Decentralizing evidence-based decision-making in resource limited setting: A case of SNNP region, Ethiopia

Abstract

Background Access to and the use of accurate, valid, reliable, timely, relevant, legible and complete information is vital for safe and reliable healthcare. Though the study area has been implementing standardized Health Management Information System (HMIS), there was a need for information on how well structures were utilizing information and this study was designed to assess HMIS data utilization. Methods Facility based retrospective study was conducted in Southern Nations Nationalities and People's Region (SNNPR) in April, 2017. We included data from 163 sample facilities. Data use was evaluated by reviewing eight items from performance monitoring system that included activities from problem identification to monitoring of proposed action plans. Each item reviewed was recoded to yes or no and summed to judge overall performance. Results About half (52%) of woredas, 26.2% health centers (HCs), 25% hospitals and 6.2% health posts (HPs) reviewed their performance monthly but only 20% woredas, 6.2% HCs, 1.5% HPs and no hospital prepared action plans after reviewing performance. Summary of 8 items assessed showed that majority of facilities (87.5% hospitals, 81.5% HPs and 70.8% HCs) were poor in data utilization. Conclusions Only about half of woredas and below one-fifth of health facilities were utilizing HMIS data and a lot to move to catch-up country's information revolution plan. Lower health care systems should be supported in evidence-based decision-making and progress should be monitored routinely quantitatively and/or qualitatively.

Refining the Performance of Routine Information System Management (PRISM) framework for data use at the local level: An integrative review

“…Findings from this review informed the development of the definitions for RHIS data use and related terms used in the refined PRISM-Act framework ( Fig 2 ). Definitions for these terms were primarily extracted from three articles which explicitly defined RHIS data use steps [ 12 , 17 , 46 ] and merged; these are presented in Table 8 .…”

“…This review identified 45 papers investigating RHIS data use at the district or health facility-level in LMICs, of which 24 measured RHIS data use. More than a third of the 33 original research articles were from Ethiopia, which may be explained by Ethiopia’s commitment to an “information revolution,” with particular emphasis on enhancing RHIS data use at the local administrative levels [ 17 , 38 , 45 , 46 , 54 ].…”

“…Use of the refined PRISM-Act framework should address this issue, by ensuring that each delineated RHIS data task, such as data processing and data analysis, are measured separately. A 2020 study from Ethiopia [ 17 ] made an important discovery when disaggregating data use into multiple steps and measuring each step separately. While a low proportion of health facilities reviewed their performance monthly (performance identification), an even lower proportion prepared action plans after reviewing performance (prioritization and action planning).…”

“…This highlights the importance of measuring data analysis, reporting, and data-informed decisions and actions separately, which will help identify which RHIS data tasks are functioning well, and which require additional support. Endriyas et al’s [ 17 ] approach to measuring data use steps can serve as a helpful resource for implementers and researchers.…”

Trends and Challenges in Regional Life Cycle Management: A Bibliometric Analysis

“…As has been the case for corporations, research institutions and professional associations for years, public authorities are increasingly being confronted by complex decisionmaking processes in a fast-developing political, economic and social environment [1][2][3][4]. The increasing responsibilities and budgets of regions in various countries demand integrated responses if they are to truly deliver on their often high-profile sustainability objectives.…”