JMIR Publications

ABSTRACT

Background:

Background:

Weak Health Information Systems (HIS) hobbles countries' ability to effectively manage and distribute their resources to match the burden of disease. The Capacity Building and Mentorship Program (CBMP) was implemented in selected districts of the Amhara region to improve the HIS performance; however, evidence about the effectiveness of the intervention was meager.

Objective:

This study aimed to determine the effectiveness of routine health information use for evidence-based decision-making among health facility and department heads in the Amhara region, Northwest Ethiopia.

Methods:

Methods:

The study was conducted in 10 districts (five from the intervention group and five from the comparison group) of the Amhara region. We employed a quasi-experimental study design in the form of a pretest-posttest comparison group. Data were collected from June to July /2020 on heads of department and facilities in 36 intervention and 43 comparison facilities. The sample size was calculated using double population formula and recruited 172 participants from each group. We applied a Difference-in-Difference (DID) analysis approach to determine the effectiveness of the intervention. Heterogeneity of the program effect among subgroups were assessed using Difference-in-Difference-in-Difference. The beta coefficients, 95% CI, and p-value were calculated for each parameter, and we determined that the program was effective if the interaction term was significant at P<0.05.

Results:

Results:

Data were collected from 155 (90%) and 166 (96%) participants in the intervention and comparison groups in the end-line survey, respectively. The average level of information use for the comparison group at baseline and end line was 37.3% [31.1%, 43.6%] and 43.7% [37.9%, 49.5%], respectively, and for the intervention group was 52.2% [46.2%, 58.3%] at baseline and 75.8% [71.6%, 80.0%]. The study indicated that the net program change over time was 17% [5%, 28%], (P=.003). The subgroup analysis also indicated that location was significant with the heterogeneity program effect of a Difference-in-Difference-in-Difference estimate 0.16 [0.026, 0.29] (P=.02). However, sex, age, education, salary, and experience were not significant effect of 0.046 [-0.089, 0.182], -0.002 [-0.015, 0.009], -0.055[-0.190, 0.079], -1.63[-5.22, 1.95], and -0.006 [-0.017, 0.005], respectively.

Conclusions:

Conclusion: The Capacity Building and Mentorship Program (CBMP) was effective in enhancing the capacity of study participants in utilizing routine health information systems for decision-making. We noted that urban facilities had benefited more than their counterparts. The intervention is proven to produce positive outcomes and shall be scaled up to other districts. Moreover, the mentorship modalities for rural facilities should be redesigned to maximize the benefit. Clinical Trial: Study registration: PACTR202001559723931 (www.pactr.org)