| 摘要: | Background: The necessity of sound information system as a support to the various developmental activities of the Health sector in The Gambia was identified as early as 1976 when the Health Statistic unit was established.
A striking indicator of this lack of attention is the paucity of basic data available on private health care provision. The Health Management Information system is the main system where all health data should be managed and stored for planning, decision-making and reference in the Gambia.
The objective: to explore the factors responsible for the failure of the private for profit health facilities to report data to the health management information system under the ministry of health as envisioned in the National Health Policy (2007-2011).
Methods: A qualitative method was employed in ten (10) health facilities, five for profit and five for NGOs with two senior personnel’s from the Ministry of Health and Social Welfare, in order to explore their opinions of why the private for profit health facilities failed to report to HMIS.
Semi-structured questionnaires were used in exploring their opinion regarding the failure of non-reporting by the non-state actors in the health care delivery system in the Gambia; purposive sampling was employed to get valid data from key informants.
Data analysis: codes and coding were used; the findings were categorized into themes and were written accordingly.
Result: according to the findings; there are four main factors responsible for the failure of non-reporting regarding the opinions of the proprietors of these private health facilities; poor collaboration, weak Human resources, poor regulation, and inefficient communication.
Personnel’s from the Health Ministry also complained of the regulation; there is no act that mandate both the public and the private health facilities to report service data to HMIS unit, thus leaving a big gap in the system, most of these facilities are situated within the most densely populated area in the country, and people prioritize their care. So a large number of patients sought care from them. By and large, the data collected by the ministry is incomplete, there is under reporting which can have serious implication with policy and planning for the health sector.
Discussion: Ready availability of essential health information is imperative for the development of informed and effective systems for improving health of societies.
The findings revealed a wide range of interlinked factors responsible for the failure of reporting by the private health facilities and also the inefficiency and ineffectiveness of the HMIS in The Gambia. The lack of clear understanding of the purpose of HMIS by the private healthcare providers suggested that decision-making in the country health system may be less than adequately informed.
Conclusion: This study revealed the factors responsible for the failure of reporting of health data by the private health facilities to the health management information system of the Ministry of Health namely; lack of data-based decision-making at the central level, poor collaboration, weak Human resources, poor regulation, inefficient communication and reporting is not mandatory as there is no law enforcing it by the private providers. |
