Health Information System and Disease Surveillance Situation Analysis and Model Proposal in Umbadda Province Khartoum State (2000)

Abstract

A cross-sectional descriptive study was conducted in Umbadda province, Khartoum State during the year 2000. The main objective of the study was to evaluate the present Health Information System (HIS) and Disease Surveillance (D.S.) with the view of proposing a comprehensive model. The study mainly focused on analyzing the HIS and D.S. in the study area so as to draw lessons for improving the system. Qualitative as well as quantitative data were collected using pre-tested, precoded questionnaire, check-list and key informants depth interviews. The study revealed that the indicators used in HIS and D.S. are institutional and facility based. The system had no community indicators and had no information about those who have no access to the system or its workers. The private sector was not included in the system. The standardized registration books and forms cover only the governmental health facilities (31%) while the non-governmental (69%) were not covered. A lot of data were collected and reports were send to the high level on regular basis but analysis and use of data at the local level was not practiced at all. The training of health personnel in registration, reporting and simple statistical methods was poor. Feed-back process was weak and only 22.5 % of the health centres stated that it is practiced. The file keeping system was poor and 75 % of the health facilities had no places to keep the records. Lack of 55 communication, only 2.5% of the health centres had communication means. As regard the surveillance system, there was no standardized case-definition for the communicable diseases under surveillance. The system depends on (10) selected sentenil centres and no active surveillance is practiced. The number of population and maps for the catachment areas were not available except in 4 centres (5%) in which health area was tried. Registration of vital events was poor, birth certificate can be issued in 13.7% of the health facilities while death certificate was present only in 5% of the centres. Umbadda Province has no hospital to act as first referral level and to be supportive for PHC activities and training of heath cadre. Some of the health personnel had low awareness and weak commitment towards the HIS system. Duplication and waste existed because the system had many subsystems and vertical programmes send separate reports. The study recommended a set of recommendations at the provincial, state and federal levels to strengthen the system and to bridge the gaps as regards availability of standardized registration books, training of the health personnel in registration, reporting and simple statistical methods, training in registration of vital events, training in analysis and use of data at the local level. Inclusion of the private sector in the system, strengthening feedback process, increase awareness and commitment of the heath personnel towards the system need to be added, and also increase the capacity 56 building of the system as regards to the communication, transportation means. Availability of suitable places for keeping the records and availability of qualified statistical staff in all centres should be considered. Management Information Support Model for District Health System Based on Primary Health Care is recommended to be implemented by the health authorities all over the country