Health information system in primary health care units of the Central Zone, Tigray, Northern Ethiopia

Abstract Background Health information systems require the management of health information through health management information systems and research and knowledge management. In many low-income countries, including Ethiopia, poor data quality and limited use of health information remain major chal...

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Main Authors: Letekirstos Gebreegziabher Gebretsadik, Abate Bekele Belachew, Gebregziabher Berihu Gebrekidan, Alemayohu Bayray, Akberet Lemlem, Lewtnesh Berihun Dangew, Haftom Temesgen Abebe
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Medical Informatics and Decision Making
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Online Access:https://doi.org/10.1186/s12911-025-03078-5
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author Letekirstos Gebreegziabher Gebretsadik
Abate Bekele Belachew
Gebregziabher Berihu Gebrekidan
Alemayohu Bayray
Akberet Lemlem
Lewtnesh Berihun Dangew
Haftom Temesgen Abebe
author_facet Letekirstos Gebreegziabher Gebretsadik
Abate Bekele Belachew
Gebregziabher Berihu Gebrekidan
Alemayohu Bayray
Akberet Lemlem
Lewtnesh Berihun Dangew
Haftom Temesgen Abebe
author_sort Letekirstos Gebreegziabher Gebretsadik
collection DOAJ
description Abstract Background Health information systems require the management of health information through health management information systems and research and knowledge management. In many low-income countries, including Ethiopia, poor data quality and limited use of health information remain major challenges in the health system. Reliable health data quality is essential for evidence-based decision-making and improving quality health service delivery. This study aimed to assess and explore the contextual factors of the quality and utilization of health information in primary health care units in the Central Zone, Tigray, Northern Ethiopia. Methods A facility-based cross-sectional quantitative and qualitative study design was used. A total of seven primary health care units and four district health offices were selected. Data were collected via document review, structured questionnaires and in-depth interviews. A three-month document review was conducted to assess data accuracy via lot quality assurance sampling. Forty-eight health professionals, including Woreda Health Office heads, facility heads, health management information system focal persons, service providers and health extension workers, were interviewed for quantitative analysis. Additionally, 23 key informants with the same roles participated in the qualitative interviews. Descriptive statistics were computed, and thematic analysis was conducted for the qualitative data. Results Four of the seven primary health care units have assigned health management information system personnel, and five of them have necessary equipment for health management information systems. The average lot quality assurance sampling of the primary health care units ranged from 35 to 60%, which falls below the national threshold of 90% data accuracy. In knowing and measuring the dimensions of data quality, the informants described this as a difficult task despite acknowledging its importance. Similarly, the culture of data use for decision making was limited. Conclusion This study revealed that primary health care units in the Central Zone of Tigray face significant challenges in terms of data quality and utilization, primarily due to the limited capacity of service providers, unclear understanding of data quality dimensions and weak data use culture. The average lot quality assurance sampling accuracy rates are below the acceptable level, indicating issues in the data documentation and validation processes. Addressing these gaps through targeted capacity-building, including the integration of HMIS curricula at the university level and system-level improvements such as implementing computerized systems, ensuring accountability and allocating budgets, is needed to strengthen health information systems and enable evidence-based decision-making at all levels of the health system.
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spelling doaj-art-16f37eafd73e48eb9ab102c25c144f262025-08-20T03:45:30ZengBMCBMC Medical Informatics and Decision Making1472-69472025-07-0125111210.1186/s12911-025-03078-5Health information system in primary health care units of the Central Zone, Tigray, Northern EthiopiaLetekirstos Gebreegziabher Gebretsadik0Abate Bekele Belachew1Gebregziabher Berihu Gebrekidan2Alemayohu Bayray3Akberet Lemlem4Lewtnesh Berihun Dangew5Haftom Temesgen Abebe6Department of Biostatistics, School of Public Health, College of Health Sciences, Mekelle UniversityResearch Unit of Population Health, Faculty of Medicine, University of OuluDepartment of Health Systems, School of Public Health, College of Health Sciences, Mekelle UniversityHead of Research and Community Services, College of Health Sciences, Mekelle UniversityEthiopian Public Health InstituteDepartment of Statistics, College of Natural and Computational Sciences, Mekelle UniversityDepartment of Biostatistics, School of Public Health, College of Health Sciences, Mekelle UniversityAbstract Background Health information systems require the management of health information through health management information systems and research and knowledge management. In many low-income countries, including Ethiopia, poor data quality and limited use of health information remain major challenges in the health system. Reliable health data quality is essential for evidence-based decision-making and improving quality health service delivery. This study aimed to assess and explore the contextual factors of the quality and utilization of health information in primary health care units in the Central Zone, Tigray, Northern Ethiopia. Methods A facility-based cross-sectional quantitative and qualitative study design was used. A total of seven primary health care units and four district health offices were selected. Data were collected via document review, structured questionnaires and in-depth interviews. A three-month document review was conducted to assess data accuracy via lot quality assurance sampling. Forty-eight health professionals, including Woreda Health Office heads, facility heads, health management information system focal persons, service providers and health extension workers, were interviewed for quantitative analysis. Additionally, 23 key informants with the same roles participated in the qualitative interviews. Descriptive statistics were computed, and thematic analysis was conducted for the qualitative data. Results Four of the seven primary health care units have assigned health management information system personnel, and five of them have necessary equipment for health management information systems. The average lot quality assurance sampling of the primary health care units ranged from 35 to 60%, which falls below the national threshold of 90% data accuracy. In knowing and measuring the dimensions of data quality, the informants described this as a difficult task despite acknowledging its importance. Similarly, the culture of data use for decision making was limited. Conclusion This study revealed that primary health care units in the Central Zone of Tigray face significant challenges in terms of data quality and utilization, primarily due to the limited capacity of service providers, unclear understanding of data quality dimensions and weak data use culture. The average lot quality assurance sampling accuracy rates are below the acceptable level, indicating issues in the data documentation and validation processes. Addressing these gaps through targeted capacity-building, including the integration of HMIS curricula at the university level and system-level improvements such as implementing computerized systems, ensuring accountability and allocating budgets, is needed to strengthen health information systems and enable evidence-based decision-making at all levels of the health system.https://doi.org/10.1186/s12911-025-03078-5UtilizationData qualityHealth informationDecision makingPrimary health care unit
spellingShingle Letekirstos Gebreegziabher Gebretsadik
Abate Bekele Belachew
Gebregziabher Berihu Gebrekidan
Alemayohu Bayray
Akberet Lemlem
Lewtnesh Berihun Dangew
Haftom Temesgen Abebe
Health information system in primary health care units of the Central Zone, Tigray, Northern Ethiopia
BMC Medical Informatics and Decision Making
Utilization
Data quality
Health information
Decision making
Primary health care unit
title Health information system in primary health care units of the Central Zone, Tigray, Northern Ethiopia
title_full Health information system in primary health care units of the Central Zone, Tigray, Northern Ethiopia
title_fullStr Health information system in primary health care units of the Central Zone, Tigray, Northern Ethiopia
title_full_unstemmed Health information system in primary health care units of the Central Zone, Tigray, Northern Ethiopia
title_short Health information system in primary health care units of the Central Zone, Tigray, Northern Ethiopia
title_sort health information system in primary health care units of the central zone tigray northern ethiopia
topic Utilization
Data quality
Health information
Decision making
Primary health care unit
url https://doi.org/10.1186/s12911-025-03078-5
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