Poor use of DQM for health and health information at the community and district levels in Rwanda and other LMICs was found, particularly in data sources. Based on the identified barriers to high-quality data systems, the main achievement of this study was the development of an intervention model for health DQM and health information use at the community and district levels in Rwanda.
THE RESEARCH STUDY
General Introduction
Background to the Study
Their evaluation of EHRs found that health data interoperability allowed health information to be shared among health care entities involved in the continuum of care. Several research findings have reported poor implementation of district health information systems (DHIS), which are the cornerstones for DQM and health information use in LMIC (Sun, 2003).
Problem Statement
There was a need for an intervention model that could facilitate the treatment of issues related to health DQM and use of health information, especially at the local and district level, in resource-limited contexts such as Rwanda, to make "better health information" an achievable goal, for better health.
Overall Purpose of the Study
Objectives of the Study and Research Questions
How health information is currently used at the community and district level in the selected district of Rwanda. What are the problems associated with the use of DQM and health information at the community and district level in the selected district of Rwanda.
Research Settings and District Health Information Systems in Rwanda
Research Methodology
The second study was a survey of health information users to collect quantitative and qualitative data on their experiences with the data collection processes. In Study 1, the target population and subjects were the health data in the SIS and SISCom databases of the district health information system.
Significance of the Study
The findings of this study can be useful for different stakeholders involved in health DQM and the use of health information, as well as planners and evaluators in the health sector. The findings of this study can inspire the researcher's understanding and the acquisition of new knowledge about health DQM and the use of health information.
Theoretical Framework
Health information use: this phase enforces the health information culture and commitment to DQM mainly through feedback to different health levels from which the data were reported. This study addressed all phases of the health information cycle model and the CDC's six steps for effective evaluation of health programs were followed (Glenaffric Ltd, 2007).
Operational Terms
District Health Information System: District Health Information System (DHIS) is an integrated and decentralized health information system program that aims to empower communities in decision making and planning of health care interventions to improve the coverage, quality and efficiency of health services. This includes data management and health information use by CHWs, health workers at primary health care units (Community level) and health workers at district level (Walsham, 2001).
Literature review
Use of health information: Refers to the use of health information for decision making, and includes making health information accessible to intended users through feedback and data sharing, evidence-based decisions, and policy making and planning interventions to improve the quality of health care , and use information for research.
Conclusion
STUDY FINDINGS
Introduction
Phase one: evaluation phase
- Paper 1: Review of published evidence
- Paper 2: In situ clinical data collection evaluation
- Paper 3: In situ community data collection evaluation
Evaluation of clinical data quality management and health information use in Bugesera District, Rwanda. Information System (DHIS) database and to evaluate the use of health information in the Bugesera district of Rwanda. Data quality management (DQM) and use of health information are essential components of routine health management information systems (HMIS) that aim to generate accurate health data and reliable health information [1], to serve as evidence-based for health care planning and delivery, policy and decision-making and evaluation of disease outcomes and the success of community and health facility-based health programs [2, 3].
In Rwanda, a District Health Information System (DHIS) has been in place since the year 2000 to strengthen the lower level of health system through continuous formative surveillance and data quality audit [ 8 , 9 ]. The oversight of data quality audit was also associated with the perception of data management and health information use. Title: Evaluation of Community Data Quality Management and Health Information Use in Bugesera District, Rwanda.
Evaluation of community data quality management and health information use in Bugesera District, Rwanda. Studies have shown that training in data quality management processes, oversight, and feedback has impacted community health data quality and health information use.
Additional findings
- Introduction
- Methodology
- In depth interviews for CHWs
- Interviews at Health Centers
- Focus group interviews at District Hospital
- Findings
The researcher participated in the data collection by CHWs and in this way observations were made and in-depth interviews were conducted at the same time. To select participants for the focus group interviews, two health centers were randomly selected. The findings of the unit/service managers and the 14 senior nurse managers are all presented and analyzed together.
At the district level, 12 respondents were selected using convenience sampling technique, including senior and deputy chief nursing officers, heads of units/services, health center supervisors and doctors. All respondents from the above-mentioned categories were included in the focus group interview, as they happened to be available on the day of the interview. The findings of the in-depth interviews are presented in the transcription summary tables below according to the levels of health care that the participants are at, namely community, health center and district level.
Conclusion
RECOMMENDATIONS AND CONCLUSION
Introduction
Model development process
This framework provides information needs and tools at different levels to facilitate the management and use of data quality. The current development of the model considered all these levels in the context of Rwanda, namely household and community, patient and health facility, district and national levels. At each level, different stakeholders play an important role in the management of data quality and the use of health information.
The main aim of this study was to develop an intervention model for data quality management and use at the community and district levels where more efforts are greatly needed. The model was developed by classifying all the findings of the systematic review and the evaluation studies according to the health system levels. These stakeholders included the staff of the Ministry of Health involved in data management and the use of health information, the staff of the Community Health Department, and one expert in Health Management Information Systems and health system strengthening who works as a consultant in HMIS in the Ministry of Health of Rwanda.
Description of Model for health DQM and health information use at community and district
The next level of health care is the health center, where a multidisciplinary team of health care providers plays an important role in providing health care services and DQM and utilization. They must all be involved in the task after developing a proper understanding of DQM processes and use of health information, which can make them perceive data, data management and the usefulness of data positively, and therefore they can strive for the quality of health. data and usage. The staff responsible for health data management and all persons involved in the delivery of health services must be adequately trained to provide high quality data and to maximize the use of available health information, to assist health centers in meeting the same goal, and collaborating with the central level through computerized health information systems and narrative reports.
This can help the system generate timely, accurate, complete and reliable health data useful for effective planning, decision making and evaluation of disease outcome and the progress of health programs implemented within the district. The staff at central level must therefore be highly trained to have a correct understanding of health data management and use, the leadership it requires, and the information culture so that a high level of health data and maximum use of available health information is achievable. They should be the cornerstone of health sector policy making and strategic planning, monitoring and evaluation of health care programs and health system as a whole.
Recommendations
The central level, in turn, must guide and ensure overall coordination and leadership for other levels to have a clear policy for handling and using health information, the strategies in place to achieve the highest level of health data quality and use, key indicators and their definitions, necessary tools to manage health information systems and carried out DQA, supervision and evaluation of the health system as a whole and district level. District Health Information System Management in Rwanda and similar settings in LMIC must redouble efforts in their leadership and management so that high quality health data and maximum use of available health information is an achievable goal. The proposed intervention model for health DQM and use of health information may be useful for improving health DQM and use at the community and district levels if implemented.
Contribution of the study to the existing knowledge
Conclusion
Yes, the quality of the data is really very important to know what is actually going on. We were told in training that we need to report correctly without delay and avoid errors, so data quality is important!” Yes, I said, health data quality is important, but it is difficult to do because it takes many days!.
The quality of the report is therefore very important, but it is very difficult to achieve. Yes, the quality of the reported data is very important, so we have done the work, but we need more knowledge because we see that we do not know how to do the report properly. The quality of health data is important, but it is difficult to achieve because it takes many days for people to understand its meaning.
Findings from the focus group at the District Hospital Question 1: Do you think the quality of health data is important? Yes, the quality of health data is important so that we know the progress and outcomes of diseases as we treat patients."
