ASSESSING THE MANAGEMENT AND UTILISATION LEVEL OF HEALTH INFORMATION MANAGEMENT SYSTEMS IN WEST MAMPRUSI DISTRICT

ABSTRACT
The study is designed to investigate and analyse the management and utilization of Health Management Information Management System (HIMS) in West Mamprusi District. The objectives are to establish the type of health data/information generated at the health units and how it is processed and stored; describe the levels of utilization of health data/information; assess the level of flow of data/information to and from the health unit; study the main factors and constraints that influences the effectiveness of HIMS in West Mamprusi District; and make recommendations on how to improve HMIS.
This study adopted both qualitative and quantitative research paradigms. The study was conducted in the two Health Sub-Districts (HSD) in West Mamprusi. Data collection methods employed are: documents review, key informant interviews and a Semi – structured questionnaire.
Findings indicate that most health units inherited a very fragmented paper-based information system. Despite interest in HIMS, Clinics and Drug Shops did not have HIMS in place. Data is collected at the health facility level. All the private practitioners and drug shops expressed interest in HIMS. A computerised HIMS database is being used in the DDHS‟s office. Flow of data from the health units to the district level was improving. All the health units that were visited did not have a resource centre and therefore poor storage of data. HIMS records were used for one or all of the following: reference, management and planning, research surveys, monitoring and evaluation. Major constraints facing HIMS in the District were: unavailability of computerized health information systems, general lack of stationery, inadequate and unskilled manpower, lack of transport, poor motivation and no proper storage facilities and that lead to misplacement of records.
From the findings, it is concluded that the management and utilization of the HMIS is still inadequate. Majority of the reporting health units were government owned implying that private practitioners were not represented and yet they have a significant role in health care delivery. Health workers did not appreciate the importance of HIMS.
Based on the above issues the study recommends that: there is need to establish record offices/resource centres at all health centres; HIMS focal persons should be stationed at each sub district and provided with computer and transport to facilitate the collection of data and use of simple excel to collect and analyse data for the health facilities under the sub district; the government should take the initiative to recognise and include private practitioners in the HIMS; and Health workers including those in private practice should be trained in data management.


CHAPTER ONE
INTRODUCTION
1.0 Background
Health Information and Management Systems are highly becoming significant for assessing and improving the quality and coverage of health services. Globally, there is a change in health seeking and delivering behaviours such as from curative care to preventive care, from hospital care to community and public health care, from centralised to decentralised health care, from an explicit project approach to an all-inclusive sectorial approach and this has called for the reforms of the fragmented health information management systems into a single and an all-inclusive health information management systems. Reformation of health information management systems is fundamental in the whole world especially for developing countries since the adoption of primary health care as a global strategy is critical for achieving the „health for all‟ goals (Campbell 1997).

Health Information Management Systems (HIMS) is a new system designed to help in the collection and management of Health Information and it as well provide support to health managers at all levels of health services for management purposes and decision making.

HIMS is known to be “a set of mechanisms and techniques organised for the purpose of producing data that can positively influence decisions made by management at all the health facilities for the betterment of health care provision” (Lippeveld, Sauerborn, and Bodart 2000). HIMS is very vital to Ghana Health Service (GHS) and the Ministry of Health (MOH) since it is an important part its data Resource Centre. HIMS comprises of collection, storage, analysis and usage of the health data that is collected to address noticeable concerns as show in the data or system. Usually, health information data is collected from every health facility and this was initially collected and compiled before being submitted to the District Health Administration (DHA) to the Health Information Officer who then compiles it together with other reports from all the other health facilities in the district and then forward to the Regional Heath Administration for review and planning purposes. Ghana Health Service and for that matter the Ministry of Health(MOH) accords so much significance to the establishment and maintenance of an HIMS that generates, on a consistent basis, accurate, complete and significant data for the management of health establishments at all levels of the health care delivery system. The new model of HIMS ensures that the data collected should be used to advance the efforts of health facilities in providing standard preventive and curative care.

The HIMS functions at different levels: that is at MOH, GHS (National, Regional, District, Community Level). Below are some requirements at the district level

Collect, compile, analyse, use and disseminate data to relevant bodies,

Submit regular reports on sub districts and the District as a whole, that is on monthly, quarterly and annual basis;

Provide feedback to reporting Health facilities in the district and to the Region as well;

Introduce and explain the indicators to administrators at the District Assembly (DA) with regular and timely reports for immediate actions;

Review and follow up with individual health units for clarifications;

Input data into the computerised DHIMS 2;

Budget for DHIMS activities;

Conduct frequent supportive monitoring and coaching visits to improve development and maintenance of the DHIMS in the district.

Technical determining factors for the effective implementation of HIMS include quality of data, design of the system and availability and efficient use of information technology. However, these are not the only determining factors that affect smooth implementation of HIMS, these are: organisational and environmental factors that refers to the country‟s information principles, the model of the DHIMS, the roles and responsibilities of the different actors and the available resources for DHIMS implementation, and the behavioural factors which refers to the knowledge and skills, attitudes, values, and motivation of those involved in the production, collection, collation, analysis, and dissemination of information (Lafond and Field 2003).

Some preconditions are required to be in place to enable HIMS to function effectively and efficiently. These include:

Country specific Available Information policies: this refers to the country‟s available

and functional legislative and regulatory framework policies on acquisition and standards of use of information for both public and private providers.

Financial Resources: this refers to the investments needed to be made in the processes for the production of health information (collection of data, collation, analysis, dissemination, and use)

Human resources: this refers to adequate and efficient recruited and trained personnel at all levels of the health facilities to ensure appropriate use

Communication infrastructure: this refers to adequate communication channels such as computers, electricity and internet and national framework for transmission and management or storage of information.

Coordination and leadership: this refers to mechanism systems to effectively and efficiently lead and coordinate HIMS.

The overall goal of any HIMS is to enable health facilities make decisions in a more transparent and efficient approach, based on evidence with the objective of producing timely, relevant and quality information to support decision making .

There has been a strong acknowledgement for the need of quality data right from the beginning of initiation of sector reforms; this is an essential part of the planning, management and policy development of the health system processes that were being introduced. With emphasis on performance, there is the need to create an integrated and efficiently functioning health information system. Investments in terms of communication infrastructure and human resource for management and utilisation of heath information however remain limited and uncoordinated.

In recent years there have been thorough activities in the area of health information management in Ghana. This is partially in response to the overall changes in the development-planning arena. The current Poverty Reduction Strategy (GPRS II), which represents the Government‟s development agenda, aims at transforming Ghana into a Middle Income Country by 2015. Within this framework, health care as well as protection of the vulnerable within a decentralised, democratic environment has been given a new boost. The Monitoring and Evaluation framework demands information from diverse areas of health care delivery and systems development. The strategic objectives of the GPRS II are also anchored in the Millennium Development Goals and thus demands specific data and reports on health sector activities aimed at meeting the set targets. There has been an effort by the Ghana Health Service to improve data collection, entry and access with the introduction of DHIMS 2 where information if entered from the Sub District, can be view at the national level as compared to the DHIMS 1.

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Item Type: Ghanaian Project Material  |  Attribute: 81 pages  |  Chapters: 1-5
Format: MS Word  |  Price: GH50  |  Delivery: Within 30Mins.
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