Table 2 Themes, Codes And Supporting Verbatim
THEMES | CODES | VERBATIM |
|---|---|---|
Facility Staff and VHTs are positively receptive of an optimal health data management and utilization process and underscore the value therein | Healthcare workers and VHTs understand what health data is, and they underscore its value in optimal healthcare delivery | “Health data is the data or information that we collect from health-related activities. This can include the age, sex, weight of the person and they disease they are suffering from.” FGD1 “Captures data about disease incidence rate.” KII3 “Captures patient medical and drug history for future reference” KII3 “Data can help anticipate need” FGD3 “This data helps in emergency mitigation” FGD2 “This data helps us when we are referring patients” FGD3 |
The facility staff indicated knowing how to use the respective HMIS tools available at their disposal in the respective departments, and they routinely collected the data in physical form | “I use specific HMIS book to capture lab records. Each department has a specific book.” KII1 “There are different HMIS books they use like 105, 33B etc.” KII4 | |
Staff and VHTs improvise to ensure health data is collected | “Sometimes we buy books where we enter the data when we run out of HMIS tools. We transfer this data when the registers arrive.” KII1 | |
There is a need to develop and implement a robust, elaborate and standard training module in the core aspects of data management (collection, handling and utilization) for the data focal personnel and other healthcare staff | The data training was deemed inadequate, and a more standardized approach was advocated for | Facility staff are computer literates but not to a level of using basic analytic tools. This includes focal data personnel at the facility “Make the certificate of 2 years the minimal standard of recruitment so they improve the skills of the data personnel.” KII4 “Avail farther training and mentorships.” KII1 “There might be a knowledge gap in data utilization.” KII2 “People don’t know the idea of comparing trends.” KII1 “The data personnel are trained, but their trainers are also insufficient. I think they learn more on job and the good thing they ask “what is this?” (Referring to indictors) and we teach them here” KII1 “The training we receive is not enough” |
|  | VHTs requested for more contact time, for training. Also, interactions come with financial benefits for them | “The training we receive is not enough” FGD1 “They should increase the frequency of training” FGD2 “We have training meetings every quarter at the district where they give us a small allowance if we attend” FGD3 |
Develop or adopt realistic data quality control protocols to fit all facility data processes | There is minimal coordination between healthcare personnel and data staff | “The HMIS focal person picks the data from each department and submits it to the HCIV or the district without any discussion with the departments about the data picked” KII4 |
There is minimal supervision of data in each department | There is supposed to be data cleaning, then verification etc., but these may all be skipped “I don’t supervise data management in my department” KII1 “I have never compared trends and am not so sure it is done at the district” KII3 | |
Performance evaluation is more quantitative than qualitative | “The implementing partner sets a target of like 10 positives per day.” KII 1 | |
Create a conducive workspace in terms of facilities, equipment, staffing and renumeration | The facility lacks a data office to support the data flow processes | No organized data room Rudimentary means of data recording “We don’t have/use a computer currently” (KII1) “From Mirambi, you have to go to Masaka to make a photocopy since the facility lacks a photocopier”(KII4) |
There is insufficient human resource capacity to optimally execute data management at the facility | Understaffing “We are critically understaffed at this facility”KII1 “Work is overwhelming: I am supposed to work for only 3 days a week yet I end up working for 5 days and no one pays for the extra 2 days” KII2 “At some point, both midwives got maternity leave at the same time” KII1 | |
VHTs argued that appropriate incentives will improve their overall output, especially in data collection and utilization | “We need to be prioritized for healthcare services to motivate us.” FGD1 “They should give us free health services” FGD 4 “VHTs are not prioritized while receiving treatment at the facility” FGD2 “We need a standard allowance for data collection that should be paid in time.” FGD 3 “Our allowance is very small, and yet again it delays.” FGD 4 | |
The pull supply system would both optimize routine data utilization and reduce associated shortages | Existing procurement and resource allocation policies don’t exploit health data thus hindering capacity building among staff | “We make orders basing on the data we have but NMS and JMS supply what they have.” KII 3 “Allocation of resources is at a higher level. Therefore, knowing all this (having datasets) may not help the decisions that are made at a higher level.” KII 1 |
Limited supplies are exposing VHTs to poor working conditions that totally compromise their output in the data chain | VHTs lack wet season gear “It’s hard to do home visits in the rain season because we don’t have rain coats, gumboots and umbrellas” FGD 2 “We need torches, umbrellas and gumboots” FGD 3 “The bicycles they gave us no longer work” FGD 1 “The villages are so big; we may end up walking long distances” FGD1 | |
Shortages in tools and other supplies increase the data workload | “We occasionally run out of registers and we always improvise. When the registers come, those who can, transfer this information but this essentially doubles our workload.” KII1 “Sometimes they bring us the tools abruptly, they call us and then force us to work under extreme pressure” FGD3 | |
The facility liaises with other public health centres to overcome some shortages | “We usually borrow registers from other HCs if they have.” KII5 | |
There is a need for improved coordination between the facility and its implementation partners to create harmony in health data management | The facility and respective implementing partners run parallel recruitment and training schedules | “Implementing partners recruit data staff on short contract basis. So, the staff are not motivated after all the contracts are to expire soon.” KII5 “We received training from Mildmay at Brovard Hotel, and from Rakai at the District.” KII2 “Each time they bring a new trainer” KII6 |
Quality control, and M&E protocols implemented by the facility are divergent from those implemented by partners | “The implementing partner sets a target of like 10 positives per day.” KII 1 “Funders demands(targets) give us so much pressure.” KII5 “You may be pushed to force a positive to hit the targets or else, the implementing partner will ask questions” KII1 | |
Health data from private health units is mostly missed | Under reporting especially from local drug shops, TBAs, and illegal HC structures” KII4 “There are many private HCs that don’t report.”KII6 “Some health structures operate illegally so we can’t collect their data” KII4 | |
Reduction in information relay time, and improved community engagement will optimize the impact of health data utilization | Data dissemination is inadequately funded | “There is a plan to warn communities about seasonal diseases but it is not funded. The program is therefore implemented at just around 50%”. (KII4) |
There is a big time-lag between data collection and expected utilization. The local relevance of the data is mostly lost to time | “There are quarterly assessments and comparisons.” KII6 “There’s no local analysis and therefore results are only relayed back after the district quarterly meetings.” KII1 Therefore, feedback from data collected can come as late as 6 months | |
Information is not relayed back to the communities where data is collected. The communities get bored of the monotonous data collection routine without feedback | “Data is not given back to people by health organizations that collect it” FGD 1 “We revisit the communities every after 3 months but people get tired of us” FGD2 “We are not given feedback about the research projects we partake in.” FGD3 “We are not given explanations for failed programmes, so we also can’t explain to community members.” FGD3 | |
VHTs need support from healthcare workers during community engagement | “Relaying information to the public needs a new face, not only the usual VHTs” FGD3 “People are so adopted to the VHTs that it is becoming hard to collect data” FGD3 “Some people think we don’t have capacity to do our work” FGD2 | |
Community members have economic expectations from home visits | “Some community members think we are paid a lot of money and we don’t share with them.” FGD2 “People think we are supposed to give them something each time we visit them, eventually they chase us since we don’t give anything.” FGD4 | |
Political affiliations influence health information relay to the community | “Some people think we have political intentions so they don’t welcome us” FGD2 “Some people believe we are campaigning for the government so they resent us” FGD3 |