Use of district health information system data to facilitate decision making in Uasin- gishu sub county hospitals, Kenya

Abstract

Comprehensive and dependable information is basis for making decisions. WHO building blocks: services delivery, health information, products and technologies, health workforce, financing and governance. Aim of study was to assess use of DHIS2 data to facilitate decision making in Uasin Gishu Sub County Hospitals. Specific objectives were to determine level of knowledge, organizational, technical and individual factors prompting District Health Information System2 data use in Uasin Gishu Sub Hospitals. Study was conducted in Uasin Gishu-Sub County Hospitals (Kapseret, Kesses, Ainabkoi, Moiben, Turbo and Ziwa). Study used quantitative and qualitative methods using cross-sectional design. Questionnaire was administered to gather quantitative data from 283 providers who were selected randomly while 10 key informers were purposively selected for in-depth interviews. Quantitative data was analyzed using R Software for descriptive, bivariate and multivariate logistic regression. Thematic analysis was used to analyze qualitative data using Qualitative Data Analysis (QDA) software. Bivariate association comparing independent variables and dependent was calculated using Pearson’s Chi Square test and fishers exact test where chi square assumptions were violated. Multivariate analysis was done using logistic regression to measure for predictors. A P value of 0.05 was considered as significant. Findings of numerical variables were depicted in graphs, charts and tables. Results for qualitative data were summarized in form of themes. Approval was got from KeMU SERC and NACOSTI. Consent was sought from participants of the study. Study found that 68.4% respondents reported good, very good or excellent competence levels in data management using DHIS2, DHIS2 information application to inform policy and operational planning was reported as good, very good, and excellent by 37.3%, 18.9%, and 8.0% respectively. Half of the participants (50.0%) acknowledged availability of funds to support DHIS2, champions promoting use of DHIS2 information were records officers (56.2%). Moreover, 61.7% of participants agreed or strongly agreed age influences health workers adoption and use DHIS2 while 65.4% of participants were dissatisfied with IT Support from MOH. Although 80.9% of respondents had log in credentials, only 24.2% had difficulty with logging into DHIS2. Furthermore, 79.5% had low or moderate level of training in DHIS2, 15.0% had never trained and this is why only a third of participants had some confidence in handling tasks using DHIS2. Inferential results show Kapseret, Moiben, and Turbo were associated with higher odds of rating as moderate vs. low or high vs. low users of DHIS2 data compared to Ainabkoi, OR: 4.15 (95% CI), 3.07 (95% CI) and 5.51 (95% CI) respectively. In addition, there is significant associations between level of knowledge, organizational, technical, individual factors and level of DHIS2 data use (p<0.05). Study concludes that level of knowledge on DHIS2 information use is fair across six Sub County Hospitals in Uasin Gishu but utilization of DHIS2 information by CHMT is low. Additionally, main funder of DHIS2 system is County Government while support from National Government is minimal; age influences users’ adoption of DHIS2 data. Level of training on DHIS2 is generally low while utilization of information on DHIS2 to facilitate decisions range from moderate to low. Consequently, study recommends that County scales up utilization of DHIS2 information and generate policy measures to facilitate decision making.