Use Of Information In Decision Research Articles

Utilization of routine health data and its determinants among healthcare workers in public health facilities of harari region, eastern Ethiopia

BackgroundRoutine health information is the pillar of the planning and management of health services and plays a vital role in effective and efficient health service delivery, decision making, and program improvement. Little is known about evidence-based actions to successively advance the use of information for decision making. Therefore, this study aimed to assess the level and determinants of routine health data utilization among health workers in public health facilities in the Harari region, Ethiopia.MethodsAn institutional-based cross-sectional study design was used from June 1 to July 31, 2020. A total of 410 health care providers from two hospitals and five health centers were selected using a simple random sampling technique. Data were collected through a structured questionnaire complemented by an observational checklist. The collected data were thoroughly checked, coding, and entered into Epi-data version 4.6 before being transferred to Stata version 14 for analysis. Frequency and cross-tabulations were performed. To measure factors associated with routine use of health data, bivariate and multivariate logistic regression analyzes were performed. The odds ratio with a 95% CI was calculated, and then a p-value of less than 0.05 was considered significant.ResultThe general utilization of routine health data was 65.6%. The use of routine health data was significantly associated with healthcare workers who had a positive attitude towards data [AOR = 4 (2.3–6.9)], received training [AOR = 2.1 (1.3–3.6)], had supportive supervision [AOR = 3.6 (2.1–6.2)], received regular feedback [AOR = 2.9 (1.7–5.0)] and perceived a culture of information use [AOR = 2.5 (1.3–4.6)].ConclusionsSixty percent of health professionals had used routine health data utilization. Training, supervision, feedback, and the perceived culture of information were independently associated with the use of routine health data utilization. Therefore, it is critical to focus on improving data utilization practices by addressing factors that influence the use of routine health data.

BUSINESS INTELLIGENCE: STATIC AND DYNAMIC ASPECTS OF THE WORLD MARKET

Objective. Determination of the state and features of the development of Business Intelligence as a type of decision support system in the world. Methods. The following methods and techniques of cognition were used in the research process: theoretical generalization and comparison, analysis and synthesis, induction and deduction, generalization and systematization. Results. It was established that business intelligence (BI) is a type of decision support system (DSS), which is a large-scale, interactive information system designed to ensure the collection, processing (in particular, analysis and visualization), storage and use of information for decision-making, the demand for which, in view of the significant and exponentially growing amount of information that must be taken into account by the management of the enterprise when making management decisions, the imperatives of transparency and the validity of management decisions, is constantly growing. It was determined that BI began to be actively discussed in scientific and business circles since the 80s of the 20th century. It was established that at the current stage of development, the global BI market is dynamically developing and is characterized by the following features: 1) significant and growing market capacity; 2) complex market architecture; 3) asymmetry and disproportionality of development; 4) significant structural features of the offer and a high level of market concentration; 5) significant structural features of demand. It was determined that as of 2022, the world market of BI is estimated at 29.42 billion dollars, in 2030 - 54.27 billion dollars.It is substantiated that the BI market is quite segmented, it includes the following segments: market of BI software, market of BI platforms and services; the local BI market (On-Premise BI) and the cloud BI market (Cloud BI); BFSI for Banking, Financial Services and Insurance (BFSI), IT BFS, Retail BFS, Healthcare BFS, etc.; the North American BI market, the European BI market, the Asia-Pacific region BI market, etc., the BI market of individual countries. Based on information about the state and features of the development of the segments of the BI market, it was established that the largest and most developed segments of the BI market are: the BI software market, the cloud BI market, the BI market for IT, the North American market; the fastest growing segments of the BI market are: BI platforms, applications and services market, cloud BI market, mobile BI market, Asia Pacific BI market, BI market for BFSI. It has been proven that despite the fact that the IT market is characterized by a fairly developed subject structure, the leading companies of the IT market are: IBM (USA), Oracle (USA), Microsoft (USA), AWS (USA), Salesforce (USA), Sisense (USA), MicroStrategy (USA), Teradata (USA), etc., this market is characterized by a high level of concentration, because Microsoft's share is 36% of the IT software market, 71% of cloud IT. It has been established that BI is most actively implemented by large companies.

Healthcare providers’ views of factors influencing family planning data quality in Tshwane District, South Africa

The family planning service requires a routine health information system (RHIS) that can produce quality data that will be used for making decisions. However, the quality of data generated is not always of a good standard. Its usefulness in making data-driven decisions in family planning service is questionable. The study intended to assess the quality of family planning data and determine healthcare providers' (HCPs') views on factors influencing data quality in Tshwane district. The study was carried out in 13 healthcare institutions in Tshwane district, Gauteng province, South Africa. This paper reports on the quantitative strand of a mixed methods study. A sample of 111 HCPs was selected through a stratified random sampling technique, and six months of monthly reports from 13 institutions were reviewed for data quality. A self-administered questionnaire and a tick sheet were utilised to collect data from the HCPs and to review monthly reports for data quality, respectively. The Statistical Package for the Social Sciences (SPSS) programme for Windows version 24.0.0 was used to analyse the data. Data quality, mainly accuracy and timeliness, was a challenge. Many HCPs were not trained in the RHIS. They viewed several issues relating to organisational, behavioural and technical factors as barriers to data quality. The low quality of family planning data has a negative impact on policy development and decision-making.Contribution: There is a need for capacity building through training and supportive supervision, provision of adequate human and technical resources to enhance data quality and use of information for decision-making.

A Hybrid System For Pandemic Evolution Prediction

The areas of data science and data engineering have experienced strong advances in recent years. This has had a particular impact in areas such as healthcare, where, as a result of the pandemic caused by the COVID-19 virus, technological development has accelerated. This has led to a need to produce solutions that enable the collection, integration and efficient use of information for decision making scenarios. This is evidenced by the proliferation of monitoring, data collection, analysis, and prediction systems aimed at controlling the pandemic. This article proposes a hybrid model that combines the dynamics of epidemiological processes with the predictive capabilities of artificial neural networks to go beyond the prediction of the first ones. In addition, the system allows for the introduction of additional information through an expert system, thus allowing the incorporation of additional hypotheses on the adoption of containment measures.
 
 
 

Value of Information: Exploring Behavioral and Social Factors

There is growing interest within and beyond the economics community in assessing the value of information (VOI) used in decision making. VOI assessments often do not consider the complex behavioral and social factors that affect the perception, valuation, and use of information by individuals and groups. Additionally, VOI assessments frequently do not examine the full suite of interactions and outcomes affecting different groups or individuals. The behavioral and social factors that we mention are often (but not always) innately-derived, less-than-conscious influences that reflect human and societal adaptations to the past. We first discuss these concepts in the context of the recognition and use of information for decision making. We then find fifteen different aspects of value and information pertinent to VOI assessments. We examine methodologies and issues related to current VOI estimation practices in economics. Building on this examination, we explore the perceptions, social factors, and behavioral factors affecting information sharing, prioritization, valuation, and discounting. Information and valuation issues are then considered in the context of information production, information trading and controls, and information communication pathologies. Lastly, we describe issues relating to information useability and actionability. Our examples mention the value and use of geospatial information, and more generally concern societal issues relating to the management of natural resources, environments, and natural and anthropogenic hazards. Our paper aims to be instrumentally relevant to anyone interested in the use and value of science.

Turnover Intention And Associated Factors Among Health Information Technology Professionals Working In Public Health Institution, South Gondar Zone, Northwest Ethiopia

Background Place of work turnover is critical to health information technology professionals (HIT) and health information systems as it indications dropping skilled and competent health information professionals. However, the progress of surviving plans requests a strong acceptance of the place of work variables that either inspire health information staff to persist active or principal them to dispensation their recent working organization. Objective This study was deliberate to measure intention to leave and associated factors among health information technology professionals working in south Gondar zone public health institution, Amhara Region, Ethiopia Methods A cross-sectional study was carried out among 122 health information technology professionals. Data were collected using structured pre-tested self-administered questionnaires from September 1 to October 1/2020. The collected data were entered into Epi-info Version 7 and exported to SPSS version 20 software for analysis. Bivariate and multivariable logistic regression was employed to detect influences associated with dependent and independent variables. Odds ratio (OR), with 95% CI and p< 0.05 were computed to determine the level of significance. Results Based on the operational definition the total score of intent to leave health information technology professionals from the organization was 64.8% [95% CI: 56.6-72.9]. Among the applicant variables for multivariable analysis 3 variables like the marital status of the respondents [OR: 0.49(0.231-1.042)p:value 0.000], performance appraisal of the respondents [OR: 7.0(2.66-18.45) p:value 0.000] and recognition of the respondents [OR: .447(.783-3.513) p:value 0.002] had to have a significant association with intention to leave and performance appraisal of the respondents were significantly associated 8.29 times [AOR: 8.29(3.002-22.889)p:value 0.001] to leave of the respondents from the working organization. Conclusion and recommendation The magnitude of health information professionals’ intention to leave was found to be high, which can extremely affect the coverage and quality of information management and the use of information for decisions in the zone. Health care policy-makers and hospital managers need to develop and institutionalize evidence-based retention strategies taking into consideration the predictors of health information professionals’ intention to leave.

Sustainable tourism indicators as policy making tools: lessons from ETIS implementation at destination level

This paper aims to analyse the roles sustainable tourism indicators (STIs) play in policy making processes at destination level through a three-dimensional framework: 1) instrumental (direct use of information for decision-making), 2) conceptual (awareness raising) and 3) symbolic (legitimate decisions). The European Tourism Indicator System (ETIS) is taken as a reference system as the only common framework developed by the European Commission to measure and monitor tourism sustainability. Our empirical research follows a three-step approach. Firstly, we analysed ETIS to investigate its potential to be linked to tourism policy. Secondly, we took Zuid Limburg, the Netherlands as a case study, to assess the role of ETIS pilot implementation at the destination. Finally, we performed a comparative analysis of 11 destinations that have tested ETIS, to better frame the weight of the indicator roles in local policy making processes. We conclude that so far the STIs developed within ETIS have had limited instrumental and symbolic use, while their conceptual role, related to the social learning process resulting from their implementation, can be considered a pre-condition for other roles to emerge. Moreover, the indicators’ role within policy making is closely linked to the specific governance context, influencing and being influenced by it.

Designing and Delivering Webinars to Improve Science Communication and Engagement between Environmental Researchers and Natural Resource Practitioners

Research across natural resource management disciplines has identified an implementation gap between researchers and managers, where institutional norms and practices limit integration of novel data and observations into decision-making. This gap has largely been addressed using one-way science communication tools such as publications and conference presentations. While these tools can be designed and delivered effectively, mounting evidence suggests two-way communication builds more trust, enhances engagement, and may lead to more active use of scientific information in decision-making. The National Oceanic and Atmospheric Administration (NOAA) Western Regional Collaboration Team’s West Watch webinar is a one-way communication tool that shares information about climate, weather, and ocean condition anomalies to an internal audience of NOAA experts and key partners. NOAA is interested in expanding this tool to improve information accessibility and use by communities of interest that NOAA serves. This research uses a mixed-methods approach to evaluate how West Watch could change to function as a two-way communication tool, facilitating bilateral information movement between research presenters and the audience. Research results, supported by literature, inform five best practices and recommendations for changes to West Watch, as well as the design and implementation of future science communication tools.

Routine health information system in the health facilities in Yaound\xe9\u2013Cameroon: assessing the gaps for strengthening

BackgroundManagement of health data and its use for informed-decision making is a challenging health sector aspect in developing countries. Monitoring and evaluation of health interventions for meeting health-related Sustainable Development Goals (SDGs), and Cameroon Health Sector Strategy (HSS) targets is facilitated through evidence-based decision-making and public health action. Thus, a routine health information system (RHIS) producing quality data is imperative. The objective of this study was to assess the RHIS in the health facilities (HFs) in Yaoundé in order to identify gaps and weaknesses and to propose measures for strengthening.MethodsA health facility-based cross-sectional descriptive study was carried out in the six health districts (HDs) of Yaoundé; followed by a qualitative aspect consisting of in-depth interviews of key informants at the Regional Health Office. HFs were selected using a stratified sampling method with probability proportional to the size of each HD. Data were collected (one respondent per HF) using the World Health Organization and MEASURE Evaluation RHIS rapid assessment tool. Data were entered into Microsoft Excel 2013 and analyzed with IBM-SPSS version 20.ResultsA total of 111 HFs were selected for the study. Respondents aged 24–60 years with an average of 38.3 ± 9.3 years; 58 (52.3%) male and 53(47.7%) female. Heads of HFs and persons in charge of statistics/data management were most represented with 45.0% and 21.6% respectively. All the twelve subdomains of the RHIS were adequately functioning at between 7 and 30%. These included Human Resources (7%), Data Analysis (10%), Information and Communication Technology (11%), Standards and System Design (15%), Policies and Planning (15%), Information Dissemination (16%), Data Demand and Use (16%), Management (18%), Data Needs (18%), Data Quality Assurance (20%), Collection and Management of Individual Client Data (26%), Collection, Management, and Reporting of Aggregated Facility Data (30%).ConclusionsThe level of functioning of subdomains of the RHIS in Yaoundé was low; thus, immediate and district-specific strengthening actions should be implemented if health-related SDGs and HSS targets are to be met. A nation-wide assessment should be carried out in order to understand the determinants of these poor performances and to strengthen the RHIS.

Technical Evaluation of the Margins Between Established Risk Goals and Health Objectives for Nuclear Power Plants

This work explores recent developments in severe accident analysis and risk assessment to inform and expand on these perspectives. Variations in nuclear reactor safety policy, reactor designs, extent of use of risk information in decision making, and other aspects can impact how safety policies regarding nuclear installations are developed and implemented. In particular, the relationship of nuclear policy in the United States is explored with regard to quantitative risk criteria or goals and their relationship with health objectives. In the United States and many countries around the world, health objectives are defined with regard to the potential impact to the public in terms of “early” fatalities and “latent” fatalities. This paper discusses how the link between these health objectives and quantitative risk goals have been developed and how recent information may change the perspective originally held when the policies were established (e.g., that there would be a significant margin between the risk of operating nuclear facilities and these goals). Given that these metrics play a significant role in how current risk applications are used for operating nuclear reactors, especially when results are to be compared with thresholds, it is important to recognize the evolution and current understanding of associated embedded margins. Given the additional 30 years of insights, the expansion of risk application in the commercial nuclear reactor industry, and improvements in methodologies and computing capabilities, significant additional information has been gained. These insights are discussed and presented in this paper.

Use of Weather and Climate Information in Decisions on Conservation of Water Resources in Kilombero River Catchment, Tanzania

The authors thankfully acknowledge the financial support from Uncertainty Reduction in Models for Understanding Development Applications (UMFULA) Project under the Future Climate for Africa (FCFA). Special thanks go to Declan Conway (London School of Economics and Political Science) who contributed invaluable inputs to the publication. Abstract This study assessed the use of climate information in decisions on the conservation of water resources and determined influencing factors in Kilombero River Catchment in Tanzania. A cross-sectional research design was employed. Purposive sampling was used to select Kilombero, Ulanga and Malinyi districts and Lumemo, Nakafulu and Biro villages while simple random sampling was used to select respondents. A total of 120 household respondents were interviewed in the three villages. In addition, 7 Key Informants’ Interviews (KIIs) involving officers from Kilombero Game Controlled Area (KGCA) and Rufiji Basin Water Board (RBWB) and 3 Focus Group Discussions (FGDs) with the villagers were conducted. Quantitative data were analyzed using Statistical Package for Social Science (SPSS) and STATA computer programs while qualitative information was analyzed using content analysis. Results show nearly half of respondents of weather and climate information in decisions to conserve water resources. Although ten decisions were identified in the area, weather and climate information was highly used in deciding conservation measures (X 2 =5.992, p<0.05), construction of small pans or bore holes for water storage (X 2 =6.580, <0.05) and reducing the number of livestock (X 2 =5.889, p<0.05). Four variables which had significant and positive correlation with conservation of water resources were identified. Foremost among them is extension visits (s=0.079; p<0.01) which implied access and frequency of extension visits influence use of weather and climate information in making decisions. It is concluded that communities in the area use weather and climate information in decisions which conserve water resources. Policy makers are advised to emphasize factors which had positive significant correlation with conservation of water resources. Keywords: Climate Information Use, Water Conservation Decisions. DOI: 10.7176/JEES/10-4-06 Publication date: April 30 th 2020

Tomada de decisão do gestor escolar das escolas públicas de ensino médio no Distrito Federal e a interface com o letramento informacional

O estudo analisou o comportamento de busca e uso da informação para a tomada de decisão do gestor escolar, em relação aos padrões de letramento informacional nas escolas de ensino médio do Distrito Federal da rede pública de ensino. A pesquisa é de natureza quali-quantitativa, com uso de documentos oficiais do sistema educacional do Distrito Federal, questionário e entrevista semiestruturada. Os resultados mostram que o principal acesso à informação é realizado pela internet e que o volume de dados, aliado à falta de tempo para obtenção de informações, dificulta a tomada de decisão. Para tomar decisões, os gestores consultam informações disponíveis na escola, além do projeto político pedagógico. Verificam a origem da informação recebida e os resultados alcançados pela escola nas avaliações externas do governo. Por fim, os dados coletados pelos gestores educacionais, em relação aos padrões do letramento informacional, mostram o desenvolvimento de poucas habilidades e a necessidade de formação sistemática e adequada para aprender a lidar com a informação.

Use of Internet Health Information Among Students in Jeddah, Saudi Arabia: A Cross-Sectional Study

BACKGROUND: Internet is a resource used to deliver health information, and has the potential to provide nutrition education in particular for individuals with a good level of education. The purpose of this study was to investigate the use of internet as a source for health information and analyzing the related factors for internet as a source for health information among students in Jeddah, Saudi Arabia.&#x0D; &#x0D; METHODS: We recruited 164 high schools, undergraduate and postgraduate students living in Jeddah, Saudi Arabia. A self-administered structured questionnaire to collect data on searching the internet for health information was used. It included frequency and timing of search, type of information, use of information in decision making, general health condition and socio-demographic characteristics. Differences between students who perceived and those who did not perceive improvement in health care after using internet health information were assessed using the chi-squared test.&#x0D; &#x0D; RESULTS: 92.7% of the students usually searched the internet for health information and 84.8% perceived internet health information as a help towards improving their health status. Students at higher educational levels talked significantly more often with their doctors regarding the health information they got from the internet (p = 0.014). We found significantly higher rates of perceived improvement in health among females (p &amp;lt;0.001), participants who trusted the health information they got from the internet (p &amp;lt;0.001), those who searched the internet for health information for themselves and other persons (p = 0.034), who searched for information on health care, physical fitness and nutrition and specific diseases (p = 0.005) and those who did it to increase their knowledge (p = 0.024).&#x0D; &#x0D; CONCLUSION &amp;amp; RECOMMENDATIONS: The majority of participants perceived the health information they got from the internet as a help towards improving their health status. Interventions should be developed to enhance the use of internet health information among males and high school students.

Nested probabilistic-numerical linguistic term sets in two-stage multi-attribute group decision making

Fuzzy linguistic approach is considered as an effective solution to accommodate uncertainties in qualitative decision making. In the face of increasingly complicated environment, we usually face the fact that multi-attribute group decision making contains nested information, and the whole process needs to be evaluated twice so that the experts can make full use of decision information to get more accurate result, and we call this kind of problem as two-stage multi-attribute group decision making (TSMAGDM). However, the existing linguistic approaches cannot represent such nested evaluation information to deal with the above situation. In this paper, a novel linguistic expression tool called nested probabilistic-numerical linguistic term set (NPNLTS) which considers both quantitative and qualitative information, is proposed to handle TSMAGDM. Based on which, some basic operational laws and aggregation operators are put forward. Then, an aggregation method and an extended TOPSIS method are developed respectively in TSMAGDM with NPNLTSs. Finally, an application case about strategy initiatives of HBIS GROUP on Supply-side Structural Reform is presented, and some analyses and comparisons are provided to validate the proposed methods.

Too Worried to Judge: On the Role of Perceived Severity in Medical Decision-Making.

Ideally, decisions regarding one’s health should be made after assessing the objective probabilities of relevant outcomes. Nevertheless, previous beliefs and emotional reactions also have a role in decision-making. Furthermore, the comprehension of probabilities is commonly affected by the presentation format, and by numeracy. This study aimed to assess the extent to which the influence of these factors might vary between different medical conditions. A sample of university students were presented with two health scenarios containing statistical information on the prevalence of breast cancer and hypertension either through icon arrays (N = 71) or natural frequencies (N = 72). They also received information regarding a preventive measure (mammogram/low-sodium diet) and the likelihood of a positive mammogram or a rich-sodium diet either when suffering or not suffering from the disease. Before seeing the data, participants rated the severity of the disease and the inconvenience of the preventive measure. After reading the health scenario, participants had to rate its difficulty, and how worrisome it was. They had also to rate the prior probability of suffering from this medical condition, and the posterior probability of it, provided a positive mammogram or a rich-sodium diet. Finally, they rated the extent to which they would recommend the preventive measures. All the rates used the same 1 (little)-8 (a great deal) scale. Participants’ numeracy was also assessed. The scenarios differed significantly in perceived severity and worry, with the cancer scenario obtaining higher scores. Importantly, regression analyses showed that the recommendations in the two health scenarios depended on different variables. A model taking into consideration severity and worry rates best explained decisions in the cancer scenario; in contrast, in the hypertension scenario the model that best explained the recommendations comprised both the posterior probability estimate and the severity rate. Neither numeracy nor presentation format affected recommendation but both affected difficulty, worrying and probability rates. We conclude that previous perceptions of the severity of a health condition modulate the use of probabilistic information for decision-making. The roles of presentation format and numeracy in enabling patients to understand statistical information are also discussed.

Understanding social preferences for land use in wastewater treatment plant buffer zones

This study explores community preferences regarding alternative land uses in wastewater treatment plant buffer zones in Western Australia. The study uses the choice experiment method, and is the first study to apply this method to the context of wastewater treatment plant buffer zone management. In the study there are two information conditions and four land use options. In the first information condition different land use options were presented using text and tables only. In the second information condition land use options were presented visually as maps alongside the text and table information. A between-subject design is used to test how the presentation of information influences people’s preferences for different land use options. For both information conditions the most preferred land use option is nature conservation. Presenting visual information was found to reduce the tendency of respondents to select the status quo option, and was also associated with evidence of increased use of information for decision making. Comparing the value of the optimal land use mix to current real world buffer zone land uses identified the possibility of material welfare gains from reallocating land in buffer zones towards nature based land uses.

Case Study: From Alcoholic to Workaholic

The least liked part of their job for supervisors, managers and executives are dealing with employee performance issues. This includes performance appraisals, monitoring, discipline, and termination. Because of the dislike for this part of their job, many managers ignore problems and issues with employees until they become so severe. Some managers never deal with the problems. They push off the to someone else or they themselves leave for a different job. So, what do supervisors, managers, and executives do when faced with problem employees? There are six solutions offered to solve the problem. (1) Deal with employee problems promptly. (2) Get help from others. (3) Learn how to do progressive discipline. (4) Set a good example and teach others what you expect. (5) Stay up-to-date on laws, union regulations, and personnel policies. (6) When faced with a difficult situation, feel the fear and press forward anyway. While discipline and termination are not pleasant tasks, there are many options for dealing with them early that can turn the situation into a win/win for both the manager and the employee. There are many other reasons why organizations should improve key decisions. More positively, there are new insights, technologies, and methods that can guide decisions. Scientific advances in neuroscience and behavioral economics provide new insights for decision-making. Relatively, new technologies, including analytics, decision automation tools, and business intelligence systems, make it possible to make better use of information in decisions. 'Wisdom of crowds' approaches and technologies allow larger groups of people to participate meaningfully in decision processes. Organizations cannot afford to ignore these new options if they wish to make the best possible decisions. In this case, the writer wishes to implement alternative solutions which state: get help from others, and set a good example and teach others what you expect. These are considered the highest value option and therefore will provide the most optimal result which is a win-win solution. This case study is related to a problematic employee dealt with the management who later became an asset to the organization.

Analysing inhibitors of integrating and routinizing Health Information Systems for Universal Health Coverage: the case of Cameroon

Background and Purpose : The purpose of this paper is to describe the state of HMIS in Cameroon, with particular emphasizes on the organisational factors affect integration, routinization and use of information for decision-making for the achievement of UHC goals. Methods: This paper is based on an interpretative case study on the implementation of electronic data-based in Cameroon. Data was collected through interviews conducted with District Health Managers, Facility Information Officers, and Matron-In-charge of healthcare facilities from December 2015, to January and July 2016. Document review was used as secondary data collection. Multiple variation sampling technique was used to select interviewees. Results : Though there is a “general expectation that as electronic IS (DHIS) has been implemented, computers and Internet dongles provided to district and facilities information managers, the quality of information generated will certainly become of good quality and could be used for decision making”. This assumption neither concurs with the perspective of ICTs for development nor ICT as an agent for institutional change. According to advocates for ICT as an agent for changes IS is an institution and in order for it to bring about change, all aspects (human and non-human, social, cultural and political factors) have to be given equal attention. This paper analysed inhibitors of HMIS integration in Cameroon. Factors that affect effective routinzing, integrating and use of HMIS are; multiple data collecting tools, centralized information management, inadequate information system infrastructure, lack of IT specialist and basic computer skills and non-culture of information use. Conclusions: HMIS offers a remarkable potential for improving the efficacy and effectiveness for healthcare and also for achieving the goal of UHC. However, its integration, routinization and use are quite variable depending on the context.

Perceptions about data-informed decisions: an assessment of information-use in high HIV-prevalence settings in South Africa

BackgroundInformation-use is an integral component of a routine health information system and essential to influence policy-making, program actions and research. Despite an increased amount of routine data collected, planning and resource-allocation decisions made by health managers for managing HIV programs are often not based on data. This study investigated the use of information, and barriers to using routine data for monitoring the prevention of mother-to-child transmission of HIV (PMTCT) programs in two high HIV-prevalence districts in South Africa.MethodsWe undertook an observational study using a multi-method approach, including an inventory of facility records and reports. The performance of routine information systems management (PRISM) diagnostic ‘Use of Information’ tool was used to assess the PMTCT information system for evidence of data use in 57 health facilities in two districts. Twenty-two in-depth interviews were conducted with key informants to investigate barriers to information use in decision-making. Participants were purposively selected based on their positions and experience with either producing PMTCT data and/or using data for management purposes. We computed descriptive statistics and used a general inductive approach to analyze the qualitative data.ResultsDespite the availability of mechanisms and processes to facilitate information-use in about two-thirds of the facilities, evidence of information-use (i.e., indication of some form of information-use in available RHIS reports) was demonstrated in 53% of the facilities. Information was inadequately used at district and facility levels to inform decisions and planning, but was selectively used for reporting and monitoring program outputs at the provincial level. The inadequate use of information stemmed from organizational issues such as the lack of a culture of information-use, lack of trust in the data, and the inability of program and facility managers to analyze, interpret and use information.ConclusionsManagers’ inability to use information implied that decisions for program implementation and improving service delivery were not always based on data. This lack of data use could influence the delivery of health care services negatively. Facility and program managers should be provided with opportunities for capacity development as well as practice-based, in-service training, and be supported to use information for planning, management and decision-making.

Exploring how different modes of governance act across health system levels to influence primary healthcare facility managers\u2019 use of information in decision-making: experience from Cape Town, South Africa

BackgroundGovernance, which includes decision-making at all levels of the health system, and information have been identified as key, interacting levers of health system strengthening. However there is an extensive literature detailing the challenges of supporting health managers to use formal information from health information systems (HISs) in their decision-making. While health information needs differ across levels of the health system there has been surprisingly little empirical work considering what information is actually used by primary healthcare facility managers in managing, and making decisions about, service delivery. This paper, therefore, specifically examines experience from Cape Town, South Africa, asking the question: How is primary healthcare facility managers’ use of information for decision-making influenced by governance across levels of the health system? The research is novel in that it both explores what information these facility managers actually use in decision-making, and considers how wider governance processes influence this information use.MethodsAn academic researcher and four facility managers worked as co-researchers in a multi-case study in which three areas of management were served as the cases. There were iterative cycles of data collection and collaborative analysis with individual and peer reflective learning over a period of three years.ResultsCentral governance shaped what information and knowledge was valued – and, therefore, generated and used at lower system levels. The central level valued formal health information generated in the district-based HIS which therefore attracted management attention across the levels of the health system in terms of design, funding and implementation. This information was useful in the top-down practices of planning and management of the public health system. However, in facilities at the frontline of service delivery, there was a strong requirement for local, disaggregated information and experiential knowledge to make locally-appropriate and responsive decisions, and to perform the people management tasks required. Despite central level influences, modes of governance operating at the subdistrict level had influence over what information was valued, generated and used locally.ConclusionsStrengthening local level managers’ ability to create enabling environments is an important leverage point in supporting informed local decision-making, and, in turn, translating national policies and priorities, including equity goals, into appropriate service delivery practices.