Determinants Of Utilization Of Routine Data For Decision Making In Health Facilities In Kitui County, Kenya

ABSTRACT

Effective management of today’s health systems depends on critical use of data and information for the effective policy-making, planning, monitoring of services and making decisions. Following the decentralization of health, the district health management information systems (DHMIS) was established to support the districts in utilizing the generated data for the decisions made in health facility. However, data use has been limited and faced with inadequacy hence vital health decisions often relying on political opportunism, donor demand and infrequently repeated national studies which are insensitive to changes occurring over shorter timescale. This study was designed to identify for determinants of utilization of the routine data for decision making by the health care providers in health facilities in Kitui County in Kenya. This was a descriptive cross sectional study that adopted quantitative and qualitative research paradigms. Purposive sampling was used to select the district hospital, being the only one serving the eleven districts in the county. Multi stage cluster sampling to sample the health facilities in the districts and simple random sampling to select the respondents in the health facilities. The 110 participants completed a self-administered questionnaire. Key informant interviews, focused group discussions, observation and analysis of documents in health facilities were also applied. Recordings were transcribed and key concepts identified. Questionnaire results were edited, coded, tabulated and analyzed using the SPSS 16. Chi-square test was applied to determine the relationship between independent and dependent variables. The results showed that among the respondents 70% were females and 40% males. Majority, 64% had diploma level of education. Nurses/ midwifes were the majority, making up 81% of the workforce. Overall extent of data utilization was 66% not using data and 34% use the routine generated data. The following actors influence utilization of routine data: frequency of meetings held (𝑥 2=42.036, df=1, p=0.001), data storage and analyzing methods (𝑥 2= 30.582, df=1, p=0.001), continuous professional training (𝑥 2= 49.782, df=1, p=0.0001). Organization of the district health system influenced routine data utilization through the frequency of support supervision (𝑥 2=30.000, df=1, p=0.001), issues assessed during supervision (𝑥 2=49.164, df=2, p=0.002) and feedback report from the supervisors (𝑥 2=5.236, df=1, p=0.022). In conclusions the study demonstrates limited utilization of routine data to make decisions for health facility management and recommends the need for the government to build capacity for data utilization through on job training and strengthening the curriculum in health training institutions in data related areas. The ministry of health should standardize the parallel reporting levels and unify the reporting tools and finally ensure the districts have structured meetings, support supervision and feedback to the health care providers.