| dc.description.abstract | Introduction: Developing skilled Community Health Workers programs that are incorporated with efficient Community Health Information Systems is fundamental for the efficiency of the programs, event notification, as well as planning and monitoring at all levels. The VHT/iCCM reporting consequently impacts on decision making processes, as well as monitoring and planning for the communities at both district and national levels. The aim of this study was to assess VHT/iCCM reporting (submission, completeness and timeliness levels) in Nakapiripirit, Uganda for the period of January to December 2017. This was followed by identification of associated factors, and exploring potential barriers and facilitators of the reporting process.
Methods: We conducted a cross-sectional study with both quantitative and qualitative methods of data collection at the health facilities in Nakapiripirit district. We extracted secondary data from DHIS2 on VHT/iCCM reports submitted for the period of January to December 2017. We used simple random sampling to sample a total of 14 health facilities from a sampling frame of 17 health facilities and conveniently sampled a total of 266 VHTs. Interviewer administered questionnaires were used to collect data from VHT members and health facilities. We also conducted 12 Key Informant Interviews including peer VHT supervisors, health facility and district supervisors, in addition to 3 Focus Group Discussions with VHT members. Multiple linear regression was used to analyze the factors associated with the reporting levels with adjustment for clustering in the data. The findings from both the qualitative and quantitative methods were combined at the discussion level to make inference of the study results. Ethical approval to conduct this study was obtained from CEU, SOMREC, UNCST and the DHO of Nakapiripirit.
Results: The mean overall report submission level was 89.5, while mean completeness was 78.2 and mean timeliness was at 13.9. HC IVs had the highest submission and completeness levels, HC IIIs had the highest timeliness levels and HC IIs had the lowest timeliness levels. The factors that were associated with higher submission levels were higher facility level (P<0.001), livelihood zone (P<0.001) and age (P=0.023) while those associated with completeness were higher facility level (P<0.001) and higher age (P=0.017). Higher facility level (P<0.001) was the major factor associated with higher timeliness levels. Irregular conduct of meetings, seasonal changes and migrations, inadequate trainings, poor incentivization and peer supervision were key barriers and facilitators of the reporting levels.
Conclusion: There were relatively high levels for submission and completeness of VHT/iCCM reports in Nakapiripirit district, but with very low levels for timeliness. The age of the VHT member, the level of the health facility and the livelihood zone of the community had significant effects on the reporting levels. Irregular conduct of VHT meetings, inadequate trainings, seasonal changes with continuous migrations and illiteracy were major barriers of VHT/iCCM reporting. While incentivization, supervisions and motivation were major facilitators of VHT/iCCM reporting. | en_US |
