ABSTRACT
Background: Creating responsibility for quality healthcare data and utilization are among the basic functions of leadership. While the benefits of data quality and use are well known, the evidence around the role of healthcare information systems leadership and governance in sustaining data demand and use is limited. Therefore, this study aimed to investigate the level and contributing factors of health data quality and information use in Assosa district, Benishangule Gumuze Region. Methods: A mixed approach design, using qualitative exploration and a facility-based quantitative cross-sectional approach was used. Seventeen departments from two health facilities were enrolled for the quantitative component, while 28 in-depth interviews were conducted to complete the qualitative part of the study. A phenomenological approach was used to explore factors influencing the quality and use of health data. Quantitative data was analyzed descriptively using tables and graphs, whereas qualitative data was analyzed using content analysis guided by the framework for the social ecological model. Results: The average levels of information use and report accuracy were 38.6 and 119.33, respectively. Three themes emerged, explaining the main factors that influence quality data generation: individual characteristics, facility and environmental factors, and leadership and governance characteristics. Individual characteristics were motivation, capacity building, commitment, and digital literacy, while facility and environmental factors included infrastructure, healthcare information system resources and supportive supervision. Furthermore, among the leadership and governance related factors, healthcare data, assigning the right person, and system regulation were some of the factors which were identified. Conclusions: The level of health data quality and its utilization was low during the Asossa city adminstration. The unfriendly physical and organizational working environments and high staff turnover which negatively affected the leadership and governance of the health system are some of the reasons which were sighted with regards to the poor quality of data and information use. Therefore, interventions that have multifaceted effects on data quality and use, such as improving leadership and governance practices and behavior should be implemented. [Ethiop. J. Health Dev. 2022;36 (SI-1)]
Subject(s)
Humans , Health Status , Ecological Development , Immunoglobulin Variable Region , Total Quality ManagementABSTRACT
Background:Ethiopia utilisesthedistrict health information systemfor health information management. However,the lower level health structure seems inaccurate in comparisonto theparallel reportingsystem, withlimited evidence on its effect ondata quality and information use.Therefore,the present study aimed to assess the influence of a parallel reporting system on data quality and information use at the lower level structuresof the Amhara region, Northwest Ethiopia.Methods:The study was conducted in five districts of the Amhara region using an explanatory case study design. Twenty respondents were interviewed from the 1st30thApril 2021,usinga semi-structured key informant interview(KII)guide with multiple probes to explore relevant information. The data was transcribed into English and transferred to the Open-Code 4.02 software for analysis. Textual data werecoded, and themes were identified from the synthesis. Inductive thematic analysis was applied to identify the relationships among the emerging themes in order todraw a relevant conclusion. Results:Five themeswere emerged fromthe analysis, includingthe current practice of parallel reporting, a program area of parallel reporting, the influence of parallel reporting, reasonsfor parallel reporting,and means to avoid parallel reporting.Likewise, parallelreportingwasdone at the district level and at the point of service delivery. The respondents described maternal and child health programs often usingparallel reporting. Parallel reporting was described as havingundesirable impacts on routinely collected health data quality and use. Moreover, it increases the work burden; andaffects service quality,the the satisfactionlevelsof clients and staff, and the overall efficiency. The main reasons for practicingparallel reporting were:missing important data elements in DHIS2, single language, varying stakeholders' interests, and lack of conductinga partnerforum.Conclusion and implication:Against the national health information system'sguiding principlesand vision, parallelreporting is practicedat the lower health system levelsfor various programs. Therefore, a corrective measure should be taken to achieve the country's information revolution (IR) agenda. To avoid parallel reporting mechanisms, it is recommended that regular partner forums at the district level must be strengthened, important data elements should beincorporated into the DHIS 2, and additional language platforms should be be included in theDHIS2 system.