Experiences, barriers, and facilitators of health data use among performance monitoring teams (PMT) of health facilities in Eastern Ethiopia: A qualitative study.

Abstract

Routine health data is crucial in decision-making and improved health outcomes. Despite the significant investments in improving Ethiopia's Performance Monitoring Team (PMT), there is limited evidence on the involvement, implementation strategies, and facilitators and barriers to data utilization by these teams responding to present and emerging health challenges. Therefore, this study aimed to explore the PMT experiences, facilitators, and barriers to information use in healthcare facilities in Eastern Ethiopia. This study employed a phenomenological study design using the Consolidated Framework for Implementation Research (CFIR) to identify the most relevant constructs, aiming to describe the data use approaches at six facilities in Dire Dawa and Harari regions in July 2021. Key informant interviews were conducted among 18 purposively selected experts using a semi-structured interview guide. Thematic coding analysis was applied using a partially deductive approach informed by previous studies and an inductive technique with the creation of new emerging themes. Data were analyzed thematically using ATLAS.ti. Study participants felt the primary function of PMT was improving health service delivery. This study also revealed that data quality, performance, service quality, and improvement strategies were among the major focus areas of the PMT. Data use by the PMT was affected by poor data quality, absence of accountability, and lack of recognition for outstanding performance. In addition, the engagement of PMT members on multiple committees negatively impacted data use leading to inadequate follow-up of PMT activities, weariness, and insufficient time to complete responsibilities. Performance monitoring teams in the health facilities were established and functioning according to the national standard. However, barriers to operative data use included PMT engagement with multiple committees, poor data quality, lack of accountability, and poor documentation practices. Addressing the potential barriers by leveraging the PMT and existing structures have the potential to improve data use and health service performance.