Study area and period of assessment
The study was conducted in health facility of south west shewa zone, Oromia, central Ethiopia, from August 17 to 25, 2019. Southwest Shewa zone is one of the zonal administrations located in Oromia regional state. The zonal capital, Woliso, is 114 km from the capital city of Ethiopia, Addis Ababa. According to a report from the zonal health office in 2018, the total population of the zone was 1,101,129. There are 11 woredas and one town administration, 264 rural and 22 urban kebeles in the zone. According to population projection of 2007, there were a total of 1,101,129 populations (Male 556,194,& Female 544,935) ,and urban 149,878 and rural 951,251 residents in the zone (12). There are 4 functional government hospitals, 1 Private not for profit hospital, 54 functional health centers, and 72 different levels of private clinics and 264 health posts that serve the population living around. The study was carried out in four woredas such as Wonchi, Waliso Town, Goro and Waliso Rural. The health centers are currently implementing Health Management Information System.
- Source of the study were all health centers found in south west shewa zone,
- The study units of the assessment were selected health centers,
- Health centers implementing health management information system were included in the assessment.
Sample Size and sampling Procedure
Sample size determination
According to the WHO guideline for sampling district health system for assessing its functionality we select 4(30%) of the zone woredas were taken (13). Therefore, 22 health centers were included in the assessment and all health facilities’ documents from April to June 2019 were reviewed.
For this assessment, at zonal level, woredas were randomly selected. After selection of woredas, health centers randomly selected using lottery method depending on the number of health centers found in each woreda. All health professionals and supporting staffs working on HMIS and those are available at the time of data collection was interviewed in the study and all selected health centers were physically observed.
Data collection Instrument
The data was collected using HMIS structured questionnaires to answer the objective of the assessment. The questionnaire contains five components such as appropriateness of the card room, functionality of HMIS system (service delivery point, records, registers, completeness and timeliness of reports), Information display, Performance Monitoring Team (PMT) and supportive supervision system. Finally, data quality was observed from registers, tally sheet and reports.
Ten BSc health professionals who know local language and trained on HMIS were recruited for data collection. One day orientation was given for data collectors on data collection tools and procedures by the principal investigators.
Data collection Field Work
Quantitative data were collected from health professionals and supporting staffs working on HMIS and service delivery unit was interviewed using structured questionnaire. Prior to start the interview, data collectors were communicated with health centers head to obtain information about the staffs and whom to interview. Data was checked for completeness and accuracy by data collectors though out the data collection period.
The data was checked for completeness and coded by Epidata3.1 version. Microsoft Excel 2016 was used to develop the frameworks and SPSS version 23 was used for data analysis. A variety of descriptive statistics such as mean scoring, and percentage was calculated to describe the results.
Data Quality management
Questionnaire was prepared in English and translated to local language (Afan Oromo) and retranslated back into English to ensure its consistency. The questionnaires were pre-tested at Tare health center and to ensure that whether it is clear or not for other health centers and then some corrections was done accordingly. Data collectors were instructed to check the completeness of each questionnaire at the end of each interview. The completeness of the questionnaire at the end of the day was rechecked by supervisors.
Appropriate research ethical clearance was obtained from the ethical review committee of South West Shewa Zonal health office (reference number: WEFG/351/2019, June 2019) and woreda health office. This study was conducted in accordance with the Declaration of Helsinki: each study participant was well informed about the aim of the study, benefits and risks; informed written consent was secured from study participants; study participants’ confidentiality was maintained; no personal identifiers were used in the data collection questionnaire and codes were used in place of them; data were kept in a protected and safe location where paper-based data were kept in a locked cabinet and computer-based data were protected using passwords; the recorded data were not accessed by a third person, except the researcher; and data sharing will be enacted based on the consent and permission of research participants and the ethical and legal rules of data sharing.