Factors Influencing Timeliness of Health Management Information System (HMIS) Data in Private not for Profit Health Facilities, Kampala District, Uganda.|

Abstract

ABSTRACT Background: Evaluations of routine health facility data have identified consistent problems in HMIS completeness, accuracy and timeliness in low and middle income countries (LMIC) health settings (Garrib, et al., 2008), which limit HMIS use for routine primary health care (PHC) planning, monitoring, and evaluation (Gething, et al., 2008). An analysis of the trends on timeliness of PNFP health facility reports in Uganda from 2012/13, 2013/14 to 2014/15 showed it to be consistently low with 31.8%, 41.7% and 49.8% for the respective years. The study was therefore conducted with the aim of determining the organizational, technical and behavioral factors that have significant influence on timeliness of HMIS reporting with a focus on PNFP health facilities in Kampala district. Methodology: A descriptive cross sectional study was conducted and a predesigned questionnaire was used to collect data on organizational, technical and behavioral factors that influence timeliness of HMIS reporting from all the PNFP health facilities in Kampala that were registered in the Uganda Electronic Health Management Information System (eHMIS) .Chi square tests were used to determine significant associations between timeliness of HMIS reporting and the organizational, technical and behavioral factors within the health facility and odds ratios were calculated to determine the magnitude of the significant relationships. Findings: Timeliness of HMIS reporting in the PNFP health facilities visited was at 18.6% while 20.9% of the PNFP health facilities visited had not submitted even a single report on time. Organizational factors significantly associated with timeliness of HMIS reporting were; clearly assigned responsibility of recording delivery of health services on source documents, appropriate training for staff responsible for compilation of HMIS data, written guidelines on reporting protocols, routine and systematic processes for checking the quality of compiled reports and routine checks for timely entry and completeness of source documents. Technical factors significantly associated with timeliness of HMIS reporting were; up to date entries into the source document (registers), no stock-out of the HMIS 105 Reporting Forms in the last 12 months and facility support supervision visits during the last twelve months. Behavioral factors significantly associated with timeliness of HMIS reporting were; employment of health worker for more than 3 years, HMIS training in the last 12 months, high confidence in ability to use data for making various types of decisions and providing feedback, personal belief that collecting HMIS information is needed for monitoring facility performance. Recommendations: Ministry of health to decentralize the function of providing HMIS data collection and reporting tools to the districts and health sub districts ensuring constant availability of the Ministry of Health standardized HMIS data collection and reporting tools within the PNFP health facilities, periodic support supervision of PNFP health facilities jointly to be carried out jointly with the district health teams, health facility in charges to ensure that the responsibility of recording delivery of health services on source documents has been clearly assigned, guidelines on reporting protocols including when the reports are due are written, printed and displayed in the different wards and departments within the health facility, institute a routine and systematic process within the facility for checking the quality of compiled data and conducting routine checks for timely entry and completeness of source documents. Health workers to periodically undertake refresher training courses in HMIS data collection and reporting requirements.