Organizational Factors Influencing the Adoption of the District Health Information System 2 in Uasin Gishu County, Kenya

Abstract

Background: Sound and reliable information is the foundation of decision-making across all health system building blocks that include service delivery, health workforce, health information, medical products, vaccines and

technology, financing, leadership, and governance. This study is built on health information system pillar. Objectives: To determine the organizational factors influencing the use of DHIS2 in Uasin Gishu County. Methods: Study was conducted in Uasin Gishu-Sub County health facilities. A questionnaire was used to collect quantitative data from

283 health workers selected randomly while 10 key informants were selected purposively from this sample for in-

depth interviews. Results: Total 50.0% of the participants acknowledged that finances were adequate to run DHIS2. The main champions of DHIS2 used in decision-making were the county health records and information officers

(56.2%) and the sub-county health records and information officers (39.0%). Up to 78.5% agreed or strongly

agreed that organizational hierarchy influenced DHIS2 use and 80.8% agreed or strongly agreed that there was

improved staff performance due to DHIS2 utilization. On the other hand, the major challenges experienced in the

use of DHIS2 for evidenced-based decision-making were the lack of management support (34.3%), poor skills among

the users (48.6%), lack of adequate computers (36.7%), unreliable internet connectivity (47.1%), lack of power

backup (27.6%), and resistance to change (21.0%). Conclusion: The main funding for the DHIS2 system comes from the County government while health records and information officers are the main promoters of DHIS2 use. The

main determinants of DHIS2 used are the availability of computers, network and internet services, trained staff and

legislation. The main challenges inhibiting DHIS2 use are lack of management support, poor skills among the users,

lack of adequate computers, unreliable internet connectivity, lack of power backup and resistance to change.