ASSESSMENT OF HEALTH MANAGEMENT INFORMATION SYSTEM IN PRIMARY HEALTH CARE CENTRES IN EDO STATE, NIGERIA.

ASSESSMENT OF HEALTH MANAGEMENT INFORMATION SYSTEM IN PRIMARY HEALTH CARE CENTRES IN EDO STATE, NIGERIA.

Abstract

Introduction: A key systems building block of Primary Health Care (PHC) is an intact health management information system, which generates information to enable decision-makers at all levels of the health system to identify problems and needs, make evidence-based decisions on health policy, and allocate scarce resources optimally. A clear understanding of the usefulness of hospital information systems is lacking among healthcare personnel in Primary Health Care facilities and other levels of care in Nigeria. A gap in knowledge exists regarding the exact number of hospital information systems functionally available in Nigeria, but subjective data project less than 5% implementation of any form of hospital information technology in a country of more than 150 million people.
Objective: To assess the health management information system in Primary Health Care centres in Edo state with a view to enhancing the ability to measure health outcomes and progress towards the set targets of the Millennium Development Goals.
Methods: This was a cross-sectional analytical study. The study population comprised health personnel at the PHCs (who participated in the community survey, Focus Group Discussion participants and In-Depth Interviews) in Edo State, health service providers as well as relevant stakeholders/policy makers. Pre-tested, structured questionnaires were the tool for data collection. Data analysis was by IBM SPSS version 20 and level of significance was set at p < 0.05.
Results: A total of 432 health personnel participated. Also, 35 PHC facilities were assessed for operational capability using an observational checklist and 12 PHC facilities assessed for data quality using a data quality audit tool. Over half (51.3%) of the studied health personnel had a poor knowledge of the NHMIS and only slightly above 5% had good knowledge. Most of the health personnel (91.8%) had positive attitude and less than one-tenth had negative attitude. Most of the health personnel (94.1%) handling health data had poor practice of the NHMIS
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and only 5.9% had good practice. The determinant of good knowledge was exposure to training on NHMIS (p= 0.019). The only determinant of good practice was type of community (p= 0.007) while the determinant of utilization of the NHMIS was practice of NHMIS (p < 0.001). Just 5.7% of the health centres surveyed were capable of operating the NHMIS while most were not and three-quarters of the health centres had focal persons handling data. In terms of overall data accuracy, Pentavalent3 vaccination had major data quality issues, antenatal care had minor data quality issues and institutional birth had major data quality issues. The Key Informant Interviewee agreed that training of health personnel was a major set back in NHMIS implementation and much needed to be done to improve the current situation.
Conclusion: The study showed a huge gap in knowledge, practice and utilisation by health personnel and weak operational capacity of the PHC-NHMIS. Data quality was generally poor. Key stake holders like the government at all levels, heads of health facilities and primary care providers at the health facilities should ensure collective effort in improving the PHC-NHMIS in Edo State.

Title Page———i

Certification——–ii

Dedication———iii

Acknowledgement——-iv

Abstract ———vi

Table of Content——–vii

 

Chapter One

1.0 Introduction ——-1

1.1 Statement of Problem——4

1.2 Purpose of the Study——5

1.3 Significance of Study——8

1.4 Limitation——–9

1.5 Scope of Study——-11

 

Chapter Two

2.0 Review of Related Literature —-12

2.6 Summary of Literature Review—- 19

 

Chapter Three

3.0 Research Methodology and Procedure—22

3.1 Population ——–22

3.2 Sample and Sampling Technique—-22

3.3 Validation of the Instrument —-23

3.4 Reliability of the Instrument —–23

3.5 Data Analysis——-23

 

Chapter Four

4.0 Presentation and Discussion of Result—24

4.1 Analysis and interpretaion of Data—25

4.2 Discussion of Results——38

 

Chapter Five

5.0. Summary, Conclusion, and Recommendation  –40

5.1 Summary——–40

5.2 Conclusion——–41

5.3 Recommendation——42

References ———45

Appendix 1——–47

Appendix ———50

ASSESSMENT OF HEALTH MANAGEMENT INFORMATION SYSTEM IN PRIMARY HEALTH CARE CENTRES IN EDO STATE, NIGERIA.

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