An Analysis of the Efficiency and Effectiveness of the Policy of the National Health Information System (NHIS) on Decision-Making Support in Health Centres in Zimbabwe (2012-2018)

Abstract

The research had been conducted to analyse the efficiency and effectiveness of the policy of the National Health Information System (NHIS) on decision support in Health Centres of Zimbabwe (2011 – 2017). The research has been undertaken in pursuance of six objectives namely, to determine the existing demographic data on District Health Information System (DHIS2)database software, to describe the flaws in the processes used to update statistical data on DHIS2database software, to determine the competencies of different categories of staff  involved in NHIS data collection, to establish the nature of challenges associated with data collection and dissemination, to verify the extent to which health managers utilize the data for decision support during programming on day-to-day basis and finally, to emerge with a more improved model of NHIS policy for data collection, analysis, synthesis and reporting that can support program managers in their day-to-day decision-making than the existing one. Information was obtained through a questionnaire administered on forty-six (46) health workers who were involved in patient care data collection and reporting in the Health Centres in different Provinces.  Probability sampling was used to come up with the sample of sixty.  Descriptive correlation design  was used in describing what happened to management decisions that were made with the support of data versus those made without data support and later analysed in order to come up with research findings, conclusion as well as making of recommendations. The main finding was that the health centres in the provinces were not adhering to policy in as far as collection of quality health care in data for decision support was concerned.  This resulted in most decisions being made based on emotion, impulse, verbosity and mere personal judgement. Efforts were being done to collect Surveillance data on mortality and morbidity issues ignoring other pertinent issues like data on resources required for collection of critical information for management decision support.    Recommendation was that there was need for adherence to health information policy on report submission and feedback in Provinces.  There were limited training courses, on-job trainings and workshops on health information system in the country's tertiary institutions and also holding of routine review meetings to monitor and reinforce adherence to policy and procedures in as far as data collection is concerned. Essential resources for the speedy processing of data, timely and completeness of reporting must be made available to the practicing health workers in the Provinces for them to produce high quality data needed for decision support in all health centres in the country. The recommendations were to intensify training on NHIS, introduction of advanced training courses on Health Care Information in tertiary institutions in Zimbabwe and make available adequate resources for strengthening health information management in health centres of the country.  Hospital Departments have unique requirements for capacity building, further studies are required to investigate severely affected sections of the health centres and the characteristics of the required intervention for targeted departments.  The health centres should embrace technology in data collection, including the use of patients' diagnostic machines that collects data to the server.  The health information unit should put in place a code of conduct for the department with details on how quality standards could be met.  Further studies could be carried out with a wider population sample within country or globally and also to examine how each of the conceptual perspectives affected each category of staff and making the necessary recommendations.