Individual Factors Associated With the Implementation of A Health Management Information System At Kenyatta National Hospital

Abstract

A strategic harnessing of the power of data to healthcare systems strengthening makes a rapid and affordable progress towards achieving UHC Majority of the developed countries among them Canada, United States of America and the United Kingdom have had to budget for huge amounts of money for an impetus towards Health Management Information System (HMIS) adoption whereas developing countries are still lagging behind and struggling to make do with the old traditional healthcare setups. Health systems are the core foundations of how countries respond to new disease threats and improving health of the people. The iterative nature of the process cannot be further overemphasized; any changes in mission, operations, functions, or information and data needs must be assessed to reveal their impact on analyses already completed, since these changes could have a profound effect on the system to be acquired. The main objective of the study was to determine individual factors associated with the implementation of a Health Management Information System at Kenyatta National Hospital. The research was conducted at KNH and adopted a cross-sectional study design. The target population of the study were healthcare workers at KNH who were involved in implementing HMIS with a sample size of 263 the sample techniques used was mixed method sampling of snowball sampling, stratified sampling and convenience sampling. A sample total of 263 respondents was calculated for the quantitative study. The study utilized an in depth interview schedule, a questionnaire and a key informant interview schedule. Before processing the quantitative data, the data collected from the field was cleaned, coded, entered into a computer software and analyzed using SPSS version 21 while qualitative data was manually analyzed based on themes that were developed from responses (thematic analysis). Data presentation from the quantitative data was in form of quantitative statistics such as frequency distribution, percentages and tables use of chi square for analysis. Qualitative findings were presented in verbatim form. This study was submitted to KNH/UON Ethical Review Committee for ethical approval. Consenting was sought from individuals. Results indicated that majority of those interviewed were of the opinion that HMIS had improved services delivery by effecting efficiency especially in accident and emergency department, the wards and reception areas, generally there was improved efficiency in information handling in that, it had helped to identify patients in and through the system and there was reduction in costs. A better part of the respondents (59.3%) endorsed improvement on turnaround time as compared to (25.9%) who were against the idea. Same way, a major part (70.5%) seconded HMIS an impetus on faster service delivery contrary to a minority (18.2%). (p = 0.024). . A large part of the respondents (83.7%) was associated with higher Likert scale responses while, a minority (7.6%) disagreed with the concept. However, a few respondents were of the view that, HMIS had not improved efficiency to a larger extend since a lot of things were still done manually, no proper training and the system not fully implemented. Main challenges included, lack of technical assistance which led to loss of data which had never been recovered to date and scarce resources. In relation to the cadre of the hospital, the systems were quite complex, inadequate healthcare staff experience, scarcity of infrastructure and shortage of ICT technicians to assist in trouble shooting. There were very many refunds to patients by finance, resistance by users due to the perception that, it was a business-oriented system rather than goal oriented. Results show that the hospital uses HMIS in its day to day activities/roles in delivering health care services, (p value 0.006 and OR 6.844), with majority of the study population stating that there was an effective and fair distribution of computers in the hospital (OR 3.67). Duration worked at KNH strongly agreed and had an association with the fact that KNH had the current and up to date ICT infrastructure (OR 2.697). There was an association between resistance to change and the study population age, level of education and duration worked at KNH, (p value 0.008, 0.050 and 0.004). KNH might not be where they want or need to be as far as HMIS is concerned but they have made strides towards the right direction. Technologically, HIMS have already taken a vital role in the healthcare industry and are obliged to be organizational tools meant to create a DOI: 10.9790/0853-2101041929 www.iosrjournal.org