Integration of health management information systems in health care organizations in Kenya
Kyalo, Caroline Kawila
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Global attention to health systems strengthening has led to different quality improvement approaches in developed and developing countries. The awakening realization that information is critical for health systems functioning has directed most countries towards strengthening their existing information systems or developing new ones. Despite efforts to improve on existing information systems, fragmented information systems have emerged hindering the efforts of addressing the concern of integrating health management information systems. An integrated health management information system has greater benefits for example enhancing easy retrieval of data, timely information sharing and evidence based decision making. The purpose of this study was to prescribe a model that will facilitate the Integration of Health Management Information Systems in healthcare organizations. The objectives of the study were; to establish whether the organization factor; technical factor; behavioral factor of care providers and leadership style influenced integration of Health Management Information System in healthcare organizations in Kenya. The study was anchored on the System theory but underpinned on performance of routine information system framework. Guided by the philosophy of logical positivism and interpretivism. A mixed method research design involving quantitative and qualitative designs was used to obtain information from three counties; Kiambu (peri-urban), Kitui (rural) and Mombasa (urban) in Kenya. A study population was 479 public healthcare organization. Multi-stage sampling technique was used to select organizations that participated in this study. A sample size of 144 public healthcare organizations was drawn using the Kothari formula of calculating sample size. In each healthcare organization selected, two self-administered questionnaires were used to collect data from 243 respondents who were either the in charges or health records officers. Data was analyzed using SPSS version 21 and summary statistics such as mean scores, standard deviation and inferential statistics namely correlation and regression results were used to present the data. The study results provided statistical evidence that a positive and significant relationship exists between the organization factor (r=.472**, P˂.005), technical factor (r=.683**, P˂.005), behavioral factor (r=.507**, P˂.005) and leadership style (r=.731**˂.005) and integration of health management information systems. Technology adoption was found to significantly moderate the relationship between technical factor and integration of health management information systems, while need for information timeliness was found to moderate organization factor, technical factor and leadership style. The integration of HMIS model proposed in this study was found to be fit because it explained up to (r2 =.648) total variation in the integration of HMIS. The remaining beat of .352 is explained by the statistical error term. The std. error of .227 shows the model regression line deviates from the line of best fit. The study concluded that leadership style was quite significant in the efforts towards integration of HMIS and information timeliness was a very good moderator between the operation factors and integration of HMIS. The study recommends that; i) health system managers adopt the proposed design of data collection strategy emerging from the study findings ii) The extracted integration of HMIS model from the study findings composed of transformational leadership style, systems interoperability moderated by information timeliness and enhanced information culture should be adopted. Further studies can be done after the model is adopted to evaluate its performance.