Browsing by Author "Muiruri, Lillian"
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Item Implementation of Hospital Management information Systems on service delivery at Moi Teaching and Referral Hospital(Cheruiyot, B., Muiruri, L. & Njuguna, R. S. (2019). Implementation of Hospital Management information Systems on service delivery at Moi Teaching and Referral Hospital.World Journal of Medical Education and Research: Volume 20, Issue 1, 2019) Cheruiyot, B; Muiruri, Lillian; Njuguna, SusanHospital Management Information Systems (HMIS) has the potential to improve the quality of services delivered, as well as the efficiency and effectiveness of healthcare providers through the integration of various hospital functional units. However, the benefits of this implementation in service delivery have not been adequately addressed. This study sought to appraise the impact of the implementation of HMIS, on service delivery in Moi Teaching and Referral Hospital, (MTRH). The objectives of the study were: to examine the level of implementation of HMIS in MTRH; to establish the strategies motivating implementation and utilisation of HMIS, to assess the benefits that have been realized in utilizing Hospital Management Information Systems, and to assess the effect of HMIS on service delivery in MTRH. Cross sectional descriptive research design was utilised in the study; the sample size formula proposed by Cooper and Schildler formula was used to obtain 240 respondents from a target population of 587 users of HMIS. A structured closed-ended questionnaire and interviews were administered. Quantitative data was obtained, coded using SPSS v.21. Data was analysed using descriptive statistics, i.e. mean and standard deviations and inferential statistics i.e. Pearson Correlation Analysis and Multiple Regression Analysis. Of the 240 questionnaires distributed, 192 were filled and returned, with most respondents familiar with HMIS. The respondents moderately agreed that the implementation of HMIS was done well and as per expectations. The Hospital Records module had the highest implementation level, while Consulting Doctor module scored the lowest. On the level of utilisation of HMIS, the result indicate that the mean values were above average on a five point Likert scale. The Further Records module had the highest implementation level, with the majority agreeing that the module had been adequately utilised. Conversely, the Consulting Doctor module posted the lowest utilisation level. On the strategies motivating the utilisation of HMIS results indicate that the strategy of allaying perceptions and fears among staff on the use of HMIS is the one mostly deployed by the hospital in order to improve the level of Utilisation of HMIS. Results indicated that the anticipated benefits of HMIS were all above average. The results of the regression analysis suggested that HMIS implementation (β=.215, p˂0.05), HMIS Utilisation (β= ..697, p˂0.05), motivation strategy (β= .193, p˂0.05), and HMIS benefits (β= .045, p˂0.05) had a positive significant effect on service delivery. Therefore, the null hypothesis is rejected. The value of the F-statistic is (F=172.917, p˂0.05) is robust. The coefficient of determination value of R2= .787 means that 78.7% of the variation in service delivery at the hospital can be explained by HMIS. The study recommends that a policy be drafted to entrench HMIS implementation and utilisation in the country.Item Organizational Factors Influencing the Adoption of the District Health Information System 2 in Uasin Gishu County, Kenya(International Journal of Medical Research & Health Sciences, 2018-10) Kuyo, Richard Ole; Muiruri, Lillian; Njuguna, SusanBackground: Sound and reliable information is the foundation of decision-making across all health system building blocks that include service delivery, health workforce, health information, medical products, vaccines and technology, financing, leadership, and governance. This study is built on health information system pillar. Objectives: To determine the organizational factors influencing the use of DHIS2 in Uasin Gishu County. Methods: Study was conducted in Uasin Gishu-Sub County health facilities. A questionnaire was used to collect quantitative data from 283 health workers selected randomly while 10 key informants were selected purposively from this sample for indepth interviews. Results: Total 50.0% of the participants acknowledged that finances were adequate to run DHIS2. The main champions of DHIS2 used in decision-making were the county health records and information officers (56.2%) and the sub-county health records and information officers (39.0%). Up to 78.5% agreed or strongly agreed that organizational hierarchy influenced DHIS2 use and 80.8% agreed or strongly agreed that there was improved staff performance due to DHIS2 utilization. On the other hand, the major challenges experienced in the use of DHIS2 for evidenced-based decision-making were the lack of management support (34.3%), poor skills among the users (48.6%), lack of adequate computers (36.7%), unreliable internet connectivity (47.1%), lack of power backup (27.6%), and resistance to change (21.0%). Conclusion: The main funding for the DHIS2 system comes from the County government while health records and information officers are the main promoters of DHIS2 use. The main determinants of DHIS2 used are the availability of computers, network and internet services, trained staff and legislation. The main challenges inhibiting DHIS2 use are lack of management support, poor skills among the users, lack of adequate computers, unreliable internet connectivity, lack of power backup and resistance to change.