Browsing by Author "Mungwabi, Hosea Njoghomi"

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    Performance assessment of the national health management information system in the Eastern zone of Tanzania
    (University of Dar es Salaam, 2012) Mungwabi, Hosea Njoghomi
    This study investigated factors constraining the effective performance of the National Health Management Information System in Tanzania, inter alia, health staff participation in systems development, systems requirements from the users’ perspectives, the impact made so far and the sustainability mechanisms at various levels of the system. Descriptive research design was employed to gain deeper insight into the subject matter and ensure that the evidence collected answered the research questions. Data were collected using in-depth interviews, a questionnaire with both open and closed ended questions, observations, documentary review and informal discussions. Purposively selected 155 male and female health personnel participated in this study. The study investigated both functional and non-functional characteristics of the HMIS and revealed that identification of training needs, re-organization of computer facilities, database interfaces and clear understanding of reasons for poor systems and information use, delays in data transfer and variation in impact between individuals and health facilities are critical to smooth functioning of the HMIS. This study applied systems approach to problem solving, in which the entire system was decomposed to identify actual as opposed to perceived problems. In so doing, this study found errors and omissions made in requirements analysis, leading to dysfunctional systems. Findings reveal that the methodology used to develop the Tanzania’s HMIS was standard and that users were involved right from the beginning. Furthermore, the HMIS has greatly enhanced health staff ability to identify health issues, and has improved their confidence and ability to supervise subordinates at health facility level. However, since most of them are not involved in planning and decision-making their impact in health institutions management is negligible. Furthermore, the existing mechanism for sustainability of the HMIS varies at all levels. Government-owned health facilities cannot sustain the HMIS due to funding constraints and because they have no mandate to use health cost-sharing revenues. Nevertheless, districts and regions and ministry can sustain the system if they are aware of the importance of HMIS. Based on these findings, it is recommended that the system’s quality, information quality, data transfer and HMIS facilities should be improved to improve access and effective use of the resources. Similarly, more computers should be purchased including standby generators. Furthermore, IT sections in each district medical office should be established and manned by trained computer and information specialists. It is further recommended that Local Area Networks, Wide Area Networks and Internet should be launched, and training and retraining should be an integral part of HMIS management.