Perceptions and experiences with District Health Information System software to collect and utilize health data in Bangladesh: A qualitative exploratory study

Abstract Background: Accurate and high-quality data are important for improving program effectiveness and informing policy. Bangladesh’s health management information system adopted the District Health Information Software, Version 2 (DHIS2) in 2009 to capture real-time health service utilization data. However, routinely collected data are being underused because of poor data quality. We aimed to understand the facilitators and barriers of implementing DHIS2 as a way to retrieve meaningful and accurate data for reproductive, maternal and child health (RMCAH) services. Methods: This qualitative study was conducted in two districts of Bangladesh from September 2017 to 2018. Data collection included key informant interviews (n=11), in-depth interviews (n=23), and focus group discussions (n=2). The study participants were individuals involved with DHIS2 implementation from the community level to the national level. The data were analyzed thematically. Results: DHIS2 could improve the timeliness and completeness of data reporting over time. The reported facilitating factors were strong government commitment, extensive donor support, and positive attitudes toward the technology among staffs. Quality checks and feedback loops at multiple levels of data gathering points were helpful to minimize data errors. Introducing a dashboard makes DHIS2 compatible to use as monitoring tool. However, the barriers to effective DHIS2 implementation were lack of human resources, slow Internet connectivity, frequent changes to of DHIS2 versions, and maintaining both manual and electronic system side-by-side. Data in DHIS2 remains incomplete because it does not capture data from private health facilities. Having two parallel management information systems reporting the same RMNCAH indicators threatens data quality and increases the reporting workload. Conclusion: The overall insights from this study are expected to contribute to the development of effective strategies for successful DHIS2 implementation and building responsive health management information system. Focused strategic direction is needed to sustain the achievements of digital data culture. Periodic refresher trainings, incentives for increased performance, and an automated single reporting system for multiple stakeholders could make the system more user-friendly. A national electronic health strategy and implementation framework can facilitate creating a culture of DHIS2 use for planning, setting priorities, and decision making among stakeholder groups.

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Perceptions and experiences with District Health Information System software to collect and utilize health data in Bangladesh: A qualitative exploratory study

10.21203/rs.2.12293/v4 ◽

2020 ◽

Author(s):

Tahmina Begum ◽

Shaan Muberra Khan ◽

Bridgit Adamou ◽

Jannatul Ferdous ◽

Muhammad Masud Parvez ◽

...

Keyword(s):

Information System ◽

Data Quality ◽

Health Information ◽

Management Information System ◽

Program Effectiveness ◽

Health Management ◽

Quality Data ◽

Health Management Information System ◽

Management Information ◽

District Health

Abstract Background: Accurate and high-quality data are important for improving program effectiveness and informing policy. Bangladesh’s health management information system adopted the District Health Information Software, Version 2 (DHIS2) in 2009 to capture real-time health service utilization data. However, routinely collected data are being underused because of poor data quality. We aimed to understand the facilitators and barriers of implementing DHIS2 as a way to retrieve meaningful and accurate data for reproductive, maternal and child health (RMCAH) services. Methods: This qualitative study was conducted in two districts of Bangladesh from September 2017 to 2018. Data collection included key informant interviews (n=11), in-depth interviews (n=23), and focus group discussions (n=2). The study participants were individuals involved with DHIS2 implementation from the community level to the national level. The data were analyzed thematically.Results: DHIS2 could improve the timeliness and completeness of data reporting over time. The reported facilitating factors were strong government commitment, extensive donor support, and positive attitudes toward the technology among staffs. Quality checks and feedback loops at multiple levels of data gathering points were helpful to minimize data errors. Introducing a dashboard makes DHIS2 compatible to use as monitoring tool. However, the barriers to effective DHIS2 implementation were lack of human resources, slow Internet connectivity, frequent changes to of DHIS2 versions, and maintaining both manual and electronic system side-by-side. Data in DHIS2 remains incomplete because it does not capture data from private health facilities. Having two parallel management information systems reporting the same RMNCAH indicators threatens data quality and increases the reporting workload. Conclusion: The overall insights from this study are expected to contribute to the development of effective strategies for successful DHIS2 implementation and building responsive health management information system. Focused strategic direction is needed to sustain the achievements of digital data culture. Periodic refresher trainings, incentives for increased performance, and an automated single reporting system for multiple stakeholders could make the system more user-friendly. A national electronic health strategy and implementation framework can facilitate creating a culture of DHIS2 use for planning, setting priorities, and decision making among stakeholder groups.

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Perceptions and experiences with district health information system software to collect and utilize health data in Bangladesh: A qualitative exploratory study

10.21203/rs.2.12293/v5 ◽

2020 ◽

Author(s):

Tahmina Begum ◽

Shaan Muberra Khan ◽

Bridgit Adamou ◽

Jannatul Ferdous ◽

Muhammad Masud Parvez ◽

...

Keyword(s):

Information System ◽

Data Quality ◽

Health Information ◽

Program Effectiveness ◽

National Level ◽

Digital Data ◽

Quality Data ◽

Health Management Information System ◽

District Health ◽

Implementation Framework

Abstract Background: Accurate and high-quality data are important for improving program effectiveness and informing policy.In 2009 Bangladesh’s health management information system (HMIS) adopted the District Health Information Software, Version 2 (DHIS2) to capture real-time health service utilization data. However, routinely collected data are being underused because of poor data quality and reporting. We aimed to understand the facilitators and barriers to implementing DHIS2 as a way to retrieve meaningful and accurate data for reproductive, maternal, newborn, child, and adolescent health (RMNCAH) services. Methods: This qualitative study was conducted in two districts of Bangladesh from September 2017 to 2018. Data collection included key informant interviews (n=11), in-depth interviews (n=23), and focus group discussions (n=2). The study participants were involved with DHIS2 implementation from the community level to the national level. The data were analyzed thematically.Results: DHIS2 could improve the timeliness and completeness of data reporting over time. The reported facilitating factors were strong government commitment, extensive donor support, and positive attitudes toward technology among staff. Quality checks and feedback loops at multiple levels of data gathering points are helpful for minimizing data errors. Introducing a dashboard makes DHIS2 compatible to use as a monitoring tool. Barriers to effective DHIS2 implementation were lack of human resources, slow Internet connectivity, frequent changes to DHIS2 versions, and maintaining both manual and electronic system side-by-side. The data in DHIS2 remains incomplete because it does not capture data from private health facilities. Having two parallel HMIS reporting the same RMNCAH indicators threatens data quality and increases the reporting workload. Conclusion: The overall insights from this study are expected to contribute to the development of effective strategies for successful DHIS2 implementation and building a responsive HMIS. Focused strategic direction is needed to sustain the achievements of digital data culture. Periodic refresher trainings, incentives for increased performance, and an automated single reporting system for multiple stakeholders could make the system more user-friendly. A national electronic health strategy and implementation framework can facilitate creating a culture of DHIS2 use for planning, setting priorities, and decision making among stakeholder groups.

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Data Quality of the Routine Health Management Information System at the Primary Healthcare Facility and District Levels in Tanzania

10.21203/rs.3.rs-38381/v1 ◽

2020 ◽

Author(s):

SUSAN F. RUMISHA ◽

EMANUEL P. LYIMO ◽

IRENE R. MREMI ◽

PATRICK K. TUNGU ◽

VICTOR S. MWINGIRA ◽

...

Keyword(s):

Information System ◽

Data Quality ◽

Management Information System ◽

Health Management ◽

Health Centre ◽

Healthcare Facility ◽

Health Management Information System ◽

Management Information ◽

Service Areas

Abstract Background: Effective planning for disease prevention and control requiresaccurate, adequately-analysed, interpreted and communicated data. This study assessed the quality of routine Health Management Information System (HMIS) data at healthcare facility (HF) and district levels in Tanzania. Methods: HMIS tools used at primary health care facilities (dispensary, health centre, hospital) and district office were reviewed to assess their availability, completeness, and accuracy of collected data. The assessment involved seven health service areas namely, Outpatient department, Inpatient department, Antenatal care, Family Planning, Post-natal care, Labour and Delivery and Provider-initiated Testing and Counselling.Results: A total of 115 HFs in 11 districts were assessed. Registers (availability rate=91.1%; interquartile range (IQR):66.7%-100%) and reportforms (86.9%;IQR:62.2%-100%) were the most utilized tools. There was a limited use of tally-sheets (77.8%;IQR:35.6%-100%). Tools availability at dispensary was 91.1%, health-centre 82.2% and hospital 77.8%, and was poor in urban districts. The availability rate atthe district level was 65% (IQR:48%-75%). Reports were highly over-represented in comparison to registers’ records, with large differences observed at HF phase of the data journey and more profound in hospitals.Tool availability and data quality varied by service-areas, indicators, facility level, and districts, however, with a remarkable improvement over the years.Conclusion: There are high variations and improvements in the tool utilisation and data accuracy at facility and district levels. The routine HMIS is weak and data at district level inaccurately reflects what is available at the HFs. These results highlight the need to design tailored and inter-service strategies for improving data quality.

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Perceptions and experiences with District Health Information System software to collect and utilize health data in Bangladesh: A qualitative exploratory study

10.21203/rs.2.12293/v1 ◽

2019 ◽

Author(s):

Tahmina Begum ◽

Shaan Muberra Khan ◽

Bridgit Adamou ◽

Jannatul Ferdous ◽

Muhammad Masud Parvez ◽

...

Keyword(s):

Information System ◽

Health Information ◽

Program Effectiveness ◽

National Level ◽

Digital Data ◽

Quality Data ◽

Health Management Information System ◽

District Health ◽

Frequent Change ◽

Implementation Framework

Abstract Background: Accurate and high-quality data are important for improving program effectiveness and informing policy. Bangladesh Health Management information System (HMIS) has adopted District Health Information software 2 (DHIS) in 2009 to capture real-time health service utilization data. However, routinely collected data are being underused because of poor data quality. We aim to understand the facilitators and barriers on implementing DHIS2 as a way to retrieve meaningful and accurate data for the Reproductive, Maternal and Child Health (RMCAH) services. Methods: This qualitative study was done among two districts of Bangladesh from September 2017 to 2018. Data collection method were key informant interview (n=11); in-depth interview (n=23); focus group discussion (n=2). Study participants were individuals involved with DHIS2 implementation from the community level to the national level. The data were analyzed thematically. Results: DHIS 2could improve the timeliness and completeness of data reporting over time. The reported facilitating factors were strong government commitment, extensive donor support and positive attitude of staffs. Quality checks and feedback loops at multiple levels of data gathering points was helpful to minimize data errors. Introducing dashboard makes the DHIS2 compatible to use as monitoring tool. However, the barriers to DHIS 2 implementation were lack of human resources, slow Internet connectivity, and frequent change of DHIS 2 versions, maintaining both manual and electronic system side by side. The collected data remains incomplete as private health facilities are not covered. The parallel presence of two MISs to report same RMNCAH indicators is a threat to achieve quality data and increases workload. Conclusion: The overall insights from this study are expected to contribute to the development of effective strategies for successful DHIS 2 implementation and building responsive HMIS. To sustain the achievements of digital data culture, focused strategic direction is needed. Periodic refresher trainings, incentives for increased performance, automated single reporting system for multiple stakeholders could make the system more user friendly. A national electronic health strategy and implementation framework can facilitate creating a culture of DHIS 2 use for planning, setting priorities, and decision making among stakeholder groups

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Evolving Mechanism for Cross Validation of Data Quality in Health Management Information System (HMIS)-Perspectives and Challenges Emerging from a State in India

Indian Journal of Public Health Research & Development ◽

10.5958/0976-5506.2016.00011.5 ◽

2016 ◽

Vol 7 (1) ◽

pp. 51

Author(s):

V K Tiwari ◽

Rahul Shukla ◽

Sherin T P Raj ◽

P D Kulkarni ◽

N K Sethi

Keyword(s):

Information System ◽

Data Quality ◽

Management Information System ◽

Cross Validation ◽

Health Management ◽

Health Management Information System ◽

Management Information

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Utilization of Routine Health Information from Health Management Information System and Associated Factors Among Health Workers at Health Centers in Oromia Special Zone, Ethiopia: A Multilevel Analysis

Risk Management and Healthcare Policy ◽

10.2147/rmhp.s285604 ◽

2021 ◽

Vol Volume 14 ◽

pp. 1189-1198

Author(s):

Mohammed Ahmed Seid ◽

Negalign Berhanu Bayou ◽

Fanos Yeshanew Ayele ◽

Aregash Abebayehu Zerga

Keyword(s):

Information System ◽

Health Information ◽

Management Information System ◽

Associated Factors ◽

Health Workers ◽

Health Management ◽

Health Centers ◽

Health Management Information System ◽

Management Information ◽

Special Zone

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Data quality assessment and associated factors in the health management information system among health centers of Southern Ethiopia

PLoS ONE ◽

10.1371/journal.pone.0255949 ◽

2021 ◽

Vol 16 (10) ◽

pp. e0255949

Author(s):

Mastewal Solomon ◽

Mesfin Addise ◽

Berhan Tassew ◽

Bahailu Balcha ◽

Amene Abebe

Keyword(s):

Information System ◽

Data Quality ◽

Management Information System ◽

Health Professionals ◽

Health Management ◽

Health Centers ◽

Southern Ethiopia ◽

Health Management Information System ◽

Management Information ◽

Cross Sectional

Background A well designed Health management information system is necessary for improving health service effectiveness and efficiency. It also helps to produce quality information and conduct evidence based monitoring, adjusting policy implementation and resource use. However, evidences show that data quality is poor and is not utilized for program decisions in Ethiopia especially at lower levels of the health care and it remains as a major challenge. Method Facility based cross sectional study design was employed. A total of 18 health centers and 302 health professionals were selected by simple random sampling using lottery method from each selected health center. Data was collected by health professionals who were experienced and had training on HMIS tasks after the tools were pretested. Data quality was assessed using accuracy, completeness and timeliness dimensions. Seven indicators from national priority area were selected to assess data accuracy and monthly reports were used to assess completeness and timeliness. Statistical software SPSS version 20 for descriptive statistics and binary logistic regression was used for quantitative data analysis to identify candidate variable. Result A total of 291 respondents were participated in the study with response rate of 96%. Overall average data quality was 82.5%. Accuracy, completeness and timeliness dimensions were 76%, 83.3 and 88.4 respectively which was lower than the national target. About 52.2% respondents were trained on HMIS, 62.5% had supervisory visits as per standard and only 55.3% got written feedback. Only 11% of facilities assigned health information technicians. Level of confidence [AOR = 1.75, 95% CI (0.99, 3.11)], filling registration or tally completely [AOR = 3.4, 95% CI (1.3, 8.7)], data quality check, supervision AOR = 1.7 95% CI (0.92, 2.63) and training [AOR = 1.89 95% CI (1.03, 3.45)] were significantly associated with data quality. Conclusion This study found that the overall data quality was lower than the national target. Over reporting of all indicators were observed in all facilities. It needs major improvement on supervision quality, training status to increase confidence of individuals to do HMIS activities.

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Utilization of Health Management Information System and Associated Factors in Hadiya Zone Health Centers, Southern Ethiopia

Research in Health Science ◽

10.22158/rhs.v1n2p98 ◽

2016 ◽

Vol 1 (2) ◽

pp. 98 ◽

Cited By ~ 3

Author(s):

Ermias Abera ◽

Kidist Daniel ◽

Taye Letta ◽

Desalegn Tsegaw

Keyword(s):

Information System ◽

Health Information ◽

Management Information System ◽

Health Management ◽

Health Information System ◽

Health Centers ◽

Southern Ethiopia ◽

Health Management Information System ◽

Management Information ◽

Key Indicators

Background: Health Information systems are increasingly important for measuring and improving the quality and coverage of health services. Reliable and timely health information is vital for operational and strategic decision making that save lives and enhances health. In Ethiopia information quality and use remain weak, particularly at district health offices and primary health care facilities to facilitate decision making. Therefore this study will be designed to greatly signal the current status of Health Management Information System (HMIS) in study area.Objective: To assess the utilization of health management information systems and associated factors at health centers in Hadiya zone, Southern Ethiopia, 2014.Methods: A cross sectional study was conducted in health institutions by interviewing units/departments of health centers from April to June, 2014. Quantitative data was collected using structured questionnaires, check lists, observation and interview guide by trained data collectors. Data was analyzed using SPSS version 20 and descriptive and logistic regression analysis was carried out.Results: The finding of the study revealed that utilization of health management information was 242(69.3%) in all the study units/departments of health centers. Health center units/department had key indicators (AOR=3.67; 95%CI: 2.11, 6.39), completeness of data format (AOR=3.42; 95%CI: 1.65, 7.08), consistency of data (AOR=1.91; 95%CI: 1.05, 3.48) were found to be significantly associated with utilization of health information system at 95% level of significance. Conclusion: Health center units/departments had key indicators, completeness of data and consistency of data were predictors of utilization of health management information system. Therefore, in-service training and updating of staff involved in Health Management Information System (HMIS) at district, strengthening health information system inputs, timely and concrete feedbacks with establishment of functional Health Management Information System (HMIS).

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