Factors Influencing Utilization of Health Information System in the Management of Missed Appointments among HIV Positive Patients in Mombasa County, Kenya

Abstract

A health system requires a well-functioning health information system to enhance measurement of health outcomes, and ensure effective health care decisions. This process of utilizing health information, increases retention rate, improves patients‘ health outcome and reduces cost of care. With low retention rates among HIV positive patients, this study aimed at determining the factors associated with the utilization of health information in curbing missed appointments. The research study was guided by the following specific objectives: to establish infrastructural factors influencing health information utilization; to assess the influence of staff capacity on health information utilization; to determine the influence of staff supervision on utilization of health information; and to establish the existing behavioral factors that influence health

information use among CCC health care providers. This study utilized descriptive cross- sectional study design using quantitative method of data collection to assess utilization

of health information among healthcare workers. The study population for this research was approximately 215 CCC, a sample size of 69 health care workers in the three high volume hospitals offering HIV care in Mombasa County that contributed to high defaulter rate. Primary data was obtained via questionnaires while secondary data was obtained from hospital records available, via checklist. The data was coded and analyzed using the statistical package for social sciences (SPSS). A p-value of less than 0.05 was considered as statistically significant, Asymptotic Significance (2-sided) results indicated a p-value of .000 across all the four factors in relation to the Independent variable on Chi-square test (Infrastructure X1=138.182, p value .001, Staff capacity X1=168.368, p value .000, support supervision X1=145.811, p value .000 and behavioral factors X1=202.570, p value .000). For Spearman Rank Correlation, a strong positive correlation between supervisory factors and utilization of health information (r=.811, 9=.000), an indication that staff supervision improved data utilization hence reducing gaps that could lead to missed appointments, weak positive correlation between Infrastructural factors and utilization of health information, (rs=.114, p=.384), an indication that infrastructure was important mode in support of data capture and generation of reports thus improving in utilization of data reducing missed appointments. Moderate negative correlation between behavioral factors and utilization of HMIS, (rs= -.505, p=.000) an indication that staff attitude did not interfere with utilization of information therefore did not affect management of missed appointments. The study concludes that effective support supervision for the CCC health care workers in management of missed appointments would greatly improve data use and thus able to identify where gaps are, hence reducing number of missed appointments among HIV positive patients. Also the study concludes that effective quality targeted training of the staff would improve in data collection and use therefore reducing number of missed appointments among HIV positive patients. The study recommends establishment of SOPs to guide support supervision and also emphasis on continual training among the staff in the CCC. The institutions to also invest on reliable internet network for effective health information systems. There is need for further research to be done to determine other influencing factors in the service delivery of the 47 county governments.