Health Management Information System Implementation and Utilization for Evidence-Based Decision Making in East Wollega, Western Oromia, Ethiopia.

Abstract

Background: Many opportunities to achieve national objective for better population health remain unused and countless life is lost due to failure of usage of health information system for evidence based decision making. However, in Ethiopia, data quality and use remain weak, particularly at Zonal health department, District Health Offices and primary health care facilities, which have primary responsibility for operational management. Objective: To assess the implementation and utilization of health management information system at zonal, district and facility levels in East Wollega Zone. Methods: A facility based cross-sectional study was conducted from September,10 - October 1, 2013 in East Wollega ZHD, 8 Woreda health offices, 16 health centers, and 31 health posts selected by multistage sampling technique. Both quantitative and qualitative research methods were used. Data was collected using structured questionnaires in 219 units/departments and document review checklist in 56 units for quantitative method. In-depth interview guide was used for qualitative study after ethical clearance was taken from JU and letter of permission was taken from respective organization. Descriptive and multiple logistic regressions were employed using SPSS version 16.0 for windows and the finding was presented in tables and figures. Statistical significance was declared at P<0.05. The qualitative data was analyzed thematically and the finding was narrated and triangulated with quantitative findings. Result: There were 219 respondents and among these 69(31.5 %) were from administrative and 150(68.5%) were from health care facilities. Majority of the respondents were diploma nurses. Seventy percent of the respondents took short course training on HMIS. Monthly data accuracy, completeness and timeliness were 88, 62, and 57 percent respectively which are far below National expectation. HMIS quality decreases as the hierarchical level of organization decrease. Half of the respondents confirmed the use of information. There is only limited or no evidence based decision making. Only in5.2% of the assessed administrative and health care facilities had evidence based decision making. Conclusion and Recommendations: it can be concluded that Statistics are weak, and local program managers make a little use of them. In addition, lack of, evidence-based program implementation. Quality was poorer at most bottom facilities. It is recommended that emphasis should be given to lower level health facilities which are the generators of data and local managers better practice evidence based decision making.