Human resource capacity for information management in selected public healthcare facilities in Meru County, Kenya

Introduction Reliable health information is essential for decision making in the healthcare system. Information management in Kenya was considered the weakest area under the Health Information System pillar mainly due to inadequate health workers capacity. The study therefore aimed at assessing health workers skills and current training needs for information management in the selected healthcare facilities. Methods Cross-section research design was adopted and both purposive sampling technique and censuses were used to establish the study participants. Analysis was done using SPSS version 20 and results were presented in tables, charts and graphs. Results It was established that capacity building was usually undertaken through on-job trainings i.e. 85.1% (103) health workers had on-job training on filling of data collection tools and only 10% (13) had received formal classroom training on the same. Further, only 9.1% (11) health workers had received information management training while 90.9% (110) had not received such training. Health workers demonstrated below average skills on information management i.e. only 17.4% (21) could check for data accuracy, only 16.5% (20) could compute trends from bar charts and only 16.5% (20) could transform the data they collected into meaningful information for use. Conclusion The researcher recommended that healthcare facilities management teams develop a competency based framework for defining the desired skill mix for information management and have a yearly Training Needs Assessment for assessing training needs for information management among the health workers.


Introduction
For effective coordination of healthcare activities, high quality information is crucial and this is generated and managed under the pillar of Health Information System (HIS). Properly organized HIS is a prerequisite for the efficient administration of health services and their planning should be given high priority [1]. Globally, there is a rigorous demand for HIS so as to ensure a well functioning health system, especially because of increased accountability for resource allocation and the need for measuring health outcomes. Further, for donors and decision-makers to invest financially in HIS, it is important that performance requirement of the generated information is of high quality, accurate, complete and reliable [1].
World Health Organization (WHO) [2] revealed that there were comparatively few papers discussing the shortage of HIS skills among the general health personnel and even fewer papers which actually described the training needs requirement and the ideal distribution of the skills across the various healthcare facilities on information management. Kenya has had a long history of health sector reform with HIS being established in 1984 in each district thereby, decentralizing health data and information processing to the facility level. However, more investment was required to adequately sustain HIS operations especially in the peripheral health units where data collection registers were often improvised and reporting forms not always available. This caused inaccurate data entry which was untimely and often incomplete compromising the quality of information collected and its consequent underuse by the various stakeholders [3]. Currently the HIS Department at the ministry of health in Kenya is grossly understaffed with only 11% of the human resource requirements in post. The major gaps were in the cadre of Health Records and Information Officers (gap of 88.3%), Information, Communication and Technology (ICT) officers (gap of 96.6%), and statisticians (gap of 100%) [4]. The Kenya HIS policy therefore stated that in the absence of specialized HIS personnel, the general health workers must have the basic information management skills which included the ability to accurately undertake data collection, information analysis and interpretation. Further, the Government of Kenya report [3]   Study design: Cross-sectional design was used. It was used because it provides a snapshot of the exposed variables across a wide population without manipulating or influencing the study population in any way. Cross-section design was also used because it could produce multiple outcomes and various variables could be studied at a given point in time.

Data collection:
Both open-ended and closed-ended, structured questionnaires which were self administered were used to collect data. An observation check-list was also used to assess the work environment for conducting information management activities in the selected facilities in Meru County.

Data management and analysis:
The data obtained from this study was subjected to statistical analysis using descriptive statistics. After collection of data, it was edited, coded and Page number not for citation purposes 3 examined for errors and omissions then corrected appropriately. In the coding process, data was organized into categories after which, numerals were assigned to each item prior to entering them into the computer for storage. After entering using the Statistical Package for Social Statistics (SPSS) program version 20, the data was subjected to descriptive and qualitative analysis. Correlation coefficient was used to establish relationships between the variables. The results were then presented using tables, graphs and pie charts, besides narrative descriptions.

Results
Four public healthcare facilities were engaged during this process idea on how to check for data accuracy, 21 (17.4%) were average, and 21 (17.4%) were above average. Ability to compute trends from bar charts was also assessed i.e. (Figure 1). Respondents' ability to use information for identifying gaps and setting targets was also assessed as shown in (Figure 2). The ability to transform data into meaningful information for use at the department level showed that majority of the respondents were unable to perform this function (Figure 3).  Table 1). Correlation coefficient between the dependent and independent variables was done and results were as seen in (Table 2).

Discussion
Health worker skills and knowledge on information management was assessed to determine their ability to handle health information.
Government of Kenya [5] report noted that there was little attention paid to the quality of information produced in the country and that the general health workers were not adequately skilled to handle health information. Miriam, Vicki and Maxine [6] say that the general skills required for health workers to manage data and information effectively include the ability to analyze the data that they collect, so that they can use it to make meaningful decisions from the information generated. Data analysis required basic knowledge on computer use. However from the data collected only one-half of the health workers had knowledge on computer use. Quantitative analysis was also conducted to determine the correlation of the dependent and the independent variables as depicted in (