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Association Between Infrastructure, Staffing and Training, Validity of Data, Management Support and Quality of Health Management Information System (Hmis) In Malindi Sub-County, Kenya

Show simple item record ZIROH, Christopher K. 2019-11-18T11:27:29Z 2019-11-18T11:27:29Z 2019
dc.description.abstract Health Management Information System (HMIS) is a core component of a functioning Health System. Its role is to make available reliable, complete and timely health service data which is useful for the informed decision-making process in health services management. HMIS is also vital for assessing the health needs of populations and groups, and for planning, implementation, monitoring, and evaluation of healthcare interventions. Such management support capability is crucial especially within the context of severe limitations on finance and other resources. Despite this crucial role, HMIS especially in the developing world are weak and unable to provide the expected health systems support. In Kenya, the HMIS data shows imperfections, as timely and comprehensive data are not always available and even if available, not output-oriented. In Malindi Sub-County of Kenya, data quality and timeliness is not optimal and there is a great deal of overlaps in data collection, often making it not helpful for management decisions and local health programs. These imperfections are an impediment to quality health service delivery. In a cross-sectional study, the association between availability of HMIS infrastructure, levels of staffing and training in HMIS, completeness, accuracy and timeliness, management support for HMIS work and quality of HMIS in Malindi Sub-County, Kenya was determined. Saturated sampling method was used to sample 127 HMIS health workers from 81 health facilities in the district. Data collection used a pre-tested semi-structured questionnaire. Data was analyzed using SPSS (version 19). Chi-square tests was used for proportionality and P≤0.05 was the cut-off for testing significance. The study found out that the health information infrastructure is poor with inadequate working space, lack of proper Standard Operating Procedures and reporting tools, and inadequate equipment to support HMIS in Malindi Sub-County. As much as the staff were trained in HMIS, they were not directly involved in HMIS work. Perception on quality and in regards to completeness, accuracy and timeliness varied across the trained staff. There was poor supervision and feedback as ways of management support in the Sub-County. Additional regression analyses showed that out of all the HMIS Infrastructure, adequate space for HMIS (P<0.0001), SOP and reporting tools (P=0.004), and data processing equipment (P=0.02) were significantly associated with higher odds of quality in HMIS at Malindi Sub-County. However, budget support was not associated with quality of HMIS. On Staffing and Training, staff who indicated that they had undergone training were 1.43 more likely to lead to quality in HMIS (P=0.045) while those demonstrating competencies and better remuneration were 2.30 more likely to lead to quality in HMIS (P=0.006). However, deployment had no association with quality of HMIS in Malindi Sub-County. On validity of HMIS data, completeness (P=0.044), accuracy (P=0.034) and timeliness (P=0.029) had a higher odds of increasing quality in HMIS at Malindi Sub-County. All the management support variables i.e. supervision of the health workers (P=0.540) and provision of feedback (P=0.650) were not associated with HMIS quality in Malindi Sub-County. The study recommends for requisite investment in health management information infrastructure to enable effectiveness and efficiency in the management of health systems. This should include making available working space, equipment, reporting tool, internet connectivity, standard operating procedures among other tools. Functional Health information systems will only be possible with adequate and skilled human resource. There is also need to strengthen management and budgetary support for health information systems. These are critical if effective HMIS is to be implemented in healthcare in Malindi Sub-County and beyond. Information generated will form critical background for support systems not only in Malindi Sub-County but also in other devolved systems. en_US
dc.publisher Maseno University en_US
dc.title Association Between Infrastructure, Staffing and Training, Validity of Data, Management Support and Quality of Health Management Information System (Hmis) In Malindi Sub-County, Kenya en_US
dc.type Thesis en_US

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