Does an innovative paper-based health information system (PHISICC) improve data quality and use in primary healthcare? Protocol of a multicountry, cluster randomised controlled trial in sub-Saharan African rural settings

Abstract

IntroductionFront-line health workers in remote health facilities are the first contact of the formal health sector and are confronted with life-saving decisions. Health information systems (HIS) support the collection and use of health related data. However, HIS focus on reporting and are unfit to support decisions. Since data tools are paper-based in most primary healthcare settings, we have produced an innovative Paper-based Health Information System in Comprehensive Care (PHISICC) using a human-centred design approach. We are carrying out a cluster randomised controlled trial in three African countries to assess the effects of PHISICC compared with the current systems.Methods and analysisStudy areas are in rural zones of Côte d’Ivoire, Mozambique and Nigeria. Seventy health facilities in each country have been randomly allocated to using PHISICC tools or to continuing to use the regular HIS tools. We have randomly selected households in the catchment areas of each health facility to collect outcomes’ data (household surveys have been carried out in two of the three countries and the end-line data collection is planned for mid-2021). Primary outcomes include data quality and use, coverage of health services and health workers satisfaction; secondary outcomes are additional data quality and use parameters, childhood mortality and additional health workers and clients experience with the system. Just prior to the implementation of the trial, we had to relocate the study site in Mozambique due to unforeseen logistical issues. The effects of the intervention will be estimated using regression models and accounting for clustering using random effects.Ethics and disseminationEthics committees in Côte d’Ivoire, Mozambique and Nigeria approved the trials. We plan to disseminate our findings, data and research materials among researchers and policy-makers. We aim at having our findings included in systematic reviews on health systems interventions and future guidance development on HIS.Trial registration numberPACTR201904664660639; Pre-results.

Health Data quality and its associated factors among Health Professionals in Ethiopia: Systematic review and Meta-analysis

“…Quality data has a big bene t to health system performance improvement and maintaining quality of patient care by providing accurate, complete timely health information (12). Evidence-based decision making is based on the Availablity of timely, complete, and t-for-use data (13). This systematic review and meta-analysis found that data quality among health professionals was 75.6%.…”

Using and improving the PHISICC paper-based tools in the health facility laboratories: Examples of Human Centered Design taking systems thinking into practice, in Côte d'Ivoire and Nigeria

“…Although Mozambique was also a study site for PHISICC, the team there did carry out the RCT but without the HF Labs component, due to logistical constraints. The methods of the RCT trials are fully reported elsewhere ( 14 ).…”

Researching, co-creating and testing innovations in paper-based health information systems (PHISICC) to support health workers’ decision-making: protocol of a multi-country, transdisciplinary, mixed-methods research programme in three sub-Saharan countries

“…The PHISICC tools are being tested in real-life situations in the three countries, using a cluster randomized controlled trial design. Details on the trial protocol are available elsewhere, including its registry [35,36]. Briefly, study areas were selected based on the availability of remote, rural health facilities, serving vulnerable populations, and being reasonably accessible to carry out research activities.…”