Health Workers' Perceptions on Data-informed Decision-Makingpracticesin Primary Health Care Units at Awi Zone, Northwest Ethiopia

Background: Data-informed decision making is influenced by organizational, technical, and behavioral factors. Behavioral factors are the major contributing factors for data-informed decision-making practices. This study aimed to explore health workers' perceptions of data-informed decision making at primary health care units in Awi zone. Method: A cross-sectional qualitative study was undertaken to explore health workers' perceptions on the barriers of health data-informed decision-making practices. Eleven healthcare workers were purposively selected from primary hospitals, health centers and health posts. Medical doctors, nurses, midwifes and health extension workers were selected as key informants for the in-depth interview. The selected healthcare workers were asked about their perceptions that affect health data use practices. The data obtained was analyzed through thematic analysis using Open Code software. Analysis was performed using three themes namely, organizational, behavioral, and technical barriers of data-informed decision making. Results: All the health care workers including health extension workers utilized a data-informed decision-making practice at least once during their point of care. Five of the eleven key informants reported their data-informed decision-making practice as reviewing quality of facility data, while none of them reported data-informed decision-making practices for their monthly performance monitoring. Behavioral factors included negligence, workarounds, and skill gaps. Organizational factors included staff turnover and shortage of recording tools. Technical factors included high workloads which lead to data error and paper-based systems were considered major barriers to data-informed decision-making practices.

Research ethics policies and practices in health research institutions in sub-saharan African sountries: results of a questionnaire-based survey

Objective To describe the state of research ethics policies and practices in health research institutions in sub-Saharan African countries. Design A structured questionnaire was used to solicit information on research ethics from health research institutions. Setting Forty-two sub-Saharan African countries. Participants Key informants from the health research institutions. Main outcome measures Existence of institutional ethics review policies and mechanisms. Results About half (51) of respondent institutions reported having policies on research ethics and 58 had written policies requiring that researchers obtain informed consent of research participants. About one-third of respondent institutions (34) had established ethics review committees; 42 required that studies went through ethics review committees and 46 had linkages with national or regional ethics organisations. Regarding operating procedures for ethics review committees; 53 had adopted standard operating procedures. Less than one-quarter of respondent institutions reported having policies in place to monitor ongoing research. Of the institutions that monitored ongoing research; 34 did an annual ethical review and 74 required a periodic written report. Only 36 provided any type of ethics training for staff; including those conducting health research and those who were not members of the ethics review committee. Conclusions There are substantial gaps in the capacity of health research institutions in the WHO African Region to undertake ethical review of studies before; during and after studies conducted. There is a need to strengthen such capacity in order to ensure the well-being of individuals enrolled in studies and that of communities that host these studies