Implementation Evaluation of District Health Information System (DHIS2) Among Public Health Institutions of Kaffa Zone, Southwest Ethiopia

Abstract

Background: District Health Information System is an integrated, open-source and web-based platform for health data collection, validation, analysis, and presentation of aggregated and individual data. It improves health service delivery by strengthening the health management information system. It is a newly implemented platform which is essential for the improvement of data quality and evidence-based decision making. This evaluation tries to indicate major strengths, weakness and the way forward for the implementation of District Health Information System. Objective: To evaluate the implementation status of District Health Information System and associated factors in Public Health Institutions of Kaffa Zone, Southwest Ethiopia, 2022. Method: Institution based single case study design was conducted with both quantitative and qualitative data collection method. The dimensions of evaluation were availability adherence and compliance. The study populations were institutions, health workers and documents with purposive sampling technique. Quantitative data were collected by self-administered questionnaire, document review and resource inventory and analyzed by using SPSS version 26.0. The qualitative data from direct observation and key informant interview was analyzed manually through thematic analysis with respective dimensions. Result: A total of seventeen health institutions and one hundred twenty six performance monitoring team members were participated in the evaluation. About 56.3% of health institutions had assigned specific units for the program. Non functionality of computers in two health centers, failure of the online system in three health centers and inadequate budget in fifteen health institutions were the major findings with respect to resource availability. Although majority of the participants (86.5%) were trained for the system, gaps were identified which is related with the training content and approach. An observation illustrates strength in using routine data entry apps but significant challenges were observed in utilization of system based data for informed decision making. Previous knowledge on HMIS, computer skill and User friendliness of the tool were significantly associated with implementation of the system. An overall evaluation result of 55.4% scored and judged as fair according to agreed judgment parameter. Conclusion: This evaluation demonstrated gaps related with non-comprehensive training method, low report timeliness and completeness which is below the national target and poor practice of exercising system data for analysis and informed decision making in contributed for fair implementation status in the study area. Possible recommendations suggested were maintaining nonfunctional computers and internet access, adequate budget allocation, integrating practical training approach and regular supportive supervision in line with the program.