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The Routine Health Information System in Palestine: Determinants and Performance

Mimi, Y. (2015). The Routine Health Information System in Palestine: Determinants and Performance. (Unpublished Doctoral thesis, City University London)


A health information system (HIS) plays an important role in ensuring that reliable and timely health information is available for operational and strategic decision making that saves lives and enhances health. Despite their importance for evidence-based decisions, health information systems in many developing countries are weak, fragmented and often focused exclusively on disease-specific programme areas. There is a broad consensus in the literature that strengthening of national HIS is desirable. An integrated HIS will provide the basis for public health professionals to look at the health system from broader more comprehensive points of view.

The routine health information system (RHIS) in Palestine does not store data at the case level but aggregates them at the Facility level only. Additionally, establishment of multiple information databases in different Ministry of Health (MoH) departments causes incompatibility between the different databases and ineffective use of information.

This study examines the availability and the utilisation of information in support of health care organisation and delivery in Palestine which entailed an assessment of the current situation to identify determinants of the RHIS performance.

The Palestinian Ministry of Health at the Ministry, District and Facility levels was the study setting while systems and staff operating at these three levels were the target population. Employing a purposive sampling method a total of 123 respondents participated in the study. Performance of Routine Information System Management (PRISM) framework and its four tools package was used to assess the performance of RHIS at the Palestinian MoH. The PRISM framework empirically tests the relationships among technical, behavioural and organisational determinants on health management information system (HMIS) process and performance.

Data quality is measured in terms of accuracy and completeness at the Facility level. However, at Ministry HMIS and District levels it is measured in terms of timeliness, data accuracy and completeness.

Data quality was good at the Ministry HMIS level. However, data completeness and accuracy at the District level were good while timeliness was immeasurable on the basis of currently adopted procedures. At the Facility level, data completeness and data accuracy were only acceptable. Use of information was poor at all three levels; the Ministry HMIS level, District and Facility. The displaying of updated data on mother‘s health, child health, Facility utilisation, and disease
12 surveillance at both the District level and at the Facility levels were poor. RHIS processes at the Ministry HMIS level were good. However, they were poor at the two levels of District and Facility. Overall, technical and behavioural determinants fared poorly at all three levels while organisational determinants at the Ministry HMIS level were very good for RHIS governance and planning but were poor for supervision, training and finance.

These findings provide evidence on the need to establish a national RHIS the utilisation of which is made legally compulsory for all. Investing heavily and systematically in building relevant staff capacity and technical infrastructure to improve performance is a key conclusion from this project.

Publication Type: Thesis (Doctoral)
Subjects: Q Science > QA Mathematics > QA75 Electronic computers. Computer science
R Medicine
Departments: Doctoral Theses
School of Science & Technology > Computer Science
School of Science & Technology > School of Science & Technology Doctoral Theses
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