Accelerating implementation of District Health Information Systems: Perspectives from healthcare workers from KwaZulu-Natal, South Africa

Champaklal C Jinabhai,Maureen N Sibiya,Surendra Thakur,Stanley C Onwubu

doi:10.4102/sajim.v23i1.1435

Champaklal C Jinabhai, Maureen N Sibiya + Show 2 more

Open Access

https://doi.org/10.4102/sajim.v23i1.1435

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Abstract

Background: Although electronic health record systems are critical for healthcare management, there has been genuine concern about the quantity and quality of data generated by these systems inhibiting its full implementation.Objectives: The purpose of this article was to explore the experiences of healthcare workers (HCWs) and challenges facing the acceleration of the District Health Information System (DHIS) in the KwaZulu-Natal (KZN) province of South Africa.Methods: In this study, an interpretive research paradigm was followed to explore the current state of electronic health in South Africa from the experiences of HCWs in the KZN province. Semi-structured focus group interviews conducted with 20 participants drawn from the district office, clinical nurse practitioners and data capturers allowed thematic analysis of data using a systems approach to link the perspectives HCWs to the design of the DHIS.Results: The participants held the view that e-health is crucial for monitoring disease trends, policy development, planning and allocation of infrastructure, information technology (IT), financial and human resources. Nevertheless, the participants highlighted a concern surrounding e-health regulations, ethics and data confidentiality; data quality and lack of interoperability of Health Information Systems (HIS). This concern was attributed to data fragmentation, internal politics and lack of coordination of the data system.Conclusions: The study suggests that good quality data – from an integrated DHIS, is highly critical for the effective utilisation, implementation and acceleration of e-health systems in the province to support epidemiological surveillance and modelling of outbreaks, such as the COVID-19 pandemic.

Highlights

In an attempt to improve the quality of data, the South African National Department of Health (NDOH) developed a District Health Information System (DHIS) to collect monthly facility-based data from the public sector primary health services and district hospitals (Nicol et al 2013)
The DHIS, which facilitates the disease surveillance process is a continuous process of data collection, analysis, interpretation and dissemination of information that is essential for immediate public health action (Ahanhanzo et al 2014; Dureab et al 2020; Pourbohloul & Kieny 2011)
Recurring epidemics, the current global coronavirus disease 2019 (COVID-19) pandemic reinforced the need to strengthen national disease surveillance systems that could predict the pattern of disease and quickly develop a strategy to mitigate against the spread to other countries (Dureab et al 2020)

Summary

Introduction

In an attempt to improve the quality of data, the South African National Department of Health (NDOH) developed a District Health Information System (DHIS) to collect monthly facility-based data from the public sector primary health services and district hospitals (Nicol et al 2013). In South Africa, primary health services are mostly provided at community centres and satellite clinics (Wright et al 2014). Whilst the e-Health 2012 strategy for South Africa stipulates that all indicator data derived from patients be captured electronically at the point of care, data collected by nurses in the clinics are historically recorded in paper-based registers (Wright et al 2014). Electronic health record systems are critical for healthcare management, there has been genuine concern about the quantity and quality of data generated by these systems inhibiting its full implementation

Objectives

Results

Conclusion