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Health Research Policy and Systems

, 11:34

First Online: 08 September 2013Received: 22 May 2013Accepted: 26 August 2013


BackgroundIn many countries, the responsibility for planning and delivery of health services is devolved to the subnational level. Health programs, however, often fall short of efficient use of data to inform decisions. As a result, programs are not as effective as they can be at meeting the health needs of the populations they serve. In Kenya, a decision-support tool, the District Health Profile DHP tool was developed to integrate data from health programs, primarily HIV, at the district level and to enable district health management teams to review and monitor program progress for specific health issues to make informed service delivery decisions.

MethodsThirteen in-depth interviews were conducted with ten tool users and three non-users in six districts to qualitatively assess the process of implementing the tool and its effect on data-informed decision making at the district level. The factors that affected use or non-use of the tool were also investigated. Respondents were selected via convenience sample from among those that had been trained to use the DHP tool except for one user who was self-taught to use the tool. Selection criteria also included respondents from urban districts with significant resources as well as respondents from more remote, under-resourced districts.

ResultsFindings from the in-depth interviews suggest that among those who used it, the DHP tool had a positive effect on data analysis, review, interpretation, and sharing at the district level. The automated function of the tool allowed for faster data sharing and immediate observation of trends that facilitated data-informed decision making. All respondents stated that the DHP tool assisted them to better target existing services in need of improvement and to plan future services, thus positively influencing program improvement.

ConclusionsThis paper stresses the central role that a targeted decision-support tool can play in making data aggregation, analysis, and presentation easier and faster. The visual synthesis of data facilitates the use of information in health decision making at the district level of a health system and promotes program improvement. The experience in Kenya can be applied to other countries that face challenges making district-level, data-informed decisions with data from fragmented information systems.

KeywordsData-informed decision making Data dashboards Data use Decision-support tools District level Health information systems Health systems strengthening AbbreviationsDASCODistrict AIDS and STI control officer

DHISDistrict health information system

DHMTDistrict health management teams

DHPDistrict health profile

DHIRODistrict health information and records officer

DMOHDistrict medical officer of health

HISHealth information systems

MOHMinistry of health

NASCOPNational AIDS and STD control program

PMTCTPrevention of mother-to-child transmission

VCTVoluntary counseling and testing.

Electronic supplementary materialThe online version of this article doi:10.1186-1478-4505-11-34 contains supplementary material, which is available to authorized users.

Tara Nutley, Sarah McNabb and Shannon Salentine contributed equally to this work.

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Autor: Tara Nutley - Sarah McNabb - Shannon Salentine


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