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Research article
Tahmina Begum
International Centre for Diarrhoeal Disease Research Bangladesh
Corresponding Author
ORCiD: https://orcid.org/0000-0001-8106-2454
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Accurate and high-quality data are important for improving program effectiveness and informing policy. Bangladesh Health Management information System (HMIS) has adopted District Health Information software 2 (DHIS) in 2009 to capture real-time health service utilization data. However, routinely collected data are being underused because of poor data quality. We aim to understand the facilitators and barriers on implementing DHIS2 as a way to retrieve meaningful and accurate data for the Reproductive, Maternal and Child Health (RMCAH) services. Methods: This qualitative study was done among two districts of Bangladesh from September 2017 to 2018. Data collection method were key informant interview (n=11); in-depth interview (n=23); focus group discussion (n=2). Study participants were individuals involved with DHIS2 implementation from the community level to the national level. The data were analyzed thematically. Results: DHIS 2could improve the timeliness and completeness of data reporting over time. The reported facilitating factors were strong government commitment, extensive donor support and positive attitude of staffs. Quality checks and feedback loops at multiple levels of data gathering points was helpful to minimize data errors. Introducing dashboard makes the DHIS2 compatible to use as monitoring tool. However, the barriers to DHIS 2 implementation were lack of human resources, slow Internet connectivity, and frequent change of DHIS 2 versions, maintaining both manual and electronic system side by side. The collected data remains incomplete as private health facilities are not covered. The parallel presence of two MISs to report same RMNCAH indicators is a threat to achieve quality data and increases workload. Conclusion: The overall insights from this study are expected to contribute to the development of effective strategies for successful DHIS 2 implementation and building responsive HMIS. To sustain the achievements of digital data culture, focused strategic direction is needed. Periodic refresher trainings, incentives for increased performance, automated single reporting system for multiple stakeholders could make the system more user friendly. A national electronic health strategy and implementation framework can facilitate creating a culture of DHIS 2 use for planning, setting priorities, and decision making among stakeholder groups
Keywords
Electronic health management information System, District Health Information System software2, Facilitators, Barriers, Bangladesh
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CURRENT STATUS: Published
View the published article at BMC Health Services Research.
No community comments so far
Submission checks complete
On 14 May, 2020
Editorial decision: Accept
On 12 May, 2020
No comments provided
Editorial decision: Minor revision
On 08 May, 2020
Review #2 received
Received 24 Apr, 2020
Reviewer #2 agreed
On 10 Mar, 2020
Reviewers invited
Invitations sent on 31 Jan, 2020
Reviewer #1 agreed
On 31 Jan, 2020
Review #1 received
Received 31 Jan, 2020
Editor assigned
On 24 Jan, 2020
Submission checks complete
On 23 Jan, 2020
Editor invited
On 23 Jan, 2020
No comments provided
Reviewer #2 agreed
On 12 Jan, 2020
Review #2 received
Received 12 Jan, 2020
Editorial decision: Major revision
On 12 Jan, 2020
Review #1 received
Received 29 Dec, 2019
Reviewer #1 agreed
On 27 Nov, 2019
Reviewers invited
Invitations sent on 26 Nov, 2019
Editor assigned
On 19 Nov, 2019
Submission checks complete
On 18 Nov, 2019
Editor invited
On 18 Nov, 2019
Version 2
Posted 12 Oct, 2019
No comments provided
Editorial decision: Major revision
On 18 Oct, 2019
Review #3 received
Received 03 Oct, 2019
Reviewer #4 agreed
On 23 Sep, 2019
Review #1 received
Received 23 Sep, 2019
Reviewer #3 agreed
On 21 Sep, 2019
Review #2 received
Received 21 Sep, 2019
Reviewer #2 agreed
On 16 Sep, 2019
Reviewer #1 agreed
On 13 Sep, 2019
Reviewers invited
Invitations sent on 02 Sep, 2019
Editor assigned
On 23 Aug, 2019
Submission checks complete
On 22 Aug, 2019
Editor invited
On 22 Aug, 2019
No comments provided
Editorial decision: Revise before sending to peer reviewers
On 01 Aug, 2019
Submission checks complete
On 26 Jul, 2019
Editor assigned
On 17 Jul, 2019
Editor invited
On 16 Jul, 2019
First submitted
On 13 Jul, 2019
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A new preprint design is coming!
We have improved readability, clarity, accessibility, and opportunities for engagement.
See the published version of this preprint at BMC Health Services Research.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Tahmina Begum
International Centre for Diarrhoeal Disease Research Bangladesh
Corresponding Author
ORCiD: https://orcid.org/0000-0001-8106-2454
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Health Services Research.
No community comments so far
Submission checks complete
On 14 May, 2020
Editorial decision: Accept
On 12 May, 2020
No comments provided
Editorial decision: Minor revision
On 08 May, 2020
Review #2 received
Received 24 Apr, 2020
Reviewer #2 agreed
On 10 Mar, 2020
Reviewers invited
Invitations sent on 31 Jan, 2020
Reviewer #1 agreed
On 31 Jan, 2020
Review #1 received
Received 31 Jan, 2020
Editor assigned
On 24 Jan, 2020
Submission checks complete
On 23 Jan, 2020
Editor invited
On 23 Jan, 2020
No comments provided
Reviewer #2 agreed
On 12 Jan, 2020
Review #2 received
Received 12 Jan, 2020
Editorial decision: Major revision
On 12 Jan, 2020
Review #1 received
Received 29 Dec, 2019
Reviewer #1 agreed
On 27 Nov, 2019
Reviewers invited
Invitations sent on 26 Nov, 2019
Editor assigned
On 19 Nov, 2019
Submission checks complete
On 18 Nov, 2019
Editor invited
On 18 Nov, 2019
Version 2
Posted 12 Oct, 2019
No comments provided
Editorial decision: Major revision
On 18 Oct, 2019
Review #3 received
Received 03 Oct, 2019
Reviewer #4 agreed
On 23 Sep, 2019
Review #1 received
Received 23 Sep, 2019
Reviewer #3 agreed
On 21 Sep, 2019
Review #2 received
Received 21 Sep, 2019
Reviewer #2 agreed
On 16 Sep, 2019
Reviewer #1 agreed
On 13 Sep, 2019
Reviewers invited
Invitations sent on 02 Sep, 2019
Editor assigned
On 23 Aug, 2019
Submission checks complete
On 22 Aug, 2019
Editor invited
On 22 Aug, 2019
No comments provided
Editorial decision: Revise before sending to peer reviewers
On 01 Aug, 2019
Submission checks complete
On 26 Jul, 2019
Editor assigned
On 17 Jul, 2019
Editor invited
On 16 Jul, 2019
First submitted
On 13 Jul, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Health Services Research.
Background: Accurate and high-quality data are important for improving program effectiveness and informing policy. Bangladesh Health Management information System (HMIS) has adopted District Health Information software 2 (DHIS) in 2009 to capture real-time health service utilization data. However, routinely collected data are being underused because of poor data quality. We aim to understand the facilitators and barriers on implementing DHIS2 as a way to retrieve meaningful and accurate data for the Reproductive, Maternal and Child Health (RMCAH) services. Methods: This qualitative study was done among two districts of Bangladesh from September 2017 to 2018. Data collection method were key informant interview (n=11); in-depth interview (n=23); focus group discussion (n=2). Study participants were individuals involved with DHIS2 implementation from the community level to the national level. The data were analyzed thematically. Results: DHIS 2could improve the timeliness and completeness of data reporting over time. The reported facilitating factors were strong government commitment, extensive donor support and positive attitude of staffs. Quality checks and feedback loops at multiple levels of data gathering points was helpful to minimize data errors. Introducing dashboard makes the DHIS2 compatible to use as monitoring tool. However, the barriers to DHIS 2 implementation were lack of human resources, slow Internet connectivity, and frequent change of DHIS 2 versions, maintaining both manual and electronic system side by side. The collected data remains incomplete as private health facilities are not covered. The parallel presence of two MISs to report same RMNCAH indicators is a threat to achieve quality data and increases workload. Conclusion: The overall insights from this study are expected to contribute to the development of effective strategies for successful DHIS 2 implementation and building responsive HMIS. To sustain the achievements of digital data culture, focused strategic direction is needed. Periodic refresher trainings, incentives for increased performance, automated single reporting system for multiple stakeholders could make the system more user friendly. A national electronic health strategy and implementation framework can facilitate creating a culture of DHIS 2 use for planning, setting priorities, and decision making among stakeholder groups
Figure 1
Figure 2
This is a list of supplementary files associated with this preprint. Click to download.
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