Background: The District Health Management Information Systems
(DHMISs) were established by the Ministry of Health (MoH) in Kenya more
than two decades ago. Since then, no comprehensive evaluation has been
undertaken. This can partly be attributed to lack of defined criteria
for evaluating them. Objective: To propose evaluation criteria for
assessing the design, implementation and impact of DHMIS in the
management of the District Health System (DHS) in Kenya. Method: A
descriptive cross-sectional study conducted in three DHSs in Kenya:
Bungoma, Murang'a and Uasin Gishu districts. Data was collected through
focus group discussions, key informant interviews, and documents'
review. The respondents, purposely selected from the Ministry of Health
headquarters and the three DHS districts, included designers, managers
and end-users of the systems. Results: A set of evaluation criteria
for DHMISs was identified for each of the three phases of
implementation: pre-implementation evaluation criteria (categorised as
policy and objectives, technical feasibility, financial viability,
political viability and administrative operability) to be applied at
the design stage; concurrent implementation evaluation criteria to be
applied during implementation of the new system; and
post-implementation evaluation criteria (classified as internal –
quality of information; external – resources and managerial
support; ultimate – systems impact) to be applied after
implementation of the system for at least three years. Conclusions:
In designing a DHMIS model there is need to have built-in these three
sets of evaluation criteria which should be used in a phased manner.
Pre-implementation evaluation criteria should be used to evaluate the
system's viability before more resources are committed to it;
concurrent (operational) - implementation evaluation criteria should be
used to monitor the process; and post-implementation evaluation
criteria should be applied to assess the system's effectiveness
