Amref Health Africa International Conference November, 2014 Nairobi, Kenya 7/2/20151

Assessment of Health Management Information System (HMIS) Performance at Health Facilities of Afar Region, 2013 Presenter: Mesfin Ayeta 7/2/20152

Presentation Outline 1. Background 2. Methods 3. Result and Discussion 4. Conclusion 5. Recommendation 7/2/20153

 In developing countries, the collection, compilation, analysis and utilization of health data remains to be practically major problem.  In Ethiopia, the HMIS is characterized by burdensome data collection and inadequate staff skill and also the information flow is fragmented (WHO, 2007).  This resulted in redundant and conflicting reports and poor quality of data in terms of accuracy and timelines. 7/2/20154 Background

 In Afar region, despite some improvements were observed; the problems on HMIS performance is still there.  However, there are not scientific evidences showing the possible determinants of HMIS performance in the region. 7/2/20155

General Objective  To assess the status of HMIS performance at health facilities level and identify its determinant factors. Specific Objectives  To assess the status of HMIS performance at health facilities  To find out challenges and best lessons of HMIS performance in health facilities 7/2/20156 Objectives

Methods Study Design  A cross-sectional study design was carried out. Data Source Study Unit  Health facilities  Service providers  Patients/Clients records 7/2/20157

Sample Size Determination The Sample size is calculated based on the study unit: Health facility:  Rule of thumb sampling method was used. The rule states, if the number of units are less than 50, take a 30-50% sample. Record Review:  Single Population Proportion formula was used. 384 Individual records were reviewed. Health Professionals:  All the selected health facilities health workers. 7/2/20158

Data collection instrument/Tools  Interview using questionnaire  Observation using checklist  Record review  Self-administrative Questionnaires  In-depth Interview 7/2/20159

Data analysis  SPSS version 20 was used to analyze quantitative data.  Tables, figures and frequencies  Logistic regression  Thematic analysis for qualitative data 7/2/201510

Results and Discussion Description of Respondents 7/2/2015 VariablesFrequency Respondent’s qualification MD/HO clinical nurse/midwife Para medicals 4 (3.2%) 80 (63.5%) 42 (33.3%) Responsibilities of Respondents Head of facility and units Clinical health service providers Para medicals 15 (11.9%) 79 (62.7%) 32(25.4%) HIMIS Training Received Not received 40 (31.7%) 86 (68.3%) 11

Existence of Performance Monitoring Team (PMT) and HMIS guideline 7/2/201512

Presence of HMIS focal person and Supervision at health facilities 7/2/201513

HMIS process and practice at Health facilities 7/2/2015 Variables Frequency YesNoI do not Know Checking reports before sending to the next level? Use standardized set of indicator Send HMIS Report based on scheduled Health facilities received written feedback on HMIS performance 41.7% 29.2% 12.5% 20.8% 35.4% 41.7% 87.5% 39.6% 22.9% 29.2% 37.5% 14

Knowledge, attitude, practice and motivation of the health personnel on HMIS performance 7/2/201515

Knowledge, attitude, practice and motivation of the health personnel in HMIS performance 7/2/201516

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Data quality of patent’s record 7/2/201518

 Health professionals culture of information use was found to be 37.3%.  Study in Jimma (2011) shows that utilization of health information was 32.9%.  In Tanzania (2011), 42% did not use the collected data for decision making process.  Study in Malawi (2005) revealed that that data is incomplete as there are gaps in the data collection tools. 7/2/201519

Factors associated with information use for decision making process  Health professionals who work in Health facilities which established PMT were 2.83 times more likely to use information.  Health care providers who had positive attitude were 2.79 times more likely to use information.  Motivated Health professionals were 3.5 times more likely to use information than not motivated. 7/2/201520

 Study conducted in Nigeria (2012) shows motivated health professionals were more likely to use information for decision making process.  Similarly, India in 2007 shows establishment of PMT had showed significant association with health professional information use. 7/2/201521

Conclusion  Data quality of HMIS tools were found to be very poor.  Information use habit of health workers for decision making were found to be very low.  Establishment of performance monitoring team, motivation and attitude health care providers were found to be significantly associated with information use. 7/2/201522

Recommendation  The regional health bureau needs to design in-service trainings on information use culture and data quality.  The regional and district health offices should regularly give supportive supervision and technical assistants to health facilities  Regional and district health offices shall encourage, train and follow up health care providers to establish performance monitoring team.  Motivating health care providers and providing training on moral and ethical issues is recommended to improve information use for decision making. 7/2/201523

THANK YOU! 7/2/201524