A Garrib, N Stoops, A McKenzie, L Dlamini, T Govender, J Rohde, K Herbst

Background. Since reliable health information is essential

for the planning and management of health services, we

investigated the functioning of the District Health Information

System (DHIS) in 10 rural clinics.

Design and subjects. Semi-structured key informant interviews

were conducted with clinic managers, supervisors and

district information staff. Data collected over a 12-month

period for each clinic were assessed for missing data, data

out of minimum and maximum ranges, and validation rule

violations.

Setting. Our investigation was part of a larger study on

improving information systems for primary care in rural

KwaZulu-Natal.

Outcomes. We assessed data quality, the utilisation for facility

management, perceptions of work burden, and usefulness of

the system to clinic staff.

Results. A high perceived work burden associated with data

collection and collation was found. Some data collation tools

were not used as intended. There was good understanding

of the data collection and collation process but little analysis,

interpretation or utilisation of data. Feedback to clinics

occurred rarely. In the 10 clinics, 2.5% of data values were

missing, and 25% of data were outside expected ranges

without an explanation provided.

Conclusions. The culture of information use essential to an

information system having an impact at the local level is

weak in these clinics or at the sub-district level. Further

training and support is required for the DHIS to function as intended.

S Afr Med J 2008; 98: 549-522.