Health information systems in Namibia

Pages358-376
DOIhttps://doi.org/10.1108/ILS-03-2018-0015
Date09 July 2018
Published date09 July 2018
AuthorCathrine Tambudzai Nengomasha,Ruth Abankwah,Wilhelm Uutoni,Lilian Pazvakawambwa
Subject MatterLibrary & information science,Librarianship/library management,Library & information services
CONTEMPORARY ISSUES IN INFORMATION
MANAGEMENT: AN AFRICAN CONTEXT
Health information systems
in Namibia
Cathrine Tambudzai Nengomasha,Ruth Abankwah and
Wilhelm Uutoni
Department of Information and Communication Studies, University of Namibia,
Windhoek, Namibia, and
Lilian Pazvakawambwa
Department of Statistics and Population Studies, University of Namibia,
Windhoek, Namibia
Abstract
Purpose This paper aims to reportsome ndings of a study that investigated health information systems
(HISs) in Namibia with a view of establishing the nature of these systems and coming up with
recommendationson how these could be enhanced.
Design/methodology/approach This study applied a mixed methods research approach, using
interviewsand survey questionnaire to collect data. Surveydata were analysed for descriptive statisticsusing
SPSS and datafrom interviews were analysed applying contentanalysis for data analysis.
Findings The ndings of this study indicatefragmented HISs resulting in duplication of diagnosis,tests
and treatment. The ndings show that there were errors in capturing data into the systems, which could
compromisethe reliability of the data and compromise service delivery.
Research limitations/implications This study was limited to two (Khomas and Oshana) of the
fourteen regions in Namibia; therefore, further studies could look at other regions, as the study ndings
cannot be generalisedto the entire country.
Practical implications The ndings and recommendations, particularly those relating to the public
health sector, could inform policies and procedures, especially those relating to the patient health passport
(card), and the way healthinformation is shared within and across health sectors.
Originality/value This study focused on healthinformation sharing, whereas a previous study on HISs
concentratedon quality of healthcare.
Keywords Health systems, Health information, Namibia, Electronic health record,
Health information systems, Patient record
Paper type Research paper
Introduction
A countrys health information system (HIS) integrates data from civil/vital registration,
censuses, population surveys, facility surveys, individual records, service records and
administrative records for policymaking and efcient management of healthcare services.
This paper forms part of a special section Contemporary issues in information management: an
African context, guest edited by Cathrine Nengomasha.
ILS
119,7/8
358
Received19 March 2018
Accepted7 May 2018
Informationand Learning Science
Vol.119 No. 7/8, 2018
pp. 358-376
© Emerald Publishing Limited
2398-5348
DOI 10.1108/ILS-03-2018-0015
The current issue and full text archive of this journal is available on Emerald Insight at:
www.emeraldinsight.com/2398-5348.htm
The ultimate goal of any HIS is to produce quality and timely information for evidence-
based decisions and interventions. HISs in developing countries, including Namibia, have
been said to be weak (Kamau et al.,2017;Khan and Edwards, 2012;World Bank, 2009).
Haoses-Gorases (2005) observed that the organisational structure of Namibias National
Health Information System (NHIS) was fragmented across different directorates and
institutions. The World Bank (2009) reported about incomplete and fragmented data
sources, which created a challenge of bringing diversedata sources into a seamless system.
A study in Namibia identied a lack of documentation as one of the challenges facing
quality healthcare in many of the health facilities and recommended enhanced
communication on quality of care, strengthening information management and data use for
quality improvement(Republicof Namibia, MOHSS, 2014, p. 2).
Namibias healthcare system
Namibias MoHSS Strategic Plan (2009-2013)stresses the governments strong commitment
to provide efcient and effective health services to the nation(Republic of Namibia,
Ministry of Health and Social Services, 2013, p. 34). Namibias health system is dominated
by the public sector in terms of nancing, service delivery and coordination (Republic of
Namibia, 2009). The Ministry of Health and Social Services (MoHSS) adopted a primary
healthcare (PHC) approach to the delivery of healthcare services to the people of Namibia
(Republic of Namibia, 2009,p.19).
Namibias healthcare infrastructure network consists of 295 clinics, 47 health centres, 30
district hospitals, three intermediate hospitals, one national referral hospital and nine Sick
Bays, as well as various social welfare service points, private hospitals and clinics (Republic of
Namibia, MoHSS, 2011). It also has about 1,150 outreach points (Brockmeyer, 2012). The public
health sector is structured in a three-tier hierarchy with national, regional and district levels.
The national level is responsible for policy formulation, regulation, planning, management
development and giving support for service provision to the entire health sector; whereas the
regional directorates are responsible for regional-level oversight and service delivery. Besides
government, faith-based organisations and non-governmental organisations, as well as the
private sector, continue to play a key role in the provision of health services. The private sector
is regulated by the Hospitals and Health Facilities Act 36 of 1994, which issues private
healthcare providers with licences for healthcare delivery, to compliment the services of the
public sector (Republic of Namibia, MoHSS, 2014).
In Namibia, an Oracle Web-based application is operational at Windhoek Central
Hospital. This application is used to manage health information in all government
departments. It covers processessuch as patient registration, diagnostic testing, billing and
patientsdischarge. The system is integrated to enable all information entered at any point
to be viewed by other departments (Khan and Edwards, 2012). A 2014 study by MoHSS
found that public healthcare facilities at the district level entered the data using a manual
system, whereas at the national level, this was done both manually and electronically
(Republic of Namibia, MoHSS,2014).
In July 2017, the MoHSS launched its second district health information system (DHIS),
one of a half dozen different data-capturingplatforms. The competing platforms meant that
information was fragmented, making it extremely difcult to consolidate, triangulate and
analyse data(Nampa,2017, para. 2).
Problem statement
HIS is an essential component of a nations health system. However, HISs in developing
countries, including Namibia, have been said to be weak, because of incomplete and
Health
information
systems
359

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