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.

The Influenceof Parallel Reporting SystemsonData Quality and Information Use in Northwest Ethiopia: Qualitative Study

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.