BMC Med Inform Decis Mak - Bridging the gaps in the Health Management Information System in the context of a changing health sector.

Tópicos

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Resumo

CKGROUND: The Health Management Information System (HMIS) is crucial for evidence-based policy-making, informed decision-making during planning, implementation and evaluation of health programs; and for appropriate use of resources at all levels of the health system. This study explored the gaps and factors influencing HMIS in the context of a changing health sector in Tanzania.METHODS: A cross sectional descriptive study was conducted in 11 heath facilities in Kilombero district between January and February 2008. A semi-structured questionnaire was used to interview 43 health workers on their knowledge, attitude, practice and factors for change on HMIS and HMIS booklets from these facilities were reviewed for completeness.RESULTS: Of all respondents, 81% had never been trained on HMIS, 65% did not properly define this system, 54% didn't know who is supposed to use the information collected and 42% did not use the collected data for planning, budgeting and evaluation of services provision. Although the attitude towards the system was positive among 91%, the reviewed HMIS booklets were never completed in 25% - 55% of the facilities. There were no significant differences in knowledge, attitude and practice on HMIS between clinicians and nurses. The most common type of HMIS booklets which were never filled were those for deliveries (55%). The gaps in the current HMIS were linked to lack of training, inactive supervision, staff workload pressure and the lengthy and laborious nature of the system.CONCLUSIONS: This research has revealed a state of poor health data collection, lack of informed decision-making at the facility level and the factors for change in the country's HMIS. It suggests need for new innovations including incorporation of HMIS in the ongoing reviews of the curricula for all cadres of health care providers, development of more user-friendly system and use of evidence-based John Kotter's eight-step process for implementing successful changes in this system.

Resumo Limpo

ckground health manag inform system hmis crucial evidencebas policymak inform decisionmak plan implement evalu health program appropri use resourc level health system studi explor gap factor influenc hmis context chang health sector tanzaniamethod cross section descript studi conduct heath facil kilombero district januari februari semistructur questionnair use interview health worker knowledg attitud practic factor chang hmis hmis booklet facil review completenessresult respond never train hmis proper defin system didnt know suppos use inform collect use collect data plan budget evalu servic provis although attitud toward system posit among review hmis booklet never complet facil signific differ knowledg attitud practic hmis clinician nurs common type hmis booklet never fill deliveri gap current hmis link lack train inact supervis staff workload pressur lengthi labori natur systemconclus research reveal state poor health data collect lack inform decisionmak facil level factor chang countri hmis suggest need new innov includ incorpor hmis ongo review curricula cadr health care provid develop userfriend system use evidencebas john kotter eightstep process implement success chang system

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