Improving information use through public health informatics systems & human resource capacity building
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The District Health Information System (DHIS) has been installed to a number of Low and Middle Income Countries (LMIC) to collect health records at a district level and share the data nationally. While data collection coverage is very high in most countries, information use is still reported to be very low. Annual data use workshops have been designed to improve the rate of information use for surveillance in Zanzibar, Tanzania. However, in order to increase data and information use, in addition to the annual workshops, real-time tools are needed to support surveillance at district and national levels and continuous data use in public health sectors. The DHIS dataset is aggregated at the district level, lacking information on location within the district and social demographic information on patients utilizing health services at the ward (shehia) level. This insufficiency, limits use in epidemiology, even if it was intended for national and district administrative purposes. There are three tiers of governance on Zanzibar: 1) regional administration (five regions); 2) district administration (10 districts per region); and 3) wards (236 shehias--smallest division of administrative regions--in all districts). The Health Management Information Systems unit (HMIS) manages the DHIS, and through the hard work of District Health Management Teams (DHMTs) has been continuously collecting quality information. It is unfortunate that collected data ends up in databases for showcasing and trivially used for decision making. HMIS acknowledges minimal data use as one of the challenges in the sector and demonstrated that data could be used for secondary data analysis. While the immediate outcome of this work is a system that analyzes real-time HMIS data on pneumonia, all upper respiratory tract infection (URTI), and diarrhea with added value data for surveillance, the long-term goal of this work is developing a Health Information System (HIS) that supports evidence-based management of Zanzibar's entire public health, using epidemiologic-embedded analysis and a well-built workforce. The other important objective of this research is to strengthen the capacity of officers' district surveillance of public health informatics practices through improved data quality, training of health surveillance officials, and development of software tools that analyze, disseminate, and facilitate information use.
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This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 License. Copyright held by author.