Health workers' use of routine health information and related factors at public health institutions in Illubabor Zone, Western Ethiopia

Early Effects of Information Revolution Interventions on Health Information System Performance in Ethiopia

Health information systems (HISs) are essential to a country's health system as they provide critical support to health policymaking, management, financing, and service delivery. A well-functioning HIS should produce timely and reliable data that are available and easily accessible to decision-makers throughout the health system. Ethiopia has transitioned from a fragmented, paper-based health management information system (HMIS) to a harmonized, digital system used at points of collection and service delivery.In 2016, the Federal Ministry of Health (MOH) launched the Information Revolution (IR), a transformative agenda aimed at enhancing the culture of data use, scaling priority HIS tools and systems, and strengthening HIS governance. Between 2016 and 2022, the MOH, Data Use Partnership, and other partners implemented a series of IR interventions that supported this agenda. These interventions included deploying and harmonizing digital HIS systems; strengthening HIS leadership, coordination, and governance; implementing the IR pathway strategy; enhancing capacity through supportive supervision, mentorship, and training; and improving performance monitoring teams. This article aims to synthesize the key HIS interventions implemented in Ethiopia as part of the IR and document the effects of these interventions on HIS performance.Early studies indicate promising improvements in HIS performance across health facilities in Ethiopia. However, challenges remain. To ensure sustainable progress, it is essential to continue addressing key challenges, such as system interoperability, HIS workforce, and capacity for data use at all levels. By building on the successes of the first Health Sector Transformation Plan and addressing these gaps, Ethiopia can advance its vision of a robust, data-driven health system capable of improving health outcomes and driving evidence-based decision-making.

Improving data use in decision-making and utilization of maternal healthcare services through a data-informed platform for health approaches in districts of the Gedeo Zone, southern Ethiopia, 2023: a cluster-randomized control trial

Background

In low-resource countries such as Ethiopia, the utilization of local data for planning and decision-making health systems was frequently constrained. In addition, despite several government initiatives, maternal health services were not completely utilized. On the other hand, efforts to effectively utilize the local data available to improve the utilization level of maternal healthcare services were insufficient, necessitating the need for a different approach.

Objective

This implementation study aims to test and validate the effectiveness of a data-informed platform for health (DIPH) strategies on data use for decision-making and utilization of maternal health services in districts of the Gedeo Zone, southern Ethiopia.

Methods

A two-arm parallel group, type II hybrid, cluster-randomized control trial design has been implemented to conduct the study between 1 September 2022 and 29 February 2024. Six woredas/districts have been assigned to the intervention arm and the other six to the control arm. Baseline and end-line data have been collected from 120 eligible health management staff (from both intervention arm and control arm). In the intervention arm, district health management staff have been given specialized training and continuous technical assistance as a package called the DIPH strategy by embedding it with the district's current decision-making platform such as Performance Review Team meetings. The DIPH strategy has mainly focused on five-step approaches such as situational assessment, stakeholder engagement, defining/setting priorities, planning, and follow-up. Health management staff in the control arm have performed their regular daily activities. The χ2 and t-tests have been used to check the effect of the intervention. In addition, difference-in-differences estimates have been calculated because the change may inherently occur over time. A P-value of <0.05 and a 95% confidence interval have been used to declare the significance of the intervention.

Discussion

The findings of this study were supposed to give insights into implementation strategies that improve data use in decision-making and utilization of maternal healthcare services at the woreda level and uncover contextual factors that boost the response of these strategies.

Health information use and associated factors among healthcare professionals in Ilu Aba Bor zone, Oromia region, Ethiopia: an institution-based cross-sectional study

BACKGROUND

Health information systems are essential for collecting data for planning, monitoring and evaluating health services. Using reliable information over time is an important aid in improving health outcomes, tackling disparities, enhancing efficiency and encouraging innovation. Studies on the level of health information use among health workers at the health facility level in Ethiopia are limited.

OBJECTIVES

This study was designed to assess the level of health information use and associated factors among healthcare professionals.

METHODS

An institution-based cross-sectional study was conducted among 397 health workers in health centres in the Iluababor zone of Oromia region in southwest Ethiopia, who were chosen using a simple random sampling technique. Data were collected using a pretested, self-administered questionnaire and an observation checklist. The Strengthening the Reporting of Observational Studies in Epidemiology reporting checklist was used to report the summary of the manuscript. Bivariable and multivariable binary logistic regression analysis was used to identify the determinant factors. Variables with a p value <0.05 at 95% CIs were declared significant.

RESULTS

It was found that 65.8% of the healthcare professionals had good health information usage. Use of Health Management Information System (HMIS) standard materials (adjusted OR (AOR)=8.10; 95% CI 3.51 to 16.58), training on health information (AOR=8.31; 95% CI 4.34 to 14.90), completeness of report formats (AOR=10.24; 95% CI 5.0 to 15.14) and age (AOR=0.4; 95% CI 0.2 to 0.77) were found to be significantly associated with health information use.

CONCLUSION

More than three-fifths of healthcare professionals had good health information usage. Completeness of report format, training, use of standard HMIS materials and age were significantly associated with health information usage. Ensuring the availability of standard HMIS materials and report completeness and providing training, particularly for newly recruited health workers are highly recommended to enhance health information usage.

Routine health information use among healthcare providers in Ethiopia: a systematic review and meta-analysis

INTRODUCTION

Healthcare policy formulation, programme planning, monitoring and evaluation, and healthcare service delivery as a whole are dependent on routinely generated health information in a healthcare setting. Several individual research articles on the utilisation of routine health information exist in Ethiopia; however, each of them revealed inconsistent findings.

OBJECTIVE

The main aim of this review was to combine the magnitude of routine health information use and its determinants among healthcare providers in Ethiopia.

METHODS

Databases and repositories such as PubMed, Global Health, Scopus, Embase, African journal online, Advanced Google Search and Google Scholar were searched from 20 to 26 August 2022.

RESULT

A total of 890 articles were searched but only 23 articles were included. A total of 8662 (96.3%) participants were included in the studies. The pooled prevalence of routine health information use was found to be 53.7% with 95% CI (47.45% to 59.95%). Training (adjusted OR (AOR)=1.56, 95% CI (1.12 to 2.18)), competency related to data management (AOR=1.94, 95% CI (1.35 to 2.8)), availability of standard guideline (AOR=1.66, 95% CI (1.38 to 1.99)), supportive supervision (AOR=2.07, 95% CI (1.55 to 2.76)) and feedback (AOR=2.20, 95% CI (1.30 to 3.71)) were significantly associated with routine health information use among healthcare providers at p value≤0.05 with 95% CI.

CONCLUSION

The use of routinely generated health information for evidence-based decision-making remains one of the most difficult problems in the health information system. The study's reviewers suggested that the appropriate health authorities in Ethiopia invest in enhancing the skills in using routinely generated health information.

PROSPERO REGISTRATION NUMBER

CRD42022352647.

Level of implementation of district health information system 2 at public health facilities in Eastern Ethiopia

Objective

The major aim of this study was to assess the level of District health information system 2 (DHIS 2) implementation in the public health facilities (HFs) in Dire Dawa City Administration.

Methods

This study was employed both quantitative (cross-sectional) and qualitative (phenomenological) study designs. All public HFs found in Dire Dawa City Administration and health workers were participated in the study. Quantitative data were collected using a pre-tested, structured, self-administered questionnaire. The collected data were entered into Epi-Data and analyzed using STATA version 14 software. A descriptive summary was computed using proportion and frequencies. Qualitative data were collected from in-depth interview with key informants (KIs), and the results were then analyzed thematically.

Results

The overall implementation level of DHIS 2 was 80%, which shows good implementation. The main difficulties encountered in implementing DHIS 2 were a lack of power backup (64.3%), unreliable internet connectivity (43%), and a lack of training (34.6%). According to an in-depth interview with a 32-year-old professional, "…there is offline and online DHIS 2 software for data collection and reporting that is an opportunity for the health center, but there is a challenge of interruption of electricity lost unsaved data and hinder data to enter and view for making a decision…."

Conclusion

The level of DHIS 2 implementation in this study was good compared to other studies in Ethiopia. However, more than half of the HFs require infrastructure maintenance and support.