Evaluation of the Performance of Routine Information System Management (PRISM) framework: evidence from Uganda
Evaluation of the Performance of Routine Information System Management (PRISM) framework: evidence from Uganda
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DOI：
10.1186/1472-6963-10-188
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发表时间：
2010-07-03
影响因子：
2.8
通讯作者：
Mukooyo, Edward
中科院分区：
文献类型：
--
作者：
Hotchkiss, David R.;Aqil, Anwer;Mukooyo, Edward
背景：卫生部门健全的政策、资源分配和日常管理决策需要常规卫生信息系统（RHIS）及时提供信息。在大多数低收入和中等收入国家，人们认为RHIS在提供可用于帮助改善卫生系统绩效的高质量数据和持续信息方面不足。此外，关于RHIS加强干预措施在改善数据质量和使用方面的有效性的证据有限。本研究的目的是评估新开发的常规信息系统管理绩效（PRISM）框架的有用性，该框架由概念框架和相关的数据收集和分析工具组成，用于评估、设计、加强和评估RHIS。本研究的具体目标是：a)评估PRISM仪器的信度和效度；b)评估PRISM概念框架的效度。方法：2004年和2007年，采用记录回顾、结构化访谈和自我调查问卷的方式，从乌干达12个地区的110家卫生保健机构收集了设施和工作人员层面的数据。分析程序包括评估所选仪器内部一致性的Cronbach's alpha，评估仪器可靠性和敏感性的test-retest分析，以及评估PRISM仪器和概念框架有效性的双变量和多变量统计技术。结果：Cronbach's alpha分析表明，衡量信息文化、RHIS任务自我效能和动机的指标具有高信度（0.7或更高）。研究结果还表明，信息文化的提升会影响RHIS任务的自我效能感、RHIS任务的能力和动机，而RHIS员工的自我效能感和存在对RHIS信息的使用有直接影响，这是RHIS绩效的一个关键方面。结论：研究结果为PRISM工具的信度和效度以及PRISM概念框架的效度提供了一定的实证支持，表明PRISM方法可以被rhs决策者和从业者有效地用于评估rhs和评估rhs强化干预措施。然而，需要更多样本量更大的研究来进一步调查PRISM仪器在探索RHIS数据质量和使用与卫生系统绩效之间的联系方面的价值。
Background: Sound policy, resource allocation and day-to-day management decisions in the health sector require timely information from routine health information systems (RHIS). In most low- and middle-income countries, the RHIS is viewed as being inadequate in providing quality data and continuous information that can be used to help improve health system performance. In addition, there is limited evidence on the effectiveness of RHIS strengthening interventions in improving data quality and use. The purpose of this study is to evaluate the usefulness of the newly developed Performance of Routine Information System Management (PRISM) framework, which consists of a conceptual framework and associated data collection and analysis tools to assess, design, strengthen and evaluate RHIS. The specific objectives of the study are: a) to assess the reliability and validity of the PRISM instruments and b) to assess the validity of the PRISM conceptual framework.Methods: Facility-and worker-level data were collected from 110 health care facilities in twelve districts in Uganda in 2004 and 2007 using records reviews, structured interviews and self-administered questionnaires. The analysis procedures include Cronbach's alpha to assess internal consistency of selected instruments, test-retest analysis to assess the reliability and sensitivity of the instruments, and bivariate and multivariate statistical techniques to assess validity of the PRISM instruments and conceptual framework.Results: Cronbach's alpha analysis suggests high reliability (0.7 or greater) for the indices measuring a promotion of a culture of information, RHIS tasks self-efficacy and motivation. The study results also suggest that a promotion of a culture of information influences RHIS tasks self-efficacy, RHIS tasks competence and motivation, and that self-efficacy and the presence of RHIS staff have a direct influence on the use of RHIS information, a key aspect of RHIS performance.Conclusions: The study results provide some empirical support for the reliability and validity of the PRISM instruments and the validity of the PRISM conceptual framework, suggesting that the PRISM approach can be effectively used by RHIS policy makers and practitioners to assess the RHIS and evaluate RHIS strengthening interventions. However, additional studies with larger sample sizes are needed to further investigate the value of the PRISM instruments in exploring the linkages between RHIS data quality and use, and health systems performance.