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تقييم نظام المعلومات الصحي في العراق == Assessment Of The National Health Information System In Iraq
Author name:
ثائر عيسى مراد
Supervisor name:
مازن غازي جاسم الربيعي | امجد داود نيازي
General topic:
Medicine
Specific topic:
Community Medicine
Degree:
Master
University:
Mustansiriyah University
Language:
English
University location:
Baghdad
First pages:
19T1178 - p.pdf
Abstract:
تعتبر الاحصائيات الصحية الرصينة ضرورة لاتخاذ القرارات السليمة في كل مستويات النظام الصحي. ولكن في الحقيقة ان نظم المعلومات الصحية في معظم البلدان تعتبر غير كافية لتوفير المعلومات اللا زمة لدعم الادارة الصحية ولهذا فان معظم النظم الحالية تعتبر كعائق اداري | Sound health statistics are essential for health decision - making at all levels of the health system. Unfortunately, health information systems in most countries are inadequate in providing the needed management support and the current systems are therefore widely seen as management obstacles rather than as tools, the current study is an attempt to assess the health information system in Iraq with recognizing the strengths, weaknesses and gaps in addition to assessment of the structure and performance of this system; it also attempts to assess the behavioral, technical and organizational determinants affecting the health information system performance. A cross - sectional study was conducted for the assessment process and the levels of the assessment included the ministry of health (national level), the health directorates (provincial level), the districts related to the health directorates reaching to the health centers level, as well as the hospitals related to the health directorates, in addition to the ministry of planning and the ministry of interior. In addition to ministry of health (central level) a total of six governorates were selected by simple random sampling including the capital Baghdad with a seven districts were selected from those governorates also by simple random sampling and a total of twenty six health centers were selected from those districts, as well a total of seven hospitals were included in the study from all governorate and they were selected according to convenience. The interview has been done by using the health metrics network assessment tool version 4, in addition to a complementary assessment tools which are the PRISM package tools that were used at the district and primary health center levels. Based on the data collected and according to the health metric network assessment tool findings the overall health information system has laid in the adequate state (65.96%) with most of its comprising components function poorly. Data dissemination and use and data management categories were the weakest with a score of 50% and 53.3% respectively, while for the resources category it was found to be adequate 63.3%, and for that of HIS indicators, data sources and information product categories they were 73.3%, 66% and 69.6% respectively. For that of the PRISM tools and the findings obtained by them from the collected data the results revealed that a low data quality in term of accuracy with 29.03% at the facility level and 55.35% at the district level, while the completeness rate was excellent with a score 96.38% at the facility level and 98.23% at the district level, for that of the timeliness it was 70.43% timeliness at the district level. The information use for a given feedback at the facility was 50% and at the district was 82.12% and for observed meeting records it was 50% for the facility and 41.6% for the district level. For that of the functionality a 34.61and 67.30% of the facilities reported having a reminder mechanism for data completeness process and meeting a deadline for submitting monthly reports respectively, Data analysis was better at the district 85.71% than at the facility 81.7%, Data display were present in all of the facilities and districts. For the technical determinant the results showed 57%, 85.7%, 71.4% and 100% of the district respondents felt that the form is complex and difficult to follow, data software is a user - friendly, information technology is easy to manage and a comprehensive picture of the health system performance is captured by the system respectively,85.7% believed that the information system collecting information from some vertical programs and one district reported of no collection at all, in addition to that 100% reported the absence of a software that integrates data from different information systems and the available information technology doesn't provide full access procedure to district and senior managers. Regarding the behavioral determinants the results revealed that overall mean confidence for the information system tasks is 69.41% while for that of the task competence the overall mean competence level is 37.1%. Knowledge of checking data quality, knowledge of health information system rationale and problem solving showed results of 35.32% 37.68% and 2.98% respectively, and that of motivation level was 43.4%. Organizational determinants results revealed that the management functions at facility and district levels were almost absent, while for the perceived promotion of a culture of information it showed a total score of 63.96% and rewarding for a good performance was 56.83%. The activities for promotion of a culture of information are a 25% at the facility level and 28.75% at the district level. And that of supervision quality at the facility were (72.80%). Availability of resources revealed that 100% of the facilities have two or more computers and calculators respectively while only 57.7% have an internet access. Access to the electricity and water supply is very high, No facility reported of running out in registers in the last 12 months. Finally, the current study shows the importance for the need of further attention to be drawn to HIS, in addition to that, increasing the awareness and well coordinated efforts that need to be done to overcome weaknesses and to provide a well functioning HIS enabling for evidence based decision making and action provision in the health system.
