Development of Integration models for community health information systems: Case study of Iganga District

Abstract

Background: The Ministry of Health and implementing partners have developed initiatives (electronic information systems) to aide in collecting, collating and reporting health data from the communities. The systems are used by Village Health Teams (VHTs) during their interaction with community members to collect data. Due to vertical programming, these community health information systems (CHIS) by the implementing partners, are being used by VHTs to collect similar data in the same ecosystem and producing parallel reports alongside the government systems. The above overarching challenges from using multiple systems bring us to this research. Objective: To investigate stakeholder requirements for an integrated Community Health Information System and develop design models which would aid the integrated system development. Methods: This research explored design science research methodology. The research took on purposive sampling technique for participants who had knowledge (used, work or have oversight over these systems) of CHIS that is implementing partners, district health team of Iganga district and Ministry of Health participants from the division of health information and department of community health. Convenient sampling was used for VHTs. A total of 29 participants were included in the research. Data collection was done using focus group discussions (FGD) and key informant interviews. Data were analysed qualitatively. The FGD data were transcribed verbatim, summarised according to pre-determined major themes. User stories were captured and from these, user requirements were developed. From the user requirements, the researcher was able to develop functional and non-functional requirements. Results: Of the 29 respondents participated in the study. Majority 20/29 (70%) were males, 22/29 (75.9%) aged 35-44 years and 17/29 (56.5%) were VHTs. Seven community health information systems were found to be operating in the district with six having similar services in Reproductive Maternal and Child Health and one focussed on HIV and TB and Household health data. User requirements of the participants were captured and from these, functional and non-functional user requirements were tabulated, such as a user-specific dashboard for quick access to the relevant monitoring and evaluation tools including indicator charts, reports, maps and other key resources in the system, ability to access data for the communities in which implementation is being carried out and many others. The business logic of the ICHS was also developed. Conclusion: The findings of this study support the development of an integrated community health information system to improve community health data management, resource mobilisation and utilisation, and coordination of efforts of the different donor programs/implementing partners to the Ministry of Health-department of community health. Implementing the proposed design models will further assist in bringing the development of an integrated system to actualisation.