Introduction:
Health information systems provide information obtained from data for decision
making in order to improve the performance of a health system. Although health
information systems can be very influential, it can not be exit on its own. It is
discussed that the flaw and inefficiency of health information system is rooted to the
powerlessness of health system and lack of incorporation in the overall health system
[1]. The benefits of using data in planning and implementation go beyond the normal
everyday functions of a heath system and include catastrophic situations.
Iran is a developing country which experiences a large number of natural disasters
each year with a significant number of casualties. Owing to the importance of data
for planning, implementation and evaluation, the necessity for sound data is even
more pronounced in a country with such conditions.
The main aim of this project is to use the city of Bam as a case study to explore the
routinely collected data systems in Iran. This investigated the collection of mortality
data from all causes, and maternal mortality specifically, in order to determine the
usefulness and application of these data systems to monitor the immediate and
ongoing health effects of a natural disaster, and to plan for future disasters.
Methods:
A mixed qualitative and quantitative method used to provide better understanding of
the problem at two main data sources, the Medical University and the Civil Registry.
This research has commenced with numeric results of maternal ratios and then has
employed a qualitative method to gain better understanding of data collection
system. The sampling methods are purposive and probability sampling. Interviews,
review of documents, and personal observation are the main data collection methods.
The data are analysed using qualitative and quantitative methods. They are presented
in four sub –chapters , three sub-chapters for non numeric results and one for
numeric results. Results:
The results show that there are dramatic differences on data collection and data
processing between the Civil Registry and the Medical Sciences University. Also it is
found that there are some sorts of shortcomings in different stages of data collection
system in each organisation. This includes incomplete data coverage, shortcoming in
academic staff, insufficient technology infrastructures, lack of training for staff,
inadequate data quality checking. Moreover, there are many limitations affecting
data collection after the earthquake. These limitations are rooted in basic problems
within the existing data collection system and a lack of co-ordination between the
groups collecting the data, including national and international aid groups that
provided help after the earthquake.
Regarding maternal mortality data collection it is found that there was no consistent
definition of maternal deaths among interviewees. All data sources are not aware of
urgently reporting of maternal deaths as it should be.
The results of the estimation of maternal mortality ratios from different sources
present inconsistent pictures. This inconsistency is found in both of the denominators
and nominators. Also, the results of case matching show that the data collected from
two different sources authorised commonly by the Medical Sciences University are
not consistent. Additional exploring on the mortality data in disaster and non disaster
cities reveal that the inconsistency is not limited to the maternal mortality data.
Indeed, there is considerable difference on the total mortality data reported by these
two organisations in target cities.
Discussion:
There are some requirements before setting the systems including introducing
appropriate rules and regulation to oblige different data sources to send the data.
Also allocating enough resources including human resources and providing
appropriate training before commencing the job are of important factor to improve
the system. Having good and strong enough communication infrastructures can
increase the speed and accuracy of data. In addition, some supervisory activities should be in placed to ensure that the data
collection procedures is on the right track and data checking is undertaken by related
stuff. Using consistent software in different organisations provides not only more
complete data by data transferring they can also improve the quality of data through
data cross checking.
Finally the data usage culture should be encouraged by the government in all levels
including national, provincial and districts levels. This can be achieved through
introducing a system of incentives for use the data in decision making and allocating
budget via the data.
Regarding disaster and data collection it is very important to have the collaboration
of international organisation to send the data to the host country. Low collaboration
might be due to this fact that there is little awareness about the importance of having
the flow of data collection after a disaster for planning for disaster stricken country.
Therefore appropriate strategies might be needed to increase this awareness in the
national and global level. This can be achieved through international organisations
such as World Health Organisations or Red Cross Organisations.
Conclusion:
The main aim of data collection is to use the data in planning and evaluation.
Incomplete and inaccurate data must be misleading and useless. in order to
strengthen the data collection system it should be established based on certain
standards to ensure that the data is complete and accurate. This would be of
importance in non disaster and disaster situation
