Data use culture for decision making at district level in Ethiopia

Abstract

Background: Underutilisation of routine health information data for local health system planning and decision- making is common in lower and middle-income countries. One of the reasons for inadequate use of available data at the district level arises from the limited capacity for analysing and interpreting data by local decision-makers. Moreover, district-level decision-makers are often uncertain about the available routine health information system's credibility. To develop an in-depth understanding, this research explored the dynamics of local data-informed decision making from the perspective of current practices, mechanisms and opportunities available to improve data use for decision making at district health system level in Ethiopia.

Methods: Qualitative data were collected from two districts of Ethiopia. The mechanism of data collection was through field observation, district-level workshops and consultations with national, regional and district health representatives. The information was triangulated and synthesised using the World Health Organization health system building block framework.

Results: Key decision-making mechanisms were Performance Monitoring Team meetings, district administrative meeting and community administrative meeting. However, there was limited evidence of local data use for routine district level planning or problem solving. In addition, we found no evidence of stakeholder engagement for collaborative decision-making. On the other hand, extensive and diverse data were available to support decision- making, ranging from health information system data, disease and emergency surveillance data and twenty additional disease or program reports.

Conclusion and Recommendation: Active use of all available health-related data and engagement with local stakeholders such as private health facilities, NGOs and non-health departments are encouraged to streamline the decision-making processes at the district level. As a health system-strengthening strategy, we recommend the district health managers and administrators to work on improving data quality and use for collaborative decision-making in problem-solving. For this, effective use of job aids and technology is of paramount importance to gain from the increasing improving data quality at the district level.