Perspectives on an Iterative and Bidirectional Information System and its Role in Improving Health Outcomes in Western Kenya: OAJBS Publishers

Perspectives on an Iterative and Bidirectional Information System and its Role in Improving Health Outcomes in Western Kenya by Beverly M Ochieng* in Open Access Journal of Biomedical Science (OAJBS)

Background: A perennial problem in information systems is the unidirectional flow of information. Bidirectional information systems are mechanisms by which consumers and providers generate, discuss and use information at each level of data collection. This paper describes opportunities in the health service delivery system for bidirectional information flow that can be established as part of the health information system to inform decisions, planning, and action by both providers and consumers of care.

Methods: The study was quasi-experimental and involved pre-and post-intervention, cross-sectional surveys at intervention and control sites. The intervention was a Community Based Health Information System. Quantitative and qualitative data were collected. The surveys covered five health facilities in the intervention sites and five in the control sites in each of the six study districts. Five clients were interviewed at each intervention and control health facility. Communities served by the selected health facilities were included in household cluster sample surveys. Thirty clusters of 10 households, each with under-five children, were included in each community served by the selected health facilities. Quantitative data were cross tabulated to compare health outcomes at intervention and control sites. A content analysis was performed on the qualitative data; themes and sub-themes that identified opportunities for bidirectional information-sharing were identified.

Results: We identified five nodal points in the health system that provide opportunities for bidirectional information sharing at the household, community, and health facility levels. Immunization coverage, skilled delivery, water treatment, and latrine use improved more at the intervention than control sites. Where all of the mechanisms were implemented, there was better performance in outcomes.

Conclusion: A conscious engagement of service providers and consumers in dialogue, using available health system information to iteratively inform decisions and actions, improves health outcomes.
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