Can Retraining Enhance the Knowledge and Attitude of Primary Health Workers towards Health Management Information System in Enugu State, Nigeria?

Abstract

Aim: There is dearth of statistical data and reliable information in our health sector. This study assessed the effectiveness of training in enhancing the knowledge and attitude of primary health care (PHC) workers toward the Health Information Management System (HMIS) in Enugu State, Nigeria. Methods: An experimental study design with an educational intervention involving a control group was conducted in 2004. A two-stage cluster sampling method with block allocation into groups was used in the selection of 57 “study” and 50 “control” respondents. A pre-tested, self administered questionnaire was used for data collection. Data was analysed with Epi-info 3.3.2 software. Results: Both group had similar socio-demographic characteristics and were generally aware of the existence of the HMIS programme at baseline. Pre-intervention, the proportion of the study and control groups identifying the core items of the National Minimum Data Set (NMDS) required to be collected at the PHC level was 80-82% for 1 and 2 items, 50-69% for 4 items each, 25-44% for 3 and 5 items and 7-22% for 5 and 2 items respectively. Post-intervention, the proportion increased significantly in the study group to 80-98% for 8 items, 73% for 1 item, 28-36% for 2 items but remained the same for “in-patient cases” and “in-patient death” unlike the control group which maintained the baseline knowledge. In both groups, the most identified item pre- and post-intervention was “National Programme on Immunization” while the least identified item was “laboratory services”. Attitudes towards data collection for HMIS were largely negative in both groups pre-intervention. But post-intervention, the proportion of the study group who believed that data collection is useful improved from 88% to 100% while the proportion who was not interested in filling the HMIS forms dwindled from 40% to 7% but the control group maintained their baseline negative attitudes. Conclusion: The educational intervention improved the PHC workers' knowledge and attitude towards the HMIS in the study area and is recommended for replication in other parts of Nigeria and Africa where information gathering in the health sector is a problem. Keywords : health information management, intervention, primary health care workers. Journal of College of Medicine Vol. 13 (2) 2008: pp. 71-77