Guidelines to improve the national health management information system at the community level: a case of maternal, newborn and child health in selected villages in Tanzania

This dissertation looks at ways of improving service delivery and uptake at the community level through the establishment of a community-based information system that eases information availability, use and communication. This study aimed at improving the existing MTUHA system at the community level. The main shortfalls of MTUHA at the community level today are the exclusion from the HMIS of people who are not able to access health services at the facilities. The aggregated data that is reported by health facilities to districts for planning and decision making is only a subset of the comprehensive community data set. It is therefore evident that relevant and timely information is not available to decision makers during planning. A descriptive study design which used action research as its approach was employed and theoretically built on the user participation and structuration theories. Both theories provided insight into how structures are formed, exploring the conditions that are produced and reproduced by people with the aim of challenging the restraining and alienating structures as well as ensured community members participated in the design and development for local ownership and commitment to the system respectively. Study results revealed that two parallel information systems existed in most villages and are male-dominated in their operations. There is a need to harmonize these two systems and strengthen the MTUHA at the community level. This research contributed in theory by improving awareness of the health situation of women and newborns. Practically it built the commitment of local communities in the form of an information system for action. Finally practical guidelines on the design of an MNCH community-based information system were developed.