Influence of logistics management information system practices on quality of reported stock data in public health facilities in Busoga region

Abstract

In Uganda, Health facilities across all levels of care must submit monthly reports to the National Health Management Information System (HMIS). The monthly HMIS 105 section 6 report is a critical tool that the Ministry of Health and other stakeholders use to track the amount of stock available for the 41 tracer commodities, so they can plan supply and quantity needed for Uganda’s health services. Despite the importance of HMIS 105 section 6 data, reporting on this section has been low – at 49% by May 2021, with facilities submitting incomplete and inaccurate data in this section. Whereas significant research has been conducted in Uganda to assess the performance of Logistics management information system in public sector in management of health commodities at subnational level as well as examine the quality of data submitted in HMIS 105, fewer studies have assessed data quality of stock data submitted in HMIS 105 section 6 and the likely influence Logistics management Information System (LMIS) practices have on the quality of data reported in this section. This study, therefore, examined the influence of LMIS practices (updating of stock cards, updating of electronic LMIS and self-utilization of LMIS reports) on quality (completeness and accuracy) of reported stock data in HMIS 105 section 6 in public health facilities in Busoga region. This cross-section study employed mixed methods of data collection in 47 randomly selected public health facilities in Busoga region concurrently using both paper-based (stock cards) and electronic LMIS and consecutively synchronized data to Pharmaceutical Information Portal for atleast 3 consecutive months of July – September 2023. Quantitative data were collected from document review of HMIS 105 section 6 data submitted for the month of September 2023 and review of stock cards and eLMIS (RxSolution) records for the same month. Qualitative data were collected from interview of facility in-charges and key department heads of facilities assessed. Data quality was analyzed following the WHO data quality review guidelines, using verification factors to assess accuracy. A multivariate linear regression analysis using STATA was conducted to test relationship between Variables. This study found out that whereas the report completeness was high (86%) at all levels of care, the accuracy of data reported was comparably low (46%). Updating of stock cards was low (40%) as well as updating of eLMIS records (34%). However, the finding showed higher level of care scored highly on self-utilization of LMIS reports (57%) compared to lower levels of care (34%) but did not significantly perform better than lower facilities on LMIS practices and accuracy of data reported. This study also found out that HMIS 105 section 6 reporting data completeness was not influenced by LMIS practices at the health facilities. However, data accuracy was directly influenced by LMIS practices at health facilities, with updating of stock cards negatively influencing reported data accuracy(p=0.001), contrary to updating of eLMIS (p=0.000) and self-utilization of LMIS reports (p=0.003) which had positive influence. This study indicated need to improve and strengthen HMIS 105 section 6 report data accuracy and LMIS practices at health facilities. It also highlighted that transitioning of health facilities from paper based to electronic LMIS would significantly improve accuracy of data reported in this section. Thus, investments in use of electronic LMIS and data use at health facilities may positively improve overall data accuracy.