Level of health data quality and information use, and contributing factors in the Benishangul Gumuze Region, west Ethiopia: using social ecological framework

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)]

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.

Inequalities in health care utilization for common childhood illnesses in Ethiopia: evidence from the 2011 Ethiopian Demographic and Health Survey.

BACKGROUND: Globally, 5.9 million children under the age of five died in 2015. More than half and almost one-third of those deaths occurred in sub-Saharan Africa and South Asia, respectively. Diarrhea and Pneumonia, which were the major causes of the problem, accounted for more than two million deaths of the world's youngest children every year. Like other developing countries, child health services utilization is low in Ethiopia. The aim of this study was to identify the determinant factors for the inequalities in medical treatment seeking behavior for common childhood illnesses in Ethiopia. METHODS: Data were obtained from the Ethiopian Demographic and Health Survey (EDHS) 2011. All children who had diarrhea, cough, and fever in the 2 weeks preceding the survey were included. A total of 1620 children with diarrhea, 2082 with fever, and 2134 with cough were included in the analyses. Multivariate logistic regression with a 95% confidence interval, adjusted odds-ratio, and a P < 0.05 were used to determine the independent effect of each variable. RESULTS: Household wealth-status, maternal and paternal education, and religion were found to be associated with the inequality in the use of child health services. Respondents from households with the richest, richer, and middle wealth status had higher odds of seeking medical treatment for childhood diarrhea, cough, and fever than that of the poorest ones. Maternal and paternal educational status was also associated with medical treatment seeking behavior for childhood diarrhea and fever, respectively. CONCLUSION: Household wealth and educational status of parents were possible determinant factors for the inequalities observed in health care seeking behavior. Policy interventions aimed at improving the appropriate medical treatment seeking behavior for common childhood illnesses are desirable. Practical economic policies aimed at moving those in the lower wealth quintile are essential to bridge the gap between the rich and the poor. Studies comprising qualitative and quantitative methods are recommended to further explore other determinants of health care utilization.