"There Is No Link Between Resource Allocation and Use of Local Data": A Qualitative Study of District-Based Health Decision-Making in West Bengal, India.
"There Is No Link Between Resource Allocation and Use of Local Data": A Qualitative Study of District-Based Health Decision-Making in West Bengal, India.
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DOI：
10.3390/ijerph17218283
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发表时间：
2020-11-09
影响因子：
--
通讯作者：
Iqbal Avan B
中科院分区：
文献类型：
--
作者：
Bhattacharyya S;Issac A;Girase B;Guha M;Schellenberg J;Iqbal Avan B
背景：需要多个部门之间的有效协调，包括数据共享，以实现卫生服务的合理决策。印度有一个地区规划过程，涉及部门根据共享数据分配地方资源。本研究评估了地区一级的决策过程，重点关注地方数据用于母婴保健资源分配的程度。方法：在印度西孟加拉邦的两个地区，对关键决策会议进行直接观察，并对关键举报人进行定性访谈。对地区卫生系统内保存的数据进行了内容分析，以了解可用数据的类型和共享机制。这些信息是根据世卫组织卫生系统块按主题三角化的。结果：没有结构化的决策过程，只有有限的部门间数据共享。在观察到的地区决策会议上讨论的所有21个问题的数据都在信息系统内提供。然而，只讨论了9个问题的指标，例如机构交付和免疫服务。关于基础设施和供应的讨论没有数据支持，规划目标与健康结果没有联系。结论：现有的地方数据在地区一级的决策中使用率很低。各部门之间有很大可能更好地相互作用，更好地利用数据确定优先事项、规划和后续行动。
Background: Effective coordination among multiple departments, including data-sharing, is needed for sound decision-making for health services. India has a district planning process involving departments for local resource-allocation based on shared data. This study assesses the decision-making process at the district level, with a focus on the extent of local data-use for resource allocation for maternal and child health. Methods: Direct observations of key decision-making meetings and qualitative interviews with key informants were conducted in two districts in the State of West Bengal, India. Content analysis of the data maintained within the district health system was done to understand the types of data available and sharing mechanisms. This information was triangulated thematically based on WHO health system blocks. Results: There was no structured decision-making process and only limited inter-departmental data-sharing. Data on all 21 issues discussed in the district decision-making meetings observed were available within the information systems. Yet indicators for only nine issues—such as institutional delivery and immunisation services were discussed. Discussions about infrastructure and supplies were not supported by data, and planning targets were not linked to health outcomes. Conclusion: Existing local data is highly under-used for decision-making at the district level. There is strong potential for better interaction between departments and better use of data for priority-setting, planning and follow-up.
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