Health managers' perception of the primary health care management information system: A case of Bama local government in northern Nigeria

Abstract

Evaluating the quality and performance of Primary Health Care (PHC) systems depend on the information system's capacity to generate reliable and accurate information, within social, cultural, and economic context. This paper reports an assessment of a PHC health management information system from PHC Managers'perspectives, An adapted 3-part Donabedian model informed our assessment of the structure, process and outcomes of the PHC health information system. Pre-tested, semi-structured questionnaires were administered to the PHC Coordinator, 6 Deputy Coordinators, and 18 officers responsible for the health facilities in Bama Local Government Area of Borno State. Majority of the respondents (n=11) believed that staffing at PHC level was inadequate. Only 5 (27.8%) of the managers had training specific to completing HMIS forms. All the facilities were reported to possess registers for the study year (1993), but their numbers dropped by half consecutively down the preceding years to 1990. None reported a health facility that had a copy of the requisite M&E manual guide to HIMIS. Nonetheless 14 reported that report submissions were timely; chief factors causing delays were lack of transport (35.5%), bad roads (16.1%), and scarcity of forms (9.7%). Twelve (12) of the managers judged that the data collected were always or sometimes accurate. Though only 5 crosschecked data to verify accuracy of the submissions. Eight (8) were of the opinion that computerisation was not necessary for rural PHC information system, and eleven (11) felt that the Bama PHC was not ready for computerisation. Twelve (12) of them felt that the quality of the PHC information system had improved since its devolution to the LGA, however, the main suggestions offered to improve the MIS in general were personnel training (32%), feedback from higher levels (20%), and availability of transportation (16%). The information system is only as good as the organisation it serves. Results of this study show majorgaps in the structure of the HMIS at the PHC level which is responsible for gathering data onward to the federal level that culminates in epidemiological and health information for the country. Emphasis for intervention for strengthening information systems should be on starting with generating information for local use, and building local capacity to utilise derived information for daily PHC planning, decision-making and management before the prospect of collecting data for upward submission to higher levels.