The role of Quality Improvement Process (QIP) in enhancing the effectiveness of routine health information system for health service planning in the Ejisu-Juaben Municipal of Ghana

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November, 2015
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Abstract
Decision making in health is influenced by the quality of health information generated by the health system. Routine Health Information System (RHIS) is one of such information integral and forms over 90% health information. Yet RHIS is faced with huge challenges which reduce its decision making and planning yield. However, there is limited empirical evidence on the magnitude of dysfunction in the RHIS in most health districts, Ejisu Juaben Municipal Health Directorate (EJMHD) in Ashanti Region being no exception. This study assessed the role of Quality Improvement Process (DQIP) in improving RHIS in planning and decision making. A quasi-experimental, uncontrolled before and after study involving the development of a Data Quality Improvement Process (DQIP) training module to train health staff, establish a team with the quality improvement framework for monitoring over a twelve-month period in the EJMHD. The modelled Data Quality Improvement Process (DQIP) involved RHIS management assessment tool (adapted from the Performance of Routine Information System Management [PRISM] tool package) which was administered to 141 health staff and management in 18 health facilities in Ejisu-Juaben Municipality before and after the intervention.The study evaluated the impact of the modelled Data Quality Improvement Process (DQIP) on RHIS performance at the end of the intervention period through a cross-sectional survey. Health staff and management had relatively high confidence in undertaking RHIS tasks such as data analysis, interpretation and use of data. On the contrary, their actual performance of RHIS tasks scored objectively, yielded low average scores. The baseline and endline results indicated improvement in competency gaps, after the intervention, in analysis (-37%:+3%), interpretation (-42%:+10%) and use of data (-45%:+3%) respectively. Performance in the use of RHIS at the facility level improved significantly from 30 percent in baseline to 90 percent in the endline; and similar trends were observed in other parameters. The study concludes that Quality Improvement Process (QIP) drives the effectiveness and performance of RHIS. Scaling up DQIP in the health system will necessarily lead to improved RHIS performance.
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A thesis submitted to the Department of Health Policy, Management and Economics, College of Health Sciences, School of Public Health, in partial fulfillment of the requirements for the degree of Doctor of Philosophy,
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