Background: Developing countries experiences an increasing burden of disease as well as challenges financial and human resources. Good information about the current situation of the health situation is important in planning, monitoring, evaluation, resource allocation, and need assessments. A well functioning health information system for gathering, processing, analysing and using health information will facilitate this.
Objectives: Three main areas have been examined in this thesis; an analysis of the simplicity, user-friendliness, overlap, relevance, completeness and effectiveness of data collection tools used in the Gaborone district, what this information is used for and how managers use it. The last objective has been to identify improvement possibilities the information flow between health facilities in Gaborone district and the selected health programmes.
Methodology: This thesis focuses on information flow between and information use among managers. Through a case study of HIS in the capital area, Gaborone, focusing on selected health programmes (Mental Health, Prevention of Mother To Child Transmission, Mother and Child Health, and Expanded Programme on Immunization) data were collected over a 12 weeks period. 10 observations, in a total of eight facilities and administrations, in Gaborone health district were performed. The study resulted in eight semi-structured interviews of managers in the national, district and facility levels of Botswana. Monthly reports from the PMTCT, Mental Health, EPI, MCH health programmes were collected from the facilities under observation.
Results: The information flow is diverse and fragmented, differing from programme to programme. Two coexisting HIS was identified, one formal and informal system. The SOURCE-analysis mainly revealed a problem of overlapping data collection tools. The form of the EPI programme is the only one amongst the assessed programmes that satisfy all the SOURCE criterions. The study revealed data quality discrepancies, in terms of incorrectness, incompleteness, inconsistencies and un-timeliness of delivering reports. Un-timeliness is one of the major constraints of the HIS according to the informants. An equal pattern of information use was seen among all the interviewed managers. Facility and district level seems to have a lower degree of information use than the national level. The findings are however not distinct. Human and technical resources vary from programme to programme and facility to facility.
Conclusion: The challenges of overlap, data quality, informal information channels and coordination were perceived to be interconnected and they all contributed to managers’ non-access to and use of information. It is argued that the HIS of Gaborone is unsuccessful.