Research proposal on

BY

Akumengwa Neba N(HS12 A001)

Department of Public Health and Hygiene

MPH 698

Supervisors: Dr. Nde Fon Peter.

Co-supervisor: Dr. Atashili Julius.

MPH Thesis Proposal: Assessment of

the Health Information System in the

Buea Health District

Academic Year 2013/2014

University of Buea, Cameroon1

Outline

Academic Year 2013/2014 University of Buea,

Cameroon2

Chapter I: Introduction

Background

Problem statement

Justification

Research Goal

General objective

Specific Objectives

Research questions

Research scope

Definition of terms and concepts

Chapter II: Literature Review

Chapter III: Methodology

Study design

Study area and settings

Study population and sampling

Sample Size

Inclusion criteria

Exclusion criteria

Study procedure

Data management and Data analysis

Ethical considerations

Study limitation

Timeline

Budget



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Background

Information is defined as a specific determinants

about entities such as facts, events, things,

persons, processes, ideas, or concepts1 and is

needed by people and patients, communities,

service providers, programme managers, policy-

makers, providers of funds, global agencies and

organizations.

Health information system according to

Lippeveld, et al (2000)2,11, is “a set of

components and procedures organized with the

objective of generating information which will

improve health care management decisions at all

levels of the health system”



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A WHO report (2012) 12, on the HIS assessment

of 61 countries scored Cameroons’ HIS at 45%

(present but not adequate) and recommended

more effort to be put in place towards

strengthening it.



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Problem statement

An observation made of data reported on

vaccination that was above the quantity of

supplied vaccine doses.

In addition, data about Cameroon on some

health indicators on the WHO database is often

missing.

There is also disaggregation of data

characterised by separate data collection and

reporting by parallel running programs

Assignment as a staff of health information

system is often considered a disciplinary by the

staff in Cameroon 8



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Justification

For better decision making and improved health

service delivery, there is the need for reliable,

complete, timely, accurate, adequate

information.(strong HIS)

Cameroon falls amongst the United Nations

Commission on Information and

Accountability(COIA) priority Countries that

needs focused support to improve its HIS and

its reporting on the MDGs

This study seeks to assess the adequacy in order

to improvement the HIS of Buea Health Districts.



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Research Goal

The goal of this study is to improve the health

information system in Buea Health District.

General objective

To establish the level of adequacy of the Health

Information System (HIS) in the Buea Health

District



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Specific Objectives

To determine the adequacy of components of the HIS

in Buea Health District.

To provide an overall state of adequacy of the entire

HIS

To identify the weaknesses that exist in the HIS of the

Buea Health District.

To outline priority areas for improvement of the HIS in

the Buea Health District.



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Research questions

How adequate are the various HIS components in the

Buea Health District?

What is the overall state of adequacy of the HIS in the


What are strengths and weaknesses of the HIS in


What are the priority areas for improvement on the

HIS of the Buea Health District?



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Research scope

We will focus on assessing components of health

information system (resources, indicators, data

sources, data management, information products,

dissemination and use) in the Buea Health District.

We will assess HIS components at the Regional,

Districts and health facilities and health related

organisations in the Buea District.



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Definition of terms and concepts

Information is defined as specific determination about

entities such as facts, events, things, persons, processes,

ideas, or concepts5

Information system is part of an institution that processes

and stores data, information, and knowledge.

It is defined as that socio-technical subsystem of an

institution, which comprises all information processing as

well as the associated human or technical actors in their

respective information processing roles 5.

According to Winter A, et al (2011)8, a health information

system (HIS) is an information processing and storing

subsystem of a health care organization, which may be a

single institution, for example, a hospital, or a group of

health care institutions like a health care network.

Chapter II: Literature Review


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Importance of a Health Information System.

Components of a Health Information System.

Assessment of the Components of the Health

information System.



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Study design

A descriptive survey involving groups and key

informants directly involved with the HIS activities

health Organisations and NGOs.

Study area and settings

Buea Health District in the South West Region of

Cameroon.

Settings include: Regional Delegation of Public Health,

District Health Service , Public and Private Health facilities

(14 public and 10 private), NGOs.



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Study population and sampling

Organisations/health facilities involve with HIS

activities in the Buea Health District

Purposive sampling (non-probabilistic sampling)

of Organisations involved with health information

systems activities in Buea.

A convenience sampling of Buea Health District

followed by the selection of all health facilities in

the district.



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Inclusion criteria

Organisations involved with HIS activities in the Buea

Health District.

Acceptance to participate in in-depth interview or

group interview by staff of the various

organizations/facilities selected.

Exclusion criteria

Organisations select with a non-functioning HIS unit.



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Sample Size Calculation

Our sample, made up of all 0rganisations (Regional,

District and health facilities levels) in Buea Health

District.

Sample size calculated using Cochran14 formula for

proportions, followed by adjustment using the finite

population correction for proportions formula.

A sample frame of 27 organizations, with an expected

0.5 variability and a 0.05 precision at 95% confidence

interval will be considered.



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Sample Size Calculation

Cochran14 formula for proportions

no= Z2pq/d2

Finite population correction for a proportion

n= no/1+ (n0-1/N)

N=27 (total population size)

Z=1.96 (assume normal distribution)

P= 0.5 (expected maximum variability)

d= 0.05 (precision for a 95% confidence interval)

n= 25.28 or 26 health organizations



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Study procedure

Administrative approval from: FHS, Regional

Delegation of Public Health South West.

Key informants/groups identified and

appointments set at various study settings

During appointment groups or key informants will

be briefed on components of the HIS to be

assessed.

Version 4.00 of the HMN assessment tool will be

used to collect data on their responses about the

state of the various HIS components.



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Data management and Data analysis

Data collected will be entered in to HMN Excel

Assessment Tool Version 4.00 for analysis.

Analysis will be done for each component of the

HIS, followed by and overall analysis of the entire

HIS.



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Ethical considerations

Administrative approval to carry out studies will

be obtained from the Faculty of Health Sciences

as well as from each organization participating in

the study.

Respondents will be briefed on the purpose of

the survey, will have the option to participate and

to provide reliable and accurate information about

the HIS or not to participate



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Study limitation

Non probabilistic sampling method

Some respondents may not provide honest

assessment of the state of components



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Expected Outcome

The state of adequacy of the various components

and the entire HIS are the expected outcomes.

A classification of the HIS and its components either;

Highly adequate,

Adequate,

Present but not adequate,

Not adequate is expected.



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Timeline

ACTIVITY MONTH April May June July August Septembe

r

Proposal writing

Identification of study

sites and application for

administrative approval,

setting appointments with

study population.

Data collection.

Analysis and reporting of

results.

Thesis defense



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BudgetCategory Cost

Human resources

The principal investigator (PI) and an assistant are needed to meet the various study

participants to collect data. The PI also will input data into the excel version of assessment

tool for analysis.

(Motivation for assistant)

40 000frs

Material resources

Pens and pencils, assessment forms according to component assessed and level of

assessment.

4000frs

HMN Assessment Tool Version 4.00 (forms and excel version). These tools will be downloaded

from the WHO website.

Other web material. (Internet access)

5000frs

Communication 5000frs

Transportation to book appointment and actual interview. 60 000frs

Snacks for participants 40 000frs

Data analysis 0frs

Write-up, printing assembling of the necessary number of copies ( protocol and theses) 30 000frs

Miscellaneous 50000frs

Data collection Tool


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Data analysis Tool


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Items

Highly

adequ

ate

Adequ

ate

Prese

nt but

not

adequ

ate

Not

adequ

ate at

allRation

ale/

comm

ents

Response from interviewees

Aver

age

3 2 1 0

Na

me

1

Na

me

2

Na

me

3

Na

me

4

Na

me

5

Na

me

6

Na

me

7

Na

me

8

Na

me

9

Na

me

10

Na

me

11

Na

me

12

Na

me

13

Na

me

14

I.A.1 The country has up-

to-date legislation

providing the

framework for health

information covering

the following specific

components: vital

registration;

notifiable diseases;

private sector data

including social

insurance;

confidentiality; and

fundamental

principles of official

statistics

Legisl

ation

coveri

ng all

aspect

s

exists

and is

enforc

ed

Legisl

ation

coveri

ng

some

aspect

s

exists

and is

enforc

ed

Legisl

ation

exists

but is

not

enforc

ed

There

is no

such

legisla

tion

Refrences


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1. World Health Organisation. Components of a strong health information system. A guide to the health metrics network framework. Geneva, World Health Organization: 2008

2. Health Metric Network. HMN: Issues in Health Information System. WHO. http://www.who.int/healthmetrics/library/ (accessed 19 February 2014).

3. Winter A. Haux R. Ammenwerth E. Brigl B. Hellrung N. Jahn F. Health Information Systems- Architectures And Strategies. Health informatics, e-ISBN 978-1-84996-441-8. 2. Ed .London: Springer-Verlag London Limited:2010. http://store.freecollege.org/noleech1.php (accessed 29 Jan 2014).

4. Health Metrics Network. Version 4.00. Framework and standards for country health information systems: Assessing national HIS information dissemination and use. Geneva, World Health Organization: 2008.

5. Stansfield S, Walsh J, Prata N, Evans T. Information to Improve Decision Making for Health.1,017-1,030.New York: Oxford University Press; 2006. Available from: www.dcp2.org (accessed from 15 February 2014)

8.WHO. Health Research Methodology: A guide for training in research methods. ISBN 92 9061 157 X. 2 ed. Manila: World Health Organization: 2001

11.WHO. HMN Assessing the National Health Information System, An Assessment Tool version 4.00. 2008. Availab le from: www.healthmetricsnetwork.org. (accessed from April 3rd 2014)

12. Lippeveld, Theo, R. Sauerborn, and C. Bodart. Design and Implementation of Health Information Systems. Health Information System Module. Geneva: WHO. 2000.

http://www.who.int/healthmetrics/library/

http://store.freecollege.org/noleech1.php?hidden=q:/425000

http://www.dcp2.org/

http://www.healthmetricsnetwork.org/

Thank You


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Health & Medicine

Research proposal on