The Effect of Community Health Information System on Health Care Services Utilization in Rural Ethiopia

Setegn Tigabu; Girmay Medhin; Mulusew G Jebena; Tegene Legese Dadi; Daniel Tadesse; Mekdes Demissie; Fasil Walelign Fentaye; Zelalem Tazu; Shegaw Mulu; Yibeltal Kiflie Alemayehu; Alula M Teklu

doi:10.4314/ejhs.v33i1.3S

The Effect of Community Health Information System on Health Care Services Utilization in Rural Ethiopia

Ethiop J Health Sci. 2023 Apr;33(Spec Iss 1):15-24. doi: 10.4314/ejhs.v33i1.3S.

Authors

Setegn Tigabu¹, Girmay Medhin^{1

2}, Mulusew G Jebena^{1

3}, Tegene Legese Dadi^{1

4}, Daniel Tadesse¹, Mekdes Demissie^{5

6}, Fasil Walelign Fentaye^{1

7}, Zelalem Tazu⁸, Shegaw Mulu⁹, Yibeltal Kiflie Alemayehu^{1

10

11}, Alula M Teklu¹

Affiliations

¹ MERQ Consultancy PLC, Addis Ababa, Ethiopia.
² Addis Ababa University, Aklilu Lemma Institute of Pathobiology.
³ Jimma University, Department of Epidemiology, Faculty of Public Health.
⁴ Hawassa University College of Medicine and Health Science, School of Public Health1.
⁵ College of Health and Medical Sciences, Haramaya University, Ethiopia.
⁶ Centre for Innovative Drug Development and Therapeutic Studies for Africa (CDT-Africa), College of Health Science, Addis Ababa University.
⁷ Wollo University, School of Public Health.
⁸ Addis Ababa University, Department of Statistics.
⁹ Federal Minister of Health, Ethiopia.
¹⁰ Department of Health Policy and Management, Jimma University, Ethiopia.
¹¹ Department of Global Community Health and Behavioral Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, USA.

Abstract

Background: In Ethiopia, the community health information system (CHIS) is implemented at the health post (hp) level with the aim of improving service delivery and use. We conducted a national level assessment of CHIS utilization and explored the associations of CHIS utilization with use of antenatal care (ANC), postnatal care (PNC), institutional delivery and child immunization in rural Ethiopia.

Methods: We conducted a cross-sectional study measuring community-based health service use and HP based CHIS assessment from March to May 2019. Data were collected from 343 HPs and 2,864 women who delivered in the last five years, and multistage sampling was used to select the study subjects. We used descriptive statistics for CHIS implementation and service utilization and multilevel logistic regression to investigate the association of CHIS implementation with maternal and child health care services use.

Results: Fifty five percent of the HPs were implementing CHIS. These HPs were using a paper-based household data collection tool called family folder (FF). Of the HPs, one third implemented lot quality assurance sampling (LQAS) based data quality check and 60.4% documented and followed execution of decisions. Overall, among the eligible women, 40% used ANC, close to 50% of currently married women used ANC services; 28% of women that fall in the high wealth index category used PNC within 48 hours after delivery; and 86.1% of women who had at least a high school education delivered at a health facility. Implementation of CHIS and family folder utilization and conducting LQAS based data quality check in the HPs were significantly associated with increased odds of ANC, delivery, and vaccination services use.

Conclusion: We found that better implementation of CHIS was associated with better maternal and child health service use which implies that increasing utilization of CHIS at HPs will improve mother and child health service use.

Keywords: Community health information system; Ethiopia; health posts; maternal and child health services; service utilization.

MeSH terms

Child
Cross-Sectional Studies
Delivery, Obstetric
Ethiopia
Facilities and Services Utilization
Female
Health Information Systems*
Humans
Lot Quality Assurance Sampling
Maternal Health Services*
Patient Acceptance of Health Care
Pregnancy
Prenatal Care
Rural Population