Bridging the gaps in the Health Management Information System in the context of a changing health sector.
Bridging the gaps in the Health Management Information System in the context of a changing health sector.
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DOI：
10.1186/1472-6947-10-36
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发表时间：
2010-06-25
影响因子：
3.5
通讯作者：
Nyamtema AS
中科院分区：
文献类型：
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作者：
Nyamtema AS
卫生管理信息系统对于循证决策、规划、实施和评估卫生方案期间的知情决策以及适当利用各级卫生系统的资源至关重要。本研究探讨了在坦桑尼亚不断变化的卫生部门的背景下，影响HMIS的差距和因素。2008年1月至2月，在基隆贝罗区的11个卫生设施进行了横断面描述性研究。采用半结构式问卷对43名卫生工作者进行了访谈，了解他们对HMIS的知识、态度、实践和变化因素，并对这些机构的HMIS手册进行了完整性审查。在所有答复者中，81%的人从未接受过关于人力资源管理信息系统的培训，65%的人没有适当定义这一系统，54%的人不知道谁应该使用收集的信息，42%的人没有将收集的数据用于规划、预算编制和评估服务的提供。虽然91%的人对该系统持积极态度，但在25%至55%的设施中，从未完成对HMIS手册的审查。临床医生和护士对HMIS的知识、态度和行为差异无统计学意义。最常见的从未填写的HMIS小册子是用于交付的小册子（55%）。目前的人力资源管理信息系统存在的差距与缺乏培训、监督不力、工作人员的工作量压力以及该系统的冗长和费力有关。这项研究揭示了卫生数据收集工作不佳、设施一级缺乏知情决策以及该国卫生管理信息系统变化的因素。它建议需要新的创新，包括HMIS纳入正在进行的审查的课程，为所有干部的医疗保健提供者，开发更方便用户的系统和使用基于证据的约翰科特的八步过程中实施成功的变化，在这个系统。
The Health Management Information System (HMIS) is crucial for evidence-based policy-making, informed decision-making during planning, implementation and evaluation of health programs; and for appropriate use of resources at all levels of the health system. This study explored the gaps and factors influencing HMIS in the context of a changing health sector in Tanzania. A cross sectional descriptive study was conducted in 11 heath facilities in Kilombero district between January and February 2008. A semi-structured questionnaire was used to interview 43 health workers on their knowledge, attitude, practice and factors for change on HMIS and HMIS booklets from these facilities were reviewed for completeness. Of all respondents, 81% had never been trained on HMIS, 65% did not properly define this system, 54% didn't know who is supposed to use the information collected and 42% did not use the collected data for planning, budgeting and evaluation of services provision. Although the attitude towards the system was positive among 91%, the reviewed HMIS booklets were never completed in 25% - 55% of the facilities. There were no significant differences in knowledge, attitude and practice on HMIS between clinicians and nurses. The most common type of HMIS booklets which were never filled were those for deliveries (55%). The gaps in the current HMIS were linked to lack of training, inactive supervision, staff workload pressure and the lengthy and laborious nature of the system. This research has revealed a state of poor health data collection, lack of informed decision-making at the facility level and the factors for change in the country's HMIS. It suggests need for new innovations including incorporation of HMIS in the ongoing reviews of the curricula for all cadres of health care providers, development of more user-friendly system and use of evidence-based John Kotter's eight-step process for implementing successful changes in this system.