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Strengthening Health Information System (HIS) in Ethiopia Through Mentorship and Capacity Building Project (CBMP)

Improving HIS Through Capacity Building Interventions

As part of CBMP’s objective to enhance technical and behavioral excellence in health information system by way of improving the knowledge, skills and motivation of health workforce, in the first- year implementation period, CBMP provided competency-based HIS training for health facility and administrative workers. The training modules are on basic HIS, data quality, information use, database management system, data recording and reporting, national disease classification and research method. CBMP’s story telling and mindset HIS training supports professionals to perform actual job functions by having the skills, knowledge and attitudes required to perform their jobs related with HIS properly, safely and effectively.

 

CBMP organized a five-day TOT workshop for 15 participants to further strengthen the provision of HIS to administrative and health facility professionals. This training assisted the TOT participants to acquire fundamental facilitation skills. The program expanded HIS training to basic HIS, data quality, information use, database management system, data recording and reporting, QI, national disease classification modules and research methods for 767 participants, including 422 health work forces from HCs, 174 participants from Hospitals, 136 individuals from sub-city health office and 35 others; this reach is above 100% of the annual target. The training approach was mind setting and storytelling, in which participants identified and used enabling attitudes, skills, and knowledge to improve HIS performances so that health facility data quality and information use culture improved. Evaluating training program essential to measure contribution of the training program and its outcome.  Accordingly, we found that the mean post score (73.2, SD = 14.4) was significantly higher (P < 0.0001) than the mean pre-test score (63.9, SD = 14.1). The average score increment was 9.2 with 95% CI 3.9-14.6).

Mentorship

The provision of regular mentorship is one of the key CBMP strategies for improving and maintaining the quality of HIS at facility and administrative sectors. CBMP continued to provide scheduled coaching, and mentoring to the health facilities and sub-cities in collaboration with the academic staffs, RHBs and Sub-city health offices. During the reporting period, CBMP, conducted ongoing mentorship quarterly to a total of 30 health centers, three hospitals and three sub-city health offices from the targeted areas.

The onsite mentorship focused on current HIS practice guidance; HIS structure and implementation; proper revised HMIS service data recording tool; data quality assurance and information use culture. Furthermore, the mentorship activity enabled CBMP and RHB to develop joint action plans to improve the HIS at facility and administrative level.

 

The key findings of the regular mentorship and coaching were described below.

HIS structure and implementation: The medical record unit utilization of an electronic system enhanced. The health facility having a well-organized HMIS unit and manuals which facilitate the implementation of HIS utilization improved.

Data quality: the quality of data generated from the facilities has been improved. Data quality assurance tools like LQAS has been conducted every month for both service and diseases reports. The health facility started to keeps a log book/uses electronic system that helps to track reporting completeness.

Information Use: Use of the service data recording tool has improved. Health professionals have familiarized themselves with the data elements of revised HMIS tool and have started generating reports from it. In addition, Performance Management Team (PMT) of the facilities are in place and established according to national standard and it is started convening on monthly basis. The health facility has started tracking key quality and equity indicators.

Supporting Quality Improvement initiative

TASH has implemented quality improvement (QI) initiatives to enhance quality of services. The team develops and tests ways to apply the QI concepts for HIS improvement in the local contexts. CBMP trained 12 QI team members on QI basics, the responsibilities of the QI team and how to monitor team performance.

CBMP monitored QI at TASH through follow-up visits, during which CBMP mentors worked with the QI focal persons at TASH to identify strengths and gaps, offer technical support, and provide constructive feedback based on visit findings. The QI work has produced the following results: 1) data completeness has been improved and 2) quality of documentation and reporting has improved.

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