Factors Influencing Access and Utilization of District Health Information System: a Case Study of Wajir County

Abstract

Introduction: District Health Information System (DHIS2) is a platform designed to collect, process, and report data and trends regarding health to aid the health decision-makers in making health-related decisions. It is pertinent that decision-makers such as county government health managers, departments, non-government organisations, and stakeholders utilise credible information from Routine Health Information Systems DHIS2 for Enhancing health-related outcomes and addressing inequities. A quality decision is particularly crucial in Wajir county, one of the country's poorest counties and the top 15 counties ranking on the maternal and perinatal burden. There exist low accessibility and utilisation of the health information collected in DHIS2. Most health decision-makers such as public health, policymakers, and healthcare organisations do not often consider the DHIS2 data appropriate for guiding their decisions. The low utilisation of DHIS2 has been a challenge in improving the health sector performance. Broad Objective: To establish the factors affecting access and utilization of the DHIS2 in Wajir County. Specific objectives: The study focused on influence of data infrastructure, staff technical capacity, available resources, and county health organizational support and how they influence the access and utilization of the DHIS2. Methodology:A cross-sectional study was carried out among the Wajir County health sector managers from June to August 2021. The study adopted a convergent mixed-method research design that blended quantitative and qualitative data collection and analysis approaches. The target population was managers from the Wajir County health department. A sample size of 95 was drawn from 125 managers of Wajir Health departments. Additionally, the study also inquired from 10 key informants(KIs) drawn from the health sector. Systematic sampling was employed to select managers from the various health departments. Self-administered questionnaires and an interview guide collected the primary data to determine the factors influencing access and utilization of DHIS2 in Wajir County. The Quantitative data were analysed using STATA version 11.2 to make descriptive and inferential statistics to understand the data and further presented in bar charts and tables. Descriptive statistics produced mean, standard deviation and frequencies of the responses, while inferential statistics, namely correlation and linear regression, showed the relationship between independent and dependent variables. The qualitative data was organized using themes and content analysis and discussed in narratives. Results: According to descriptive study results, there was varying perceptions or views regarding the quality of data infrastructure. From inferential analysis, data infrastructure has beneficial effects on DHIS2 access and utilization. In addition, descriptive statistics revealed that staff technical capacity limits the utilization of DHIS2. Some areas lacking quality include the employee ability to handle and interpret health data and DHIS2 customization despite many of them having a high level of education. The regression results showed that staff technical capacity positively influences access and utilization of DHIS2. Similarly, few available resources limit the use and utilization of DHIS2. According to inferential analysis, available resources positively influence utilization and access of DHIS2. Finally, the study revealed that county health organizational support has positive effect on access and utilization of DHIS2. xiv Conclusion: The study concludes that DHIS2 data infrastructure, staff technical capacity, available resources and county health organizational support are key determinants of access and utilization of DHIS2. Recommendation: To facilitate the use of DHIS2, this study recommends the departments of health at Wajir County conduct more training and workshops to impact all the health workers with knowledge and skills needed to operate DHIS2 and make use of it in decision making.Besides, Wajir County should allocate appropriate funding to all health departments, as well as partner with non-governmental organizations to help in funding some health functions.