Level of Commitment and associated factors to Use District Health Information System (DHIS2) for decision making among health providers in a resource limited settings: Cross-sectional survey

2020 ◽  
Author(s):  
Shuma Gosha Kanfe ◽  
Nebyu Demeke Mengiste ◽  
Binyam Tilahun ◽  
Mohammedjud Hassen Ahmed ◽  
Berhanu Fikadie Endehabtu

Abstract Background: Changing information use culture, one of the transformation agenda of the Ministry of Health of Ethiopia, can’t be real unless health providers have commitment to use locally collected data for evidence based decision making. Performance Monitoring Team (PMT) members’ commitment has a very paramount influence on district health information system data (DHIS2) utilization for decision making. Evidence is limited on performance monitoring team members’ commitment to use DHIS2 data. Therefore, this study will fill the evidence gap.Objective: This study aimed to assess the level of commitment and its associated factors among Performance Monitoring Team members to use DHIS2 data for decision making at health facilities in Ilu Aba Bora Zone of Oromia national regional state, Ethiopia 2020G.C.Method: Cross sectional quantitative study supplemented by qualitative methods was conducted to assess commitment level of PMT members’ to use DHIS2 data. A total of 264 participants were approached. SPSS version 20 software was used for data entry and analysis. Descriptive and analytical statistics including Bivariable and Multivariable analyses was done. Thematic analysis was conducted for qualitative part Result: Overall 121(45.8%) of the respondents had commitment to use DHIS2 data (95% CI: [40.00, 52.8]). Feedback [AOR= 1.85, 95% CI: (1.02, 3.33)], Supervision [AOR= 2.84, 95% CI: (1.50, 5.37)], Information use culture [AOR=1.92,95% CI: (1.03, 3.59)] ,Motivation [AOR=1.80, 95% CI: (1.00, 3.25)] ,Health need [AOR=3.96, 95% CI: (2.11, 7.41)] and Competency [AOR=2.41, 95% CI:(1.27,4.55)] were variables associated with level of commitment to use DHIS2 data. Conclusion: In general, less than half of the study participants had commitment to use DHIS2 data for decision making. Information use culture, Motivation, Competency, Health need, Supervision and Feedback were the most determinant factors. Providing regular supportive supervision and feedback, increasing motivation and changing attitude will help to bring cultural transformation of data use.

2020 ◽  
Author(s):  
Shuma Gosha Kanfe ◽  
Nebyu Demeke Mengiste ◽  
Mohammedjud Hassen Ahmed ◽  
Gebiso Roba Debele ◽  
Berhanu Fikadie Endehabtu

BACKGROUND Evidence based practice is a key to increase effectiveness and efficiency of quality health services. To achieve this, utilization of health facility data (DHIS2 data) is required which is determined by knowledge and attitudes of health professionals. Thus, this study aimed to assess knowledge and attitudes of health professionals to use DHIS2 data for decision making. OBJECTIVE This study aimed to assess the knowledge, attitudes and its associated factors among health professionals to use DHIS2 data for decision making at South west of Ethiopia 2020 METHODS Cross sectional quantitative study methods was conducted to assess Knowledge and Attitudes of health professionals to use DHIS2 data. A total of 264 participants were approached. SPSS version 22 software was used for data entry and analysis. Descriptive and analytical statistics including Bivariable and Multivariable analyses was done RESULTS Overall 130(49.2%) of the respondents had good knowledge to use DHIS2 data (95% CI: [43, 55.3]), whereas over 149 (56.4%) of the respondents had favorable attitudes towards the use of DHIS2 data for decision making purpose (95% CI: [53.2, 59.8]). Skills [AOR=2.20,95% CI:(1.16, 4.19)], Age [AOR= 1.92, 95% CI: (1.03, 3.59)] ,Resources[AOR=2.56, 95% CI:(1.35,4.86)], Staffing[AOR= 2.85, 95% CI : (1.49, 5.48)] and Experiences[AOR= 4.66, 95% CI: (1.94, 5.78)] were variables associated with knowledge to use DHIS2 data whereas Training [AOR= 5.59, 95% CI: (2.48, 5.42)], Feedback [AOR= 4.08, 95% CI: (1.87, 8.91)], Motivation [AOR=2.87, 95% CI: (1.36, 6.06)] and Health need [AOR=2.32, 95% CI: (1.10-4.92)] were variables associated with attitudes of health professionals to use DHIS2 data CONCLUSIONS In general, about half of the study participants had good knowledge of DHIS2 data utilization whereas more than half of respondents had favorable attitudes. Skills, resources, ages, staffing and experiences were the most determinant factors for the knowledge to use DHIS2 data whereas health need, motivation, feedback and training were determinant factors for attitudes to use DHIS2 data


10.2196/23951 ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. e23951
Author(s):  
Shuma G Kanfe ◽  
Berhanu F Endehabtu ◽  
Mohammedjud H Ahmed ◽  
Nebyu D Mengestie ◽  
Binyam Tilahun

Background Changing the culture of information use, which is one of the transformation agendas of the Ministry of Health of Ethiopia, cannot become real unless health care providers are committed to using locally collected data for evidence-based decision making. The commitment of health care providers has paramount influence on district health information system 2 (DHIS2) data utilization for decision making. Evidence is limited on health care providers’ level of commitment to using DHIS2 data in Ethiopia. Therefore, this study aims to fill this evidence gap. Objective This study aimed to assess the levels of commitment of health care providers and the factors influencing their commitment levels in using DHIS2 data for decision making at public health care facilities in the Ilu Aba Bora zone of the Oromia national regional state, Ethiopia in 2020. Methods The cross-sectional quantitative study supplemented by qualitative methods was conducted from February 26, 2020 to April 17, 2020. A total of 264 participants were approached. SPSS version 20 software was used for data entry and analysis. Descriptive and analytical statistics, including bivariable and multivariable analyses, were performed. Thematic analysis was conducted for the qualitative data. Results Of the 264 respondents, 121 (45.8%, 95% CI 40.0%-52.8%) respondents showed high commitment levels to use DHIS2 data. The variables associated with the level of commitment to use DHIS2 data were found to be provision of feedback for DHIS2 data use (adjusted odds ratio [AOR] 1.85, 95% CI 1.02-3.33), regular supervision and managerial support (AOR 2.84, 95% CI 1.50-5.37), information use culture (AOR 1.92, 95% CI 1.03-3.59), motivation to use DHIS2 data (AOR 1.80, 95% CI 1.00-3.25), health needs (AOR 3.96, 95% CI 2.11-7.41), and competency in DHIS2 tasks (AOR 2.41, 95% CI 1.27-4.55). Conclusions In general, less than half of the study participants showed high commitment levels to use DHIS2 data for decision making in health care. Providing regular supportive supervision and feedback and increasing the motivation and competency of the health care providers in performing DHIS2 data tasks will help in promoting their levels of commitment that can result in the cultural transformation of data use for evidence-based decision making in health care.


2020 ◽  
Author(s):  
Shuma G Kanfe ◽  
Berhanu F Endehabtu ◽  
Mohammedjud H Ahmed ◽  
Nebyu D Mengestie ◽  
Binyam Tilahun

BACKGROUND Changing the culture of information use, which is one of the transformation agendas of the Ministry of Health of Ethiopia, cannot become real unless health care providers are committed to using locally collected data for evidence-based decision making. The commitment of health care providers has paramount influence on district health information system 2 (DHIS2) data utilization for decision making. Evidence is limited on health care providers’ level of commitment to using DHIS2 data in Ethiopia. Therefore, this study aims to fill this evidence gap. OBJECTIVE This study aimed to assess the levels of commitment of health care providers and the factors influencing their commitment levels in using DHIS2 data for decision making at public health care facilities in the Ilu Aba Bora zone of the Oromia national regional state, Ethiopia in 2020. METHODS The cross-sectional quantitative study supplemented by qualitative methods was conducted from February 26, 2020 to April 17, 2020. A total of 264 participants were approached. SPSS version 20 software was used for data entry and analysis. Descriptive and analytical statistics, including bivariable and multivariable analyses, were performed. Thematic analysis was conducted for the qualitative data. RESULTS Of the 264 respondents, 121 (45.8%, 95% CI 40.0%-52.8%) respondents showed high commitment levels to use DHIS2 data. The variables associated with the level of commitment to use DHIS2 data were found to be provision of feedback for DHIS2 data use (adjusted odds ratio [AOR] 1.85, 95% CI 1.02-3.33), regular supervision and managerial support (AOR 2.84, 95% CI 1.50-5.37), information use culture (AOR 1.92, 95% CI 1.03-3.59), motivation to use DHIS2 data (AOR 1.80, 95% CI 1.00-3.25), health needs (AOR 3.96, 95% CI 2.11-7.41), and competency in DHIS2 tasks (AOR 2.41, 95% CI 1.27-4.55). CONCLUSIONS In general, less than half of the study participants showed high commitment levels to use DHIS2 data for decision making in health care. Providing regular supportive supervision and feedback and increasing the motivation and competency of the health care providers in performing DHIS2 data tasks will help in promoting their levels of commitment that can result in the cultural transformation of data use for evidence-based decision making in health care.


2021 ◽  
Author(s):  
Gemechu Tulu ◽  
Takele Gezahegn Demie ◽  
Tesfalem Teshome

Abstract Background: Routine health information systems (RHIS) are vital for the acquisition of data for health sector planning, monitoring, and evaluation, patient management, health education, resource allocation, disease prioritization, and decision-making. Routine health information use for decision-making is low in Ethiopia. Thus, the study aimed to assess level of routine health information use and its associated factors among managers working at public hospitals in North Shewa, Ethiopia.Methods: A facility-based cross-sectional study design with both quantitative and qualitative data collection methods was conducted from May to June 2020. A total of 102 randomly selected managers working in public hospitals in North Shewa were included in the quantitative study while six in-depth interviews were performed for the qualitative method. Quantitative data were collected using a structured self-administered questionnaire and interview guide by trained data collectors, cleaned, coded, and entered into Epi-info version 7.1 software and transferred into SPSS version 23 software for Window for further statistical analysis. Both bivariable and multivariable logistic regression analyses were performed. In the multiple logistic regression analysis, a less than 0.05 P-value was considered statistically significant. The odds ratio along with a 95% confidence interval (CI) were estimated to measure the strength of the association. Thematic analysis was done for key informant interview data.Result: In this study, the level of routine health information use for decision-making was 71.6% (95% CI: 61.8%, 79.4%). According to the multivariable logistic regression analysis, training on health information system (AOR = 0.28, 95% CI: 0.08-0.98) and supportive supervision (AOR = 0.27, 95% CI: 0.09-0.78) were found significantly associated with the use of routine health information for decision-making. Moreover, the lack of staff motivation and computer and data analysis skills were the major reasons for not using routine health information.Conclusions: Three-fourth of the managers working at public hospitals used routine health information for decision-making. Training on health information system and supportive supervision were factors associated with the use of routine health information. Therefore, training of managers and the provision of supportive supervision were highly recommended to improve the use of routine health information managers for decision-making at public health institutions.


BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e046578
Author(s):  
Shuma Gosha Kanfe ◽  
Gebiso Roba Debele ◽  
Robera Demissie Berhanu ◽  
Habtamu Setegn Ngusie ◽  
Mohammedjud Hassen Ahmed

ObjectivesTo assess utilisation of district health information system and its associated factors among health professionals in the southwest of Ethiopia, 2020.SettingPublic health facilities in the southwest of Ethiopia.ParticipantsA facility-based cross-sectional study was conducted among a sample of 260 participants.Main outcome measuresThe main outcome measure was utilisation of the district health information system.ResultsOverall, 149 (57.3%) of study participants had good utilisation of district health information systems (95% CI 50 to 64.2). Sufficient skills (Adjusted Odds Ratio (AOR) 3.83, 95% CI 1.92 to 7.64), being trained (AOR 3.90, 95% CI 1.95 to 7.79), high motivation (AOR 3.93, 95% CI 1.99 to 7.76), feedback provided (AOR 2.93, 95% CI 1.53 to 5.77) and regular supervision (AOR 3.06, 95% CI 1.56 to 6.01) were associated with utilisation of district health information systems.ConclusionsIn general, more than half of the respondents had good utilisation of district health information systems. Providing regular supportive supervision and feedback, having good skills on district health information system use, high motivation and being trained on district health information system will help to bring good utilisation of district health information system for decision making.


2020 ◽  
Author(s):  
Moges Asressie Chanyalew ◽  
Mezgebu Yitayal ◽  
Asmamaw Atnafu ◽  
Binyam Tilahun

Abstract Background: Health Information System (HIS) is the key to making evidence-based decisions. Ethiopia has been implementing the Health Management Information System (HMIS) since 2008 to collect routine health data and revised it in 2017. However, the evidence is meager on the use of routine health information for decision making among department heads in the health facilities. The study aimed to assess the proportion of routine health information systems utilization for evidence-based decisions and factors associated with it. Method: A cross-sectional study was carried out among 386 department heads from 83 health facilities in ten selected districts in the Amhara region Northwest of Ethiopia from April to May 2019. The study participants were selected using a simple random sampling technique. Descriptive statistics mean and percentage were calculated. The study employed a generalized linear mixed-effect model. Adjusted Odds Ratio (AOR) and the 95% CI were calculated. Variables with p-value <0.05 were considered as predictors of routine health information system use. Result: Proportion of information use among department heads for decision making was estimated at 46%. Displaying demographic (AOR= 12.42, 95% CI: [5.52, 27.98]) and performance (AOR= 1.68; 95% CI: [1.33, 2.11]) data for monitoring, and providing feedback to HMIS unit (AOR= 2.29; 95% CI: [1.05, 5.00]) were individual (level-1) predictors. Maintaining performance monitoring team minute (AOR= 3.53; 95% CI: [1.61, 7.75]), receiving senior management directives (AOR= 3.56; 95% CI: [1.76, 7.19]), supervision (AOR= 2.84; 95% CI: [1.33, 6.07]), using HMIS data for target setting (AOR= 3.43; 95% CI: [1.66, 7.09]), and work location (AOR= 0.16; 95% CI: [0.07, 0.39]) were organizational (level-2) explanatory variables. Conclusion: The proportion of routine health information utilization for decision making was low. Displaying demographic and performance data, providing feedback to HMIS unit, maintaining performance monitoring team minute, conducting supervision, using HMIS data for target setting, and work location were factors associated with the use of routine health information for decision making. Therefore, strengthening the capacity of department heads on data displaying, supervision, feedback mechanisms, and engagement of senior management are highly recommended.


2020 ◽  
Vol 18 (3) ◽  
pp. 181-194
Author(s):  
Megan Divett

Purpose This paper aims to evaluate perceptions of leaders and team members on productivity, satisfaction and leader-led team dynamics within an activity-based, flexible environment compared to an open plan workplace. Design/methodology/approach This study uses cross-sectional (N = 1,275) and longitudinal survey data (N = 138) collected from three offices in Australia. Baseline responses were collected 3–12 months prior to the transition into a new environment and comparison responses were collected after at least three months of working in the new environment. Paired sample t-tests and linear regression were used. Findings Team members were more satisfied and felt more productive within the activity-based working (ABW) environment compared to the open plan workplace. Leaders were more satisfied and felt team productivity improved, yet individual productivity for leaders remained the same. Occupants felt the key drivers of productivity were team Interaction and decision-making. Research limitations/implications This study focused on one activity-based building based in Australia that was consciously designed for individual focus, team working and cross-team collaboration. This style of workplace may not be representative of all activity-based environments. Originality/value Most research into ABW has relied on cross-sectional data. This study also adopts a within group, longitudinal approach to directly compare the perceptions of the same individuals over time. Activity-based environments are changing the way we think of leaders and the way they encourage productivity. This study showed that despite relinquishing an office, leaders were more satisfied and equally productive within an activity-based environment. The study also showed that teams realise greater productivity by focussing on team interaction and effective decision-making.


2021 ◽  
Author(s):  
Mesele D. Argaw ◽  
Binyam F. Desta ◽  
Zergu T. Tsegaye ◽  
Aychiluhim D. Mitiku ◽  
Afework A Atsa ◽  
...  

Abstract Background: The aim of this study was to investigate the quality of immunization data and monitoring systems in the Dara Malo district (woreda) of the Gamo Administrative Zone, Southern Nations, Nationalities and Peoples Region (SNNPR) of Ethiopia.Method: A cross-sectional study was conducted from August 4 to September 27, 2019 in Dara Malo District. The district was purposively selected during the management of a pertussis outbreak based on the hypothesis ‘there is no difference in reported and recounted immunization status of children 7 to 23 months in Dara Malo District of Ethiopia’. The study used the World Health Organization (WHO)-recommended Data Quality Self-Assessment (DQS) tools. The accuracy ratio was determined using data from the routine Expanded Program of Immunization (EPI) and household survey. Facility data spanning the course of 362 months were abstracted from EPI registers, tally sheets, and monthly routine reports. In addition, household surveys collected data from caretakers or immunization cards or oral reports. Trained DQS assessors collected the data to explore the quality of the monitoring system at health posts, health centers and district health offices. A quality index (QI) and proportions of completeness, timeliness and accuracy ratio of the first and third doses of pentavalent vaccines and the first dose of measles-containing vaccines (MCV) were made.Results: In this study, 336-month facility data were extracted. In addition, 595 children aged 7 - 23 months, with a response rate of 94.3%, were assessed and compared for immunization status using register and immunization cards or caretakers’ oral reports through the household survey. At the district level, the proportion of the re-counted vaccination data on EPI registers for first dose pentavalent was 95.20%, three doses of pentavalent was 104.2% and first dose of measles was 98.6%. However, the ratio of vaccination data compared using tallies against the reports showed evidence of overreporting with 50.8%, 45.1% and 46.5% for first pentavalent, third pentavalent and first dose of measles vaccinations, respectively. The completeness of the third dose of pentavalent vaccinations was 95.3%, 95.6% and 100.0% at health posts, health centers and at the district health office, respectively. The timeliness of the immunization reports was 56.5% and 64.6% at health posts and health centers, respectively, while the district health office does not have timely submitted on time to the next higher level for twelve months. The QI scores ranged between 61.0% and 80.5% for all five categories, namely, 73.0% for recording, 71.4% for archiving and reporting, 70.4% for demographic information, 69.7% for core outputs and 70.4% for data uses and were assessed as suboptimal at all levels.Conclusion: Immunization data completeness was found to be optimal. However, in the study area, the accuracy, consistency, timeliness and quality of the monitoring system were found to be suboptimal. Therefore, poor data quality has led to incorrect decision making during the reported pertussis outbreak management. Availing essential supplies, including tally sheets, monitoring charts and stock management tools, should be prioritized in Daro Malo District. Enhancing the capacity of healthcare providers on planning, recording, archiving and reporting, analyzing, and using immunization data for evidence-based decision making is recommended.


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