PHD theses : Medicine
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Item Evaluation of Health Information System at National and State level – Khartoum - Sudan 2014(Al-Neelain University, 2015) Amel Elamin Mohammed ElnourAbstract Introduction The health information system is recognized as the central nervous system of the health sector and the major informant to support evidence based decision and action and to preserve population health. Therefore the information system has to be regularly evaluated to grantee the development of the effective integrated system. The last comprehensive assessment was conducted in 2007 using the metrics network tools, identified the gaps and deficiencies and targeted them in strategic plans, so it was high time to check progress by this assessment Objectives The main objective of the study was to investigate health information system components at national and state levels by evaluation of inputs, determination of processes ,assessment of outputs and the identification of challenges facing HIS at all levels. Methods: A cross sectional institutional based study was conducted at health information research and evidence (HIRE) that replaced the national health information Centre (NHIC); 19 federal information units and 18 health information units in the 18 states of the Sudan Quantitative data were collected by using close and open structure questionnaire for statisticians; Computerized HMN questionnaire for assessing indicators and data management and standard checklist for equipment and infrastructure. Qualitative data were also collected by in-depth interviews by informants from federal and state directors and managers of health information and planning. Results: The findings of the study revealed that HIS plans and strategic were developed, and partially implemented. The reviewed HIS policy was formulated but not indorsed. There was no representative national coordination committee. The majority of state HIS units had adequate number of trained information technicians and statisticians while only about half of the federal units had them. v Health Statistical Technicians Training Centre (HISTTC) stopped functioning in 2013 while still needed. Continuous, refreshing and ICD-10 training programs were not adequate, supervision visits and feedback mechanism were not regularly conducted. Generally indicators witnessed considerable improvement. Usage of computers for data analysis was good, but using information and indicators by decision maker was limited. Data management witnessed a little progress. A repository, a warehouse and DHIS-2 servers were installed and prepared to function. Reporting from PHC and private sector facilities was limited and the coverage of births and deaths was deficient and data quality assurance was not regularly conducted at all levels. Generally NHIS suffered from fragmentation and lack of integration especially with vertical programs but DHIS-2 that started implementation in 2013, gave a great push towards integration by installing servers, distributing computers to most of localities and training of trainers to train information workers at locality, state and national. Conclusion: The study concluded that there was no representative national coordination committee, no legal regulations to assure perfect functioning of the system and the reviewed policy was not indorsed. Lack of data capacity on information sciences, data analysis and use, lack of training health statistical technicians and training programs for data provides and users was deficient. Data quality assurance was not regular conducted and needs improving by using proper mechanism. Recommendation: - Finalization and indorsing of the representative national coordination committee, enactment of legal regulations covering fundamental principles of information and statistics and the endorsement of the reviewed policy. - Strengthening capacity building focusing on information sciences, data analysis and use, functioning and upgrading Health Statistical Technicians Training Centre and developing needed training programs targeting all data providers and users in coordination with health training institutions. - Advocacy among decision-makers and other stakeholders to use the information and indicators that are disseminated through Sudan health observatory. - Supporting the implementation and functioning of DHIS-2to provide platform for integration HIS data management aspects and data production and dissemination and use.