A health information system (HIS) is a system designed for the collection, processing, use, and dissemination of health-related data to improve health care outcomes (1). It is essential for health system policy development and implementation, governance and regulation, health research, human resources development, service delivery, and financing (2). Routine Health Information System (RHIS) is the backbone for planning and management of the health service activities, the day-to-day patient management, health education, resource allocation, disease prioritization, and decision-making (3). A properly functioning RHIS enables the policymakers, managers, and service providers to make decisions based on evidence, ultimately leading to sustainable health outcomes in the community they serve (4).
Globally, significant human and financial resources have been invested to improve routine health information systems for planning, reporting, community health mobilization, and observing disease trends (5). Evidence-based decision-making through health information system use has become the top priority on the agenda of the government of Ethiopia and its development partners. There are minimal efforts by health workers and managers to demand and use the available routine health information for service delivery, planning, and decision-making (6).
However, most of the health workers in developing countries relate information systems with filling endless registers by names and addresses of patients, compiling information on disease every week or month, and sending reports to the next level without adequate use and feedback (7). As a result, many health systems fail to fully link evidence to decisions and suffer from a reduced ability to respond to priority health needs at all levels of the health care system (3).
Routine health information systems in developing countries do not provide the necessary information which supports decision-making. Some of the reasons are poor quality of data, weak data analysis, lack of information culture, lack of trained personnel, and Health Information System (HIS) activities seen as a burden due to high workloads especially at the health facility level (8). The use of information for evidence-based decision making is still very weak in most low- and middle-income countries (LMICs), particularly for data produced by health facilities. Findings from Africa countries indicated that routine health information use among managers remains low; 39.9% in Nigeria (9), 55.6% in Kenya (10), 42% in Tanzania (11), 59% in Uganda (12), and 65% in South Africa (13).
The use of health information in Ethiopia for policy and strategy formulation, planning, and decision making is not widely practiced. Data quality and information use remain weak, particularly at the health facilities level. Health workers spend 40% or more of their time filling in Health Management Information System (HMIS) forms but may make little or no use of information for decision- making (14). A very recent study conducted in North Gondar on the use of routine health information among health workers working at public health institutions showed that the use of health information was 78.5 %. However, the information used in Ethiopia ranges from 32.9–78.5% (15), (16). Assessment done in Jimma Zone revealed that out of 84.3% data collected daily only 22.5% of them used, only 17.7% changed their data into information at district and facility level, and used it for immediate decision making (17).
A study showed that routine health information use can be affected by the organizational, technical, and behavioral characteristics of the managers (18). Among the factors reported, training (19), computer skill (18), data analysis skill (20), computer access, availability of HMIS guidelines and formats (21), supportive supervision with effective feedbacks (8), (22), (23), data infrastructure in respect to the information and communications technology application (24), confidence level (13), and competency of managers (22) are commonly associated with routine health information use.
Owing to the observed gap in the health sector in Ethiopia, information use has been given substantial prominence in the Health Sector Transformation Plan (HSTP) as part of the information revolution which is one of the four transformation agendas. The information revolution is not only about changing the techniques of data and information management; it is also about bringing fundamental cultural and attitudinal change regarding the perceived value and practical use of information (6). Therefore, this study pursued to assess the magnitude of routine health information use for decision-making and its associated factors among managers working in Public Hospitals in North Shewa of Oromia Regional State, Ethiopia. The finding will help to change policy and improve the programs’ effectiveness, to allocate resources for interventions of health information use, and effectively implement different health sector programs and strategies.