Abstract
Background: An efficient health management information system (HMIS) improves health care delivery and outcomes. However, in most rural settings in Uganda, paper-based HMIS are widely used to monitor public health care services. Moreover, there are limited capabilities and capacity for quality HMIS in remote settings such as Kayunga district.Objectives: The quality assurance practices of HMIS in health centres (HCs) in Kayunga district were evaluated.Method: A cross-sectional descriptive study design was used to assess the quality of HMIS at 21 HCs in Kayunga district. Data were collected through in-depth interviews of HMIS focal persons as well as document analysis of HMIS records and guidelines between 15 June 2010 and 15 July 2010. The main outcomes were quality assurance practices, the HMIS programmatic challenges and opportunities. The practice of HMIS was assessed against a scale for good quality assurance practices. Qualitative data were coded and thematically analysed, whereas quantitative data were analysed by descriptive statistics using SPSS v22 software.Results: All the 21 HCs had manual paper-based HMIS. Less than 25% of HCs practised quality assurance measures during collection, compilation, analysis and dissemination of HMIS data. More than 50% of HCs were not practising any type of quality assurance during analysis and dissemination of data. The main challenges of the HMIS were the laborious and tedious manual system, the difficulty to archive and retrieve records, insufficient HMIS forms and difficulty in delivering hard copies of reports to relevant stakeholders influenced quality of data. Human resource challenges included understaffing where 43% of participating HCs did not have a designated HMIS staff.Conclusion: The HMIS quality assurance practices in Kayunga were suboptimal. Training and support supervision of HMIS focal persons is required to strengthen quality assurance of HMIS. Implementation of electronic HMIS dashboards with data quality checks should be integrated alongside the manual system.
Highlights
Problem statementRemote health care settings are at risk of inadequate health care service monitoring and delivery
The implementation of a quality assurance system for health management information systems (HMIS) yields critical signals for actual and potential errors during data collection and processing, identifies the need for technical support or indicates the necessity to adapt the system to new demands from health programmes or decision-makers (Kasambara et al 2017; Kyalo & Odhiambo-Otieno 2017; Muhindo & Joloba 2016; Nkolo et al 2008; Qazi & Ali 2009; Upadhaya et al 2016)
The study assessed the extent of the data quality assurance practices as well as challenges and opportunities in implementing HMIS in Kayunga district
Summary
Problem statementRemote health care settings are at risk of inadequate health care service monitoring and delivery. The World Health Organisation (WHO) developed a framework for strengthening health information systems (HISs) in such settings; it gives limited guidance on quality assurance practices for the data collection and utility (WHO 2010). These gaps necessitated this study to http://www.aejonline.org. In most rural settings in Uganda, paper-based HMIS are widely used to monitor public health care services. There are limited capabilities and capacity for quality HMIS in remote settings such as Kayunga district
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