Evaluation of the Use of se of Health Information System in Decision Making in Non Governmental Organizations – Gaza Governorates

Akram Hasan Nassar
أكرم حسن نصار
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Al-Quds University
The demand for timely, accurate and relevant information for decision making in health is more than ever before. In a fragmented health system like the Palestinian one, where resources are scarce and health problems are complex, the need for information is even more crucial than elsewhere. Little is known about the extent of use of information in decision making in the Non-Governmental Organizations (NGOs) in the Gaza Strip. This study aims to examine the extent to which local health NGOs follow an evidence-based decision making approach through using health information systems (HIS). The study utilized descriptive, analytical cross sectional design with a quantitative approach. Two interviewed questionnaires were used for data collection from two diverse sources; the NGO as an organization (organizational questionnaire) and the managers working in these organizations (individual questionnaire). In this census study, of the eligible 24 health NGOs, 21 NGOs had positively responded. Response rate among managers was 83.3%. The developed questionnaires were based on the Health Metrics Network (HMN) assessment tool for national HIS with adaptation to fit the Palestinian NGO context. The overall reliability coefficient for both the organizational and the individual tools were very high (0.954 & 0.904 respectively). Findings revealed adequate total HIS performance for the organizational questionnaire (57.65%) and the individual (managers) one as well (62.02%). Low performance was found regarding the use of indicators (40.47% &48.6%; organizational then managers respectively) and in the HIS data sources (53.46% & 47.27%) whereas HIS data management (61% & 68.4%) and the information dissemination and use in decision making showed high results (69.13% & 60.96%). Lesser performance was found in the evaluation of HIS resources (52.11% & 69.48%) and in HIS information products (64.0% & 45.53%). However, the main strengths could be summarized in the highly positive managers’ attitudes, the young age of most of the NGOs managers, the effective internal communications and the commitments of top managers towards computerization of the system. The main weaknesses were the lack of HIS policies & regulations, lack of HIS training activities, inadequate standardized use of performance indicators, poor use of external data sources, inadequate data presentation capacities at the operational levels and inadequate information sharing with the community. Participants working in hospitals revealed lower perceptions in all HIS components in comparison to other groups with statistically significant differences (P<0.05). Similarly, computer users elicited higher HIS performance than non-users at all components with statistical significant differences (P<0.05). Top managers elicited higher scores in information products and the availability of resources than mid and low level managers and the differences reached statistically significant levels (P < 0.05). To enhance the information based decision making, the researcher recommends developing a set of indicators and supporting their monitoring. Also, enhancing a culture conducive to the use of information in decision making is essential. Last but not least, reinforcing capacity building skills in HIS is extremely