Evaluation of the Performance of Routine Information System Management (PRISM) framework: evidence from Uganda

<p>Abstract</p> <p>Background</p> <p>Sound policy, resource allocation and day-to-day management decisions in the health sector require timely information from routine health information systems (RHIS). In most low- and middle-income countries, the RHIS is viewed as being inadequate in providing quality data and continuous information that can be used to help improve health system performance. In addition, there is limited evidence on the effectiveness of RHIS strengthening interventions in improving data quality and use. The purpose of this study is to evaluate the usefulness of the newly developed Performance of Routine Information System Management (PRISM) framework, which consists of a conceptual framework and associated data collection and analysis tools to assess, design, strengthen and evaluate RHIS. The specific objectives of the study are: a) to assess the reliability and validity of the PRISM instruments and b) to assess the validity of the PRISM conceptual framework.</p> <p>Methods</p> <p>Facility- and worker-level data were collected from 110 health care facilities in twelve districts in Uganda in 2004 and 2007 using records reviews, structured interviews and self-administered questionnaires. The analysis procedures include Cronbach's alpha to assess internal consistency of selected instruments, test-retest analysis to assess the reliability and sensitivity of the instruments, and bivariate and multivariate statistical techniques to assess validity of the PRISM instruments and conceptual framework.</p> <p>Results</p> <p>Cronbach's alpha analysis suggests high reliability (0.7 or greater) for the indices measuring a promotion of a culture of information, RHIS tasks self-efficacy and motivation. The study results also suggest that a promotion of a culture of information influences RHIS tasks self-efficacy, RHIS tasks competence and motivation, and that self-efficacy and the presence of RHIS staff have a direct influence on the use of RHIS information, a key aspect of RHIS performance.</p> <p>Conclusions</p> <p>The study results provide some empirical support for the reliability and validity of the PRISM instruments and the validity of the PRISM conceptual framework, suggesting that the PRISM approach can be effectively used by RHIS policy makers and practitioners to assess the RHIS and evaluate RHIS strengthening interventions. However, additional studies with larger sample sizes are needed to further investigate the value of the PRISM instruments in exploring the linkages between RHIS data quality and use, and health systems performance.</p

Crisis in the IS field? A critical reflection on the state of the discipline

This paper explores the issue of whether the field of IS is in crisis. To do so, the paper first starts by looking back on where the field has come from. Next, it assesses the status of the IS field by exploring where the field is now. That our current status remains a ‘fragmented adhocracy’ suggests the field may indeed be in crisis or headed for a crisis. This is compounded by the fact that there are two different views on the state of the IS field, each posing its own set of threats. One is the external view of the community (the view of IS from outside the academic field); the other is the internal view (the view from inside the IS community). By analyzing these two views, a better understanding of the problems the field faces emerges. In the next part of the paper, some thoughts are presented on where might the field go from here for overcoming its internal communication deficit. The paper proposes four different types of knowledge for structuring an IS Body of Knowledge (BoK) and following on from that, the value of creating a common BoK for the field. Lastly, the implications arising from the paper’s analysis are explored. More specifically, the paper considers various options that are available for overcoming the internal communications deficit the IS field faces. These include changing the way the field thinks about generalizations, changing the institutional publication practices, focusing more on understanding the field’s organizational stakeholders, and developing new knowledge creation and transformation networks. If IS as a field can overcome its internal communications deficits, it might ultimately contribute to the societal challenge of developing a deliberative cyber democracy and thereby help to address the social communication deficit which is a feature of modern mass societies