كلية الطب والعلوم الصحية
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Item Evaluation of The Quality of Health Information System at Locality level Khartoum State 2012(AL-Neelain University, 2014) Dr. Wiam Bushra Mohamed MustafaABSTRACT Introduction: Health information system (HIS) is a system that integrates data collection, processing, reporting and use of the information necessary for improving health services. It’s actually a crucial determinant for health planners to implement and distribute health services. The objective: to investigate the quality of health information system at locality level in Khartoum State 2012. The methodology: The study was a descriptive cross sectional study; it was limited to three randomly selected localities namely, Khartoum, Omdurman and Sharg Elneel. It was characterized by using two stages cluster sample; the sample size of health centers was 93 health centers. The health centers represented three categories namely: governmental health centers (42), non-governmental organizations centers (46) and five private centers. Direct Interviews were conducted with (93) medical directors and (93) statistical technicians at the health centers through pre-tested standardized questionnaire. In-depth interviews were carried out with the mangers and statistical technicians at the health team, locality and State Ministry of Health levels. A standard checklist was used to review the quality of statistical monthly reports and the available resources of the statistical units at the health centers. The data were analyzed using SPSS version 11, and chi-square test was used. P value < 0.05 was considered significant. Results: The study revealed that, the statistical monthly reports of the year 2010 were not up to the required standard of accuracy. The percentage of statisticians using tally tables at the governmental centers was (21.4%) while at non-governmental organizations centers, it was (37%) and (40%) at the private centers. This study showed that there was an evident inaccuracy of the information of the statistical monthly report of the year 2010, regarding the diseases reported in outpatient clinic of the health centers. Result of the completeness of the reports showed, at the non-governmental organizations centers and Private centers, a higher percentage of completeness revealed, than the governmental centers, especially in important items like immunization and antenatal care services. The statistical monthly reports were sent regularly in due time. (71%) of the medical directors used health information in the report, this was mainly confined to know disease pattern in the community. Feedback on the monthly statistical reports from the health teams to the medical directors did not exceed a percentage of (28%). All the statisticians at the governmental centers (100%) received the basic statistical training course before recruitment, while at the non-governmental organizations centers the percentage was (97.8%) and (60%) at the private centers. (47.2%) of the statisticians at different types of health centers did not receive in service training directed to HIS. At the governmental, non-governmental organizations centers and private centers there were marked shortages in the available resources, mainly computers (7.5%), photocopies (3.2%), Printers (2.1%) and cars (7.5%). No shortages in box files (96%) and cupboards (89.2%), at the three types of health centers. Results from interviews showed that, the directors at SMOH, localities and health teams, did not receive any technical training in HIS. No regular feedback between the different administrative levels. They were facing many problems like lack of supporting facilities and fund. Absent of regulations and guidelines of Health information system at the locality level. Conclusion: Health information system was inadequately functioning at the locality level in Khartoum State. There were many loopholes and negative aspects that need to be managed, mainly the inaccuracy of the statistical monthly report. The use of information was poorly practiced at all levels. There were problems reflected in the capacities, of human resources and inadequate resources. Recommendations: capacity building for the personnel involved in the system, to set clear guidlines for the health information system. It is crucial to reinforce, the feedback and use of information at all levels through measures and directions from top level decision makers, improve the working conditions and avail budget for health information system. Abstract Arabic مقدمة: نظام المعلومات الصحية هو آلية جمع ومعالجة وتحليل البيانات ونقل المعلومات التي يحتاج إليها جميع المستويات التى تقدم الخدمات الصحية للاستفادة منها بواسطة متخذى القرار لوضع االخطط التى تساعد فى تطويرهذه الخدمات الصحية. الاهداف: تقييم جودة نظام المعلومات الصحية على مستوى المحلية بولاية الخرطوم في العام 2012م. منهجية البحث: تتميز هذه دراسة بانها وصفية بأسلوب العينة العنقودية من مرحلتين ولقد كان حجم العينة بالنسبة للمراكز الصحية هو 93 مركز صحي ينقسم إلى 42 مركز صحي حكومي، 46 مركز صحي منظمات و 5 مراكز صحية خاصة حسب التوزيع النسبي. أجريت معاينات مع 93 مدير طبي و93 إحصائي بالمراكز الصحية عن طريق استبيانات مخصصه لذلك. كما أجريت المقابلات الشخصية مع مدراء الرعاية الصحية الأولية والإحصائيين على مستوى الفرق الصحية والمحلية ورئاسة وزارة الصحة الولائيه. كما تمت مراجعة التقارير الاحصائية وملاحظة الموارد المتوفرة لوحدات الإحصاء بالمراكز الصحية عن طريق قائمة ضبط. النتائج: التقارير الشهرية للعام 2010 لم تكن بالمستوى المطلوب من الدقة، وقد وجد ان نسبة الاحصائيين الذين يستعملون نظام الحزمة للتصنيف فى المراكز الحكومية لا تتجاوز (21.4%) بينما ترتفع النسبة فى مراكز المنظمات الى (37%) والمراكز الخاصة الى (40%). كما اوضحت الدراسة مستوى ملحوظ من عدم دقة المعلومات الصحية بالتقرير الاحصائى الشهرى للعام 2010 فيما يتعلق بالامراض الموجودة بسجل العيادة الخارجية بالمراكز الصحية. بالنسبة لاكتمال التقارير نجد ان مراكز المنظمات والمراكز الخاصة اظهرت معدلات اعلى من المراكز الحكومية خاصة فى المحتويات الهامة مثل التطعيم ورعاية الحوامل. يتم ارسال التقارير الاحصائية بصورة منتظمة وفى وقت محدد. (71%) من المدراء الطبيين استخدموا المعلومات الصحية الموجودة بالتقارير، لمعرفة تردد الامراض فى المجتمع. كانت نسبة التغذية الراجعة عن التقارير الاحصائية الشهرية من المحليات للمراكز الصحية (28%).