Utilisation of data and factors affecting the performance of the Health Management Information System (HMIS). The case of six Synods of Livingstonia health facilities in Malawi.

backgroundA collection of data routinely gathered at healthcare facilities to satisfy the requirements of health service statistics is called a Health Management Information System (HMIS). The purpose of this study was to ascertain how HMIS data were used and what variables affected the health system performance of Synod of Livingstonia Health Facilities at the district and basic healthcare institution levels.

methodsThis cross-sectional study included six healthcare facilities in three districts: Mzimba South, Mzimba North, and Rumphi. Health workers at the institutional and district levels completed a semi-structured questionnaire to gather data, which was then recorded using an observational checklist. Responses and observations were combined and triangulated using a thematic content analysis approach to extract pertinent information.

resultsThirteen district officials and 90 employees of healthcare facilities were surveyed in the Synod of Livingstonia Health Department (SoLHD). Only one of the three district respondents 33.3%=(1/3) reported regularly reviewing HMIS data, compared to over two-thirds 70%=(63/90) of the facility respondents who said they used the data. Primarily, HMIS data were utilised to compare service coverage performance 62%=(56/90) track illness trends over time 40%=(36/90) and provide support for community health education and promotion initiatives 53%=(48/90). Before the study, 31.4%=(28/90) of the facility staff had not received any training on HMIS-related data handling in the previous 24 months. Four months before this assessment, the District Health Office (DHO) conducted supervisory visits to less than half 34.6%=(3/9) of the health facilities. Two district respondents 66.7%=(2/3) stated that higher authorities routinely provided them with comments on the calibration of their reports on a monthly and quarterly basis. Patient load has frequently been reported to impact staff performance in terms of data administration and gathering.

conclusionIn most healthcare facilities, inadequate analysis and poor data utilisation techniques are the norm. The main issues impacting HMIS performance in the Synod of Livingstonia Health Facilities were a lack of standard operating procedures for data management, insufficient financial and human resources, and a lack of incentives and oversight.