Strengthening the national health information system through a capacity-building and mentorship partnership (CBMP) programme: a health system and university partnership initiative in Ethiopia.

BACKGROUND: A strong health information system (HIS) is one of the essential building blocks for a resilient health system. The Ministry of Health (MOH) of Ethiopia is working on different initiatives to strengthen the national HIS. Among these is the Capacity-Building and Mentorship Partnership (CBMP) Programme in collaboration with public universities in Ethiopia since November 2017. This study aims to evaluate the outcomes and share experiences of the country in working with universities to strengthen the national HIS. METHODS: The study employed a mixed-methods approach that included 247 health organizations (health offices and facilities) of CBMP-implementing woredas (districts) and 23 key informant interviews. The programme focused on capacity-building and mentoring facilities and woreda health offices. The status of HIS was measured using a connected woreda checklist before and after the intervention. The checklist consists of items related to HIS infrastructure, data quality and administrative use. The organizations were classified as emerging, candidate or model based on the score. The findings were triangulated with qualitative data collected through key informant interviews. RESULTS: The results showed that the overall score of the HIS implementation was 46.3 before and 74.2 after implementation of the programme. The proportion of model organizations increased from 1.2% before to 31.8% after the programme implementation. The health system-university partnership has provided an opportunity for higher education institutions to understand the health system and tune their curricula to address real-world challenges. The partnership brought opportunities to conduct and produce local- and national-level evidence to improve the HIS. Weak ownership, poor responsiveness and poor perceptions of the programme were mentioned as major challenges in programme implementation. CONCLUSION: The overall HIS has shown substantial progress in CBMP implementation woredas. A number of facilities became models in a short period of time after the implementation of the programme. The health system-university partnership was found to be a promising approach to improve the national HIS and to share the on-the-ground experiences with the university academicians. However, weak ownership and poor responsiveness to feedback were the major challenges identified as needing more attention in future programme implementation.

Prevalence of diarrheal diseases among schools with and without water, sanitation and hygiene programs in rural communities of north-eastern Ethiopia: a comparative cross-sectional study.

INTRODUCTION: Diarrheal diseases are a significant cause of morbidity among school-aged children due to inadequate sanitation, lack of access to potable water and poor hygiene practices. Although the incidence of these illnesses can be reduced through improved water quality and the introduction of sanitation and hygiene programs in schools, there is limited evidence to demonstrate the impact of interventions in schools in Ethiopia. The purpose of this study was to compare the prevalence and associated factors of diarrheal diseases in school-aged children between schools in Habru District, north-eastern Ethiopia that adopted water, sanitation and hygiene (WASH) interventions and those that did not. METHODS: A comparative cross-sectional study was conducted among 640 randomly selected school children (160 from schools that adopted WASH interventions and 480 from schools that did not). Trained data collectors used a pre-tested structured questionnaire and an observational checklist to collect the data. Descriptive statistics, such as frequencies and percentages, were computed to present the prevalence of diarrheal disease. Bivariate and multivariate logistic regression analyses were used to identify factors associated with diarrheal disease. RESULTS: The overall 2-week prevalence of diarrhea among school children was 30.5%. In WASH-implementing schools, the prevalence was 21.9%, significantly lower than in non-WASH-implementing schools (33.3%). In non-WASH-implementing schools, the odds of diarrheal diseases among students were significantly decreased in those students who used a clean school latrine, self-reported latrine utilization at home and were aware of the causes of diarrhea. Similarly, among students in WASH-implementing schools, self-reported latrine utilization at home, personal hygiene inspection and awareness of the causes of diarrhea were factors associated with decreasing odds of diarrhea occurrence. CONCLUSION: This study identified a high prevalence of a diarrheal disease among children in schools with no WASH interventions compared with schools that do have WASH interventions. This provides strong evidence for strengthening WASH programs in all rural schools to reduce the burden of diarrheal diseases.