-sectional; descriptive and comparative survey. Students from the Western Cape Province and the KwaZulu-Natal Province participated in the study. The main findings of the study were that althoughstudents had an adequate general knowledge on HIV/AIDS; both groups scored the lowest in the transmission modes of HIV. The media was the main source of HIV/AIDS information for students and university health care facilities need to be more proactive in informing students about the transmission of HIV/AIDS