MPH Thesis on: Assessment of the

Health Information System in Buea

Health District.

By

Akumengwa Neba N.Department of Public Health and Hygiene

Faculty of Health Sciences

University of Buea

November 2014

Supervisor: Dr. Nde Peter F.

Co-supervisor: Dr. Atashili J.

Outline

Background Problem Statement

Justification

Goal

Objectives

Research Questions

Methodology

Results/Discussion

Conclusions/Recommendations

Background

The Health Information System (HIS); is

“A set of components and procedures

organized with the objective of generating

information to improve health care

management decisions at all levels of the

health system”. Lippeveld, et al (2000)

Background Cont….

Components of the HIS;

Inputs: resources.

Processes: indicators, data sources; data

management.

Outputs: information products,

information dissemination and use.

Background Cont….

HIS in most developing countries are

weak, fragmented and often focused

exclusively on disease-specific program

areas, ( WHO, 2001)

In addition, most developing countries

District Health Information Systems are

inefficient in providing management

information. Raeisi, et al (2013)

Background Cont….

Cameroon is amongst other United

Nations Commission on Information and

Accountability priority Countries that

needs focused support to improve on

their HIS and reporting on the MDGs.

( WHO, 2012)

Background Cont..

Problem statement

Erroneous/fraudulent vaccination

reporting by health personnel.

Lack of motivation to collect data.

Quality of HIS staff.

Attitude toward assignment as a HIS Staff

Irregular, inadequate data reporting and

feedback.

Background cont..

Justification

For better decision-making

To improve health service delivery,

There is the need for a strong HIS

(with reliable, complete, timely, accurate,

adequate information).

COIA: Cameroons HIS is present but not

adequate (42.5%).( WHO, 2012)

Background Cont…

Research questions

What is the overall HIS situation?

How adequate are HIS components?

What are strengths and weaknesses of

the?

What are the priority areas for HIS

improvement?

Background Cont….

Goal To improve the HIS in Buea Health District through

identifying and highlighting the weakness inherent in the

system.

Objectives

General Objective

To established an understanding on the HIS situation

Background Cont….

Specific Objectives

To determine how adequate is the overall HIS

To determine the situation of the various HIS

components

To identify weaknesses/weaknesses existing in

the HIS

To identify priority areas for improvement on the

HIS.

Methodology

Study setting

Buea health District, RDPH, MOH, NIS

Study design

Cross-sectional study with group and in-depth interviews

Study population

Stakeholders of the HIS in BHD, RDPH, MoH

Duration of Study

Six months ( April to September)

Sampling

Non-probabilistic: convenience, purposive sampling

Sample size

27 health facilities and institutions

Methodology Cont…

Ethical Consideration

Administrative approval from: FHS, RDPH, MoH.

Study Procedure

In-depth and group interviews

HMN Assessment Tool Version 4.00 PDF topic guide

Inclusion criteria

Involvement with HIS activities

Acceptance to take part in study

Exclusion criteria

Non involvement with HIS activities

Non-acceptance to participate

Methodology Cont…

Data collection tool and technique

HMN Assessment Tool Version 4.00 PDF

Questions pre-coded: 0-24%=0, 25-49%=1, 50-74%=2, 75-100%=3

Data management and analysis

Number imputed to HMN Assessment tool Excel.

Calculation of averages, percentiles and graphs plotted.

Study limitations

Dishonest assessment by respondents

Ongoing PBF pilot project influences

The long duration of interview

Methodology Cont…

Conceptual framework

Results /Discussion

0% 25% 50% 75% 100%

Resources

Indicators

Data sources

Data management

Informationproducts

Dissemination &use

Overall HIS situation

Results /Discussion Cont..

0% 25% 50% 75% 100%

Overall

Policy and planning

Institutions, HR and financing

Infrastructure

HIS Resources

Results /Discussion Cont..

Indicators

Category Result

IndicatorsHighly adequate

83% ( 12.4 / 15 )

Results /Discussion Cont..

0% 25% 50% 75% 100%

Overall

Census

Vital statistics

Population-based surveys

Health & diseases records

Health service records

Resource records

HIS Data sources

Results /Discussion Cont..

HIS Data management

Category Result

Data managementNot adequate at all

23% ( 3.4 / 15 )

Results /Discussion Cont..

HIS Information Dissemination and UseCategories Result

Analysis and use of informationPresent but not adequate

27% ( 2.5 / 9 )

Information use for policy and advocacyPresent but not adequate

33% ( 1.0 / 3 )

Information use for planning and priority

setting

Highly adequate

83% ( 2.5 / 3 )

Information use for resource allocationPresent but not adequate

41% ( 2.4 / 6 )

Information use for implementation and

action

Adequate

73% ( 6.6 / 9 )

OverallAdequate

50% ( 15.0 / 30 )

Strengths

Highly adequate

Indicators.

Data Sources.

Population-based survey.

Dissemination and Use.

Information use for planning and priority

setting.

Strengths cont….

Adequate

Data sources

Census.

Health service records.

Resource records.

Health and disease records including surveillance.

Information products.

Dissemination and Use.

Information use for implementation and action.

Weaknesses

Not adequate at all

Data management.

Present but not adequate

Resources.

Policy and planning.

Data sources.

Vital statistics.

Dissemination and Use.

Analysis and use of information.

Information use for policy and advocacy

Priority areas for improvement

Data management.

Resource Policy and planning.

Data sources: Vital statistics.

Dissemination and use: Analysis and use

of information, use of information in

designing policy

Conclusion

This study revealed that one (data

management) amongst the six HIS

components, was not adequate at all,

while the other HIS components were

rated above 50%.

Results obtained provide a baseline from

where measures to improve on the HIS

situation could be based.

Recommendations

Reduce workload of healthcare delivery

and data collection on staff.

Motivation: financial and psychological

Introduce ICT in data management at

each level of HIS.

Well integrated and easy to understand

data collection forms.

Recommendations

Organise regular training on HIS activities

and follow-up.

Provide regular feedback to data reported

by each health facility.

Decision–making: based on information

products of the HIS.

Improvement in HIS staffing quality and

quantity..

Thank You