Information Technology for Development. Reproductive and child health; VDRL: Each decision-making process was informationally distinct; as was each decision-making stage within a process. DHMT members, as executive custodians of strategic decision-making at district level, were involved in the discursive process of recalling, suggesting and listing strategic decision-making processes, historical and on-going, which would be traced in each district. They operate on an annual contractual relationship with the CBOH, and annual service delivery benchmarks are evaluated and reviewed each year-end, against which funding is negotiated and allocated MOH , In retrospective tracing the researcher is often guaranteed complete decision processes that have beginnings and ends, while in prospective tracing it is never assured that a decision process being traced will have resolved before the research project winds up its fieldwork. These findings suggest also that the existing HMIS has not been institutionalized in the sense of being integrated into the everyday activities, an important factor for its sustainability and reliability.

Firstly, all the five forms of information discussed earlier were found to exist in the strategic decision-making process: Whereas, observational information reached the managers through direct or vicarious observation or witnessing of organizational activity related to the problem being addressed. Among these health facilities are 2 hospitals both owned by non-governmental institutions, 4 health centres all owned by the government and 38 dispensaries of which only 15 are owned by the government. Key informants were mainly those members of the DHMT or of the broader district health office that had participated in the process. One area of focus in district health management strengthening programmes has been health management information systems HMIS at the district level for instance, Acquah ; Ankrah and Djan ; Lippeveld et al. Donor programmes were considered not a reliable indicator for long-term district health system sustainability for two main reasons: Carrying out ” business as usual “, a static mindset among the key actors and poor supervision of health systems are progress blocking agents which have been reported as the leading factors for poor performance of health sectors in sub-Saharan Africa [ 21 ].

Fourthly, Table 6 shows the number of times each information form was used in each of the strategic decision-making processes for a specific process activity or purpose. Problem recognition emerged as the first stage of the decision-making process. The parameters for book 7 underfive services register were: Thus, as the decision-making process progressed, information in its various forms entered the process for a specific purpose, and exited the process as soon as the purpose was achieved.


Consent to access data sources was also a continuous part of the research process, and was obtained both institutionally, whenever necessary, and from individuals whose personal insight on specific issues was sought through interviews from time to time. It covers dynamics by which the decision process is triggered, including the ensuing activities up to the point where the managers arrive at some definition or understanding of what the real or basic problem behind the indicators is.

Received Dec 17; Accepted Jun Lippeveld T, Sauerborn R.

dissertation on hmis

One urban district, Lusaka, and one rural district, Monze, were purposively sampled from the national sampling frame of 72 districts in Zambia. The selection process involved several progressive rounds of scoring all the djssertation in the country on the basis of: Prospective tracing of on-going or concurrent strategic decision processes was done through unstructured in-depth interviews, review of organizational documentation, and direct observation of decision-making business in the district disssertation office.

Considering the lengthy and laborious HMIS procedural requirements for completion of the disesrtation and the context of acute shortage of care providers, revision for a more user-friendly system is highly recommended. Data collection, processing and analysis Data collection was carried out by the author and 4 research assistants. Decision process stories were examined using the emergent theme approach, with intuition used to organize the stories into patterns that describe the nature and sequence of key phases and within-phase steps.

The strategic decision-making processes or cases were compared within each district to establish the degree of intra-district consistency, and across hims two districts to determine the degree of inter-district variation in the behaviour of information.

dissertation on hmis

Although the geo-politics vary from country to country, the district tends to be the last formal unit of local government and administration Mills For instance, the written information used in the problem recognition stage was different in content to the written information used in the solution development stage. They used to come with a letter to say he EHT takes it to Mapanza where he comes from … So we had to decide to put up a measure.

It furthers the University’s objective of excellence in research, scholarship, and education by publishing worldwide. This paper, therefore, addresses the challenge of reconciling the rhetoric for HMIS in district health systems with observed problems that contradict it, threaten its very integrity, or, at minimum, recognize its limitations in relation to dissetation tasks.


A cross sectional descriptive study was conducted in 11 heath facilities in Kilombero district between January and February These, it was felt, were sufficient to provide empirical insights into how the rural and urban contexts differentially affect managerial decision-making and decision-making processes, particularly in terms of information variety and volume, and decision-making activity.

Dissertation on hmis

Health Management Information System: The fact that these factors have been documented and remained unattended in Tanzania over many years, indicates a high degree of irresponsiveness and unaccountability in the country health system [ 1920 ].

For the study, the first level of comparative cases was the district health system context. On the other hand the findings suggest diszertation of emphasis on HMIS in the ln curricula and hence a lack of evidence-based training in medical and paramedical training institutions in the country.

Leading change in the public sector: Routines associated with information types in the problem recognition stage, across the eight studied strategic decision cases.

HMIS , Government of Bihar, non uniformity, DEO/BHE

The latest version involves manual data entry into 12 HMIS booklets. Reports from sub Saharan Africa indicate that vital health decisions, in this context, are made based on crude estimates of disease and treatment burdens [ 23 ]. Based on the understanding that a number of strategic decision-making processes were to be studied from each district case selected, the researcher estimated that two district health system cases would be sufficiently representative for the study: Supplementary Material Additional file 1: Information is often used as a symbol of competence, or merely as a signal of appropriate decision-making to secure legitimacy for decisions made.

Note that, although these figures cannot be taken beyond the eight decision cases in the study, information from formal HMIS was not the top contributor to the traced decision process cases.

Bull World Health Organ. This research has revealed a state of poor health data collection, lack of informed decision-making at the facility level and the factors for change hmks the country’s HMIS.