Factors Influencing Performance of Routine Health Information System: the Case of Garissa Subcounty, Kenya

Abstract

Health information plays a critical role in supporting evidence based decision making for all health system pillars. Kenya Ministry of Health uses an online health information system. However, its capacity to provide reliable information is limited by low data quality, inadequate financial and human resource dedicated to health information system. Data quality assessment conducted by Garissa County department of health in 2015 showed Garissa sub county routine health data quality index performance was 53 percent compared to the overall Garissa County performance of 59.7 percent. Therefore, the purpose of this study was to determine the factors influencing performance of routine health information system in Garissa Sub County. The objectives of the study were: to evaluate how technical factors influence performance of routine health information system in Garissa Sub County, to examine how organisational factors influence performance of routine health information system in Garissa Sub County and to determine how behavioural factors influence performance of routine health information system in Garissa Sub county.The study used descriptive research design and census approach to select the target population. Data was collected using self-administered questionnaire from 72 health workers who included all health facility in charges from the 17 government owned health facilities in Garissa subcounty, all the health records information officers in Garissa referral hospital and County department of health monitoring and evaluation office, all heads of departments in iftin sub county hospital and Garissa County referral hospital, all members of Garissa Sub county and Garissa County health management teams. The data was analyzed using frequencies, percentages and spearman’s rank correlation coefficient with the aid of Statistical Package for Social Sciences software.The results were presented in tables.The correlation coefficient analysis revealed there was a significant positive relationship between availability of reporting tools (rs=0.465, p=0.000) use of standard indicators (rs=0.510, p=0.000), user friendliness of RHIS (rs=0.546, p=0.000), availability of adequate staffing for RHIS tasks (rs=0.239*, p=0.043), training of staffs (rs=0.295*, p=0.043), availability of RHIS governance structures (rs=0.354**,p=0.002), supervision of RHIS activities(rs=0.407**,p=0.000), availability of plans for RHIS (rs=0.465**,p=0.000), promotion of culture of information(rs=0.501**,p=0.000), data quality checking skills(rs=0.324**,p=0.006),staff motivation(rs=0.299*,p=0.011), and performance of routine health information.There was no significant relationship between complexity of the reporting tools (rs=0.159,p=0.091),funding for RHIS activities(rs=0.150,p=0.208), competence in RHIS tasks(rs=0.205,p=0.084), confidence level for RHIS tasks (rs=0.194,p=0.102) and performance of routine health information. The study therefore, recommends that there is need to have adequate staffing who are trained in RHIS tasks and have clear governance structures for RHIS that are communicated to all the health workers. In addition, there is need to conduct periodic support supervision for RHIS activities, use innovative ways to motivate staffs to perform RHIS related tasks and use evidence from routine health data to make decisions.