Routine Health Information System (RHIS) improvements for strengthened health system management

Abstract

Background A well‐functioning routine health information system (RHIS) can provide the information needed for health system management, for governance, accountability, planning, policy making, surveillance and quality improvement, but poor information support has been identified as a major obstacle for improving health system management. Objectives To assess the effects of interventions to improve routine health information systems in terms of RHIS performance, and also, in terms of improved health system management performance, and improved patient and population health outcomes. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library, MEDLINE Ovid and Embase Ovid in May 2019. We searched Global Health, Ovid and PsycInfo in April 2016. In January 2020 we searched for grey literature in the Grey Literature Report and in OpenGrey, and for ongoing trials using the International Clinical Trials Registry Platform (ICTRP) and ClinicalTrials.gov. In October 2019 we also did a cited reference search using Web of Science, and a ‘similar articles’ search in PubMed. Selection criteria Randomised and non‐randomised trials, controlled before‐after studies and time‐series studies comparing routine health information system interventions, with controls, in primary, hospital or community health care settings. Participants included clinical staff and management, district management and community health workers using routine information systems. Data collection and analysis Two authors independently reviewed records to identify studies for inclusion, extracted data from the included studies and assessed the risk of bias. Interventions and outcomes were too varied across studies to allow for pooled risk analysis. We present a 'Summary of findings' table for each intervention comparisons broadly categorised into Technical and Organisational (or a combination), and report outcomes on data quality and service quality. We used the GRADE approach to assess the certainty of the evidence. Main results We included six studies: four cluster randomised trials and two controlled before‐after studies, from Africa and South America. Three studies evaluated technical interventions, one study evaluated an organisational intervention, and two studies evaluated a combination of technical and organisational interventions. Four studies reported on data quality and six studies reported on service quality. In terms of data quality, a web‐based electronic TB laboratory information system probably reduces the length of time to reporting of TB test results, and probably reduces the overall rate of recording errors of TB test results, compared to a paper‐based system (moderate certainty evidence). We are uncertain about the effect of the electronic laboratory information system on the recording rate of serious...

Routine Health Information Systems in the European Context: A Systematic Review of Systematic Reviews

“…Nevertheless, RHISs continue to display a gap between recording, reporting, and the effective use of data; therefore, strengthening RHISs has become a global priority for tracking and addressing national health goals [ 62 ]. The operations of RHISs in low-income countries fall below the globally expected standard due to the production and use of poor quality data, or to not using high-quality data to make informed decisions [ 63 , 64 ]. Despite investment in RHISs in low- and middle-income countries, several problems still persist (technical, organizational, financial), thus preventing proper use of RHIS (incorrect data and nonuse of data already in the system) [ 65 ].…”

“…By identifying such problems, strategies can be established to solve them. These strategies should be established and grouped by the specific determinants found: technical, organizational, and behavioral [ 63 ]. The reason for doing so is that it is practically impossible to generalize an answer within a single overall strategy.…”

“…Behavioral strategies: These aim to improve the staff members’ competence and motivation to collect, extract, and use data effectively [ 63 ]. One of the most commonly encountered problems is the participants’ (mostly health practitioners’) refusal to use an RHIS because they consider that using a new tool will not bring any benefits.…”

“…Here, a leadership figure is very important for the purpose of providing guidance during project rollout. This is because workshops and educational interventions do not always achieve the expected results, whereas the combination of leadership and motivation can have a powerful behavioral and organizational impact on data improvement [ 63 ].…”

Researching, characterising, co-creating and testing innovations in Paper Health Information Systems (PHISICC) to support frontline health workers decision-making: protocol of a multi-country, transdisciplinary, mixed-methods research programme in three Sub-Saharan countries

“…HIS include sub-systems such as clinical records, disease surveillance, routine Health Management Information Systems (HMIS) and Logistics Management Information Systems, as well as nancial data among others [ 3 ]. However, HMIS can fail to respond to all data demands for decisions and, besides, they may not be used by decision-makers, a topic of debate for decades [ 4 ] which continues today, as exempli ed during the COVID-19 pandemic [ 5 , 6 ].…”