The operation criteria of a health management information system

Background: An iterative process before implementing any health management information system is needed, in that changes identified during the process must be evaluated to determine their effect on completed analyses. In order to achieve maximum returns on an investment or intervention evaluation should be from the outset. The process must consider system life cycle management and the organization’s policy and budget as important integral factors.Objective: To evaluate the operation phase of the implemented Health Management Information System at Kenyatta National Hospital.Design: A descriptive cross-sectional study.Setting: Kenyatta National Hospital.Subjects: Forty (40) healthcare workers who were involved in the implementation of the Health Management Information System.Results: The response rate was more than 90%. The main indicator used in evaluating the electronic HMIS in KNH was performance 17 (53.1%), Other indicators that were commonly applied in HMIS evaluation in KNH were connectivity 9 (28.1 %) and durability 7 (21.9%), all these indicators are major items to consider and evaluate in an effective HMIS, although not at a good scale it can be concluded that the HMIS at KNH was fair since it’s the first time KNH is adopting the concept.Most health workers17 (53.1%) felt that the electronic HMIS in KNH had achieved its objectives while the rest 16 (46.9%) were for the opinion that the electronic HMIS in KNH had not achieved its objectives.From the findings in the operation criteria the benefits of the electronic HMIS included improved efficiency and reduced workload.Other areas that were impacted on by the electronic HMIS were costs, and ICT skills or training.Conclusions: From the findings in the operation criteria,the indicators showing successful implementation were: routine use of HMIS in healthcare activities, managerial support for HMIS, changes in hospital structure and integrated managerial processes, HMIS advocacy, data collection, analysis and interpretation and potential for ICT expansion. For the remaining indicators respondent did not strongly agree or agree that implementation had been successful. The area in which implementation was not judged successful were: effective and fair distribution of computers, partial HMIS implementation, inadequate numbers of skilled and trained staff, and inadequate ICT infrastructure. Lastly the goal of monitoring and evaluation is not to focus on what is wrong and condemn it; rather, it is to highlight the positive aspects of the system that make it work, as well as to identify what went wrong as a basis for improving the system From the findings most health workers (53.1%) felt that the electronic HMIS in KNH had achieved its objectives which will in return lead to effective utilisation of HMIS and better healthcare service delivery

The Design Criteria in Implementation of a Health Management Information System: a Case of Kenyatta National Hospital

The study utilized an in-depth interview schedule for 33 respondents in the design phase who were selected using snow-ball, the data collected from the field was analyzed through the use of univariete and bivariete statistics. Data presentation was in form of descriptive statistics such as frequency distribution, percentages, pie charts, bar graphs and tables. The data from the design phase were summarized in three main evaluation areas targeting the perception of the HMIS, purposes and processes From the findings, in the design stage although the respondents did not show systematic ordering there was evidence to the effect that the steps were followed during the design phase. From the findings majority of the key informants were able to define HMIS and distinguish the key features of the HMIS. Out of the 33 participants, 13 (33.4%) reported that they knew the persons who originated the idea of the electronic HMIS in KNH, a similar number were involved in the conceptualization of the system, while 4 (12.2%) indicated that they were involved in designing the HMIS and 18 (54.6%) were involved in implementation. Despite the general lack of knowledge on HMIS policy the informants demonstrated adequate understanding of the objectives of the electronic HMIS in KNH. Based on the responses obtained during interviews there were multiple problems related to the manual system that existed in KNH during the pre-implementation stage and these issues served as the basis for objective setting for the current HMIS in the hospital. Most key informants felt that the hypothesized benefits of the current HMIS were being realized including improved efficiency while four key informants felt that the benefits had been partially realized. An evaluation of the manual HMIS was done during which deficiencies of the HMIS were identified through consultations involving HMIS users and stakeholder. A HMIS needs assessment was conducted and formed the basis of the electronic system requirements with specific proposals for improvement of the deficiencies identified in the manual HMIS. An evaluation of the manual HMIS was done during which deficiencies of the HMIS were identified through consultations involving HMIS users and stakeholder. During the interviews the participants were able to highlight various aspects of the IS development cycle and there was evidence to the effect that the steps were followed during the design phase plus an evaluation of the manual system was done during which deficiencies of the system were identified through consultations involving HMIS users and stakeholders. Based on the results and discussions, among the main problems that key informants described during the design phase was major inefficiencies characterized by evident mismatching of resources input and output which spanned several areas including time, human resources and finances however, participants were able to highlight various aspects of the IS development cycle and there was evidence to the effect that the steps were followed during the design phase, planning plus an evaluation of the manual system was done during which deficiencies of the system were identified through consultations involving HMIS users and stakeholders. As a recommendation we can say that NH and the MOH needs to come up with an established standardized policy for implementing interventions. Embracing modern technology is one among very many ways of improving efficiency and reducing costs within healthcare organizations. While the integration of information and health services potential benefits cannot be disputed, there are many challenges which affect its adoption, in fact, majority of organizations have abandoned their newly acquired systems only to go back to their old manual systems. The objective of this study was to determine the design phase of the implemented Health Management Information System at Kenyatta National Hospital. This study was a cross-sectional descriptive study, the targeted population of the study were 35 healthcare workers who were involved in the designing of the Health Management Information System at Kenyatta National Hospital, and the sample technique used was snowball sampling

Statistics in Climate Variability, Dry Spells, and Implications for Local Livelihoods in Semiarid Regions of Tanzania: The Way Forward

This research article published by Springer Nature Switzerland AG., 2016The Dodoma municipality, a semiarid region of Tanzania, is characterized by limited rains, lack of surface water sources, and a high frequency of extreme climate events, particularly droughts and floods. These disadvantaged settings make it vital to study long-term climate trends for signals and patterns of shifting climate regimes for integrity of local livelihood support systems, especially agriculture, recharge, and pasture developments. The area has fairly long climate records, some of which extend to about 100 years. This chapter presents detailed analysis of six climate parameters, namely, rainfall (R), atmospheric relative humidity (ARH), temperature (T), sunshine (S), radiation (RD), wind speed (WS), and evaporation (ET) records from three meteorological stations, namely, Hombolo Agrovet (HMS), Dodoma (DMS), and Makutupora (MMS). The parameters above were statistically and graphically analyzed in four time scales, namely, monthly, seasonal, annual, and time series. The results showed the area is characterized by slight spatial variability in R intensity and T magnitudes with HMS having higher T and rains than DMS and MMS. Further there are clear decreasing trends in ARH and R, while T, S, WS, ET, and RD parameters showed characteristic increasing trends. Thus, except for extreme rain events, particularly El Niño-Southern Oscillations (ENSO), which are characterized by abnormally increased R magnitudes, R intensity has generally decreased in which over the past 91 years, there has been a net R decrease of 54 mm out of annual rains of only about 550 mm/year. Compared to annual time step, however, monthly step reveals more silent features like shortening of the growing seasons. Similarly, the frequency and severity of drought episodes are increasing, all of which adversely impact agriculture, pasture development, and recharge. Similarly, disappearance of R in some months, shifting seasonality, and general declining R intensities and magnitudes are clearly observed. May rains have largely disappeared, while in January, February, March, and April rains have decreased and hence shortening the length of growing season. On the other hand, clear warming trends and declining ARH were also observed. Yet the area is marked by cyclic wetting and drying events where in recent years, drying cycles have been prolonged. However, there is more variability in the mean minimum temperature (MMT) than in mean maximum temperatures (MMMT) in all stations. Between 1961 and 2012, there has been a net 1.13 and 0.778 °C increases in annual MMT and MMMT in DMS, respectively. Like for R trends, silent features are more evident under monthly T data than annual time steps where it is clear that June had the highest increase in MMT (1.54 °C), while April had the least (only 0.662 °C). However, both trends have the potential of affecting major livelihood support systems particularly agriculture and pasture development, but also local groundwater recharge that is vital for the local economy. The study area therefore offers a rare opportunity to understand and manage changing climate regimes including on extent of dry spells and longevity of growing seasons. The changing climate trends consequently call for significant adaptation and mitigation strategies so that local activities adjust to the current climate regimes particularly on onset and end of rainfall seasons and recharge fluxes

Agency versus community participation approach in development of water supply and sanitation programmes

Agency versus community participation approach in development of water supply and sanitation programme

Effects of use of online registration system on user satisfaction at the institutions of higher learning in developing economies: A case of University of Eastern Africa

Whereas a number of institutions of higher learning have embraced Information Systems (IS), many of such institutions in developing countries are still grappling with heavy manual processes and majority of these services do not effectively meet the intended purposes. Moreover, the adopted IS by such institutions in developing countries more often have failed to effectively meet the unique individual needs of these institutions. The main objective of this study was to assess the effects of use and application of Online Registration System on user satisfaction at the University of Eastern Africa, Baraton in Kenya. A total of 289 respondents out of 1047 were sampled. A two stage sampling method was used whereby stage one involved stratified sampling in which case respondents were stratified into students and lecturers at stage two, simple random sampling method was used to ensure that each eligible member in the population has an equal chance of being included in the sample. The findings from this study revealed that even though most users were satisfied with the services offered by Online Registration System, a deeper consideration of the dimensions of quality services needed to be improved and that involves support staff training, user communication and provision of prompt services