Abstract
This thesis builds on an exploratory, interpretive case study conducted in a developing country context. It was undertaken to discover how computers and data analysis software at facility level of the health system could support various types of decision-making. Health Management Information Systems produce data about population health status and health service provision that should be used for decision-making and planning at all levels of the health system, especially at the local level where it has been collected. Nevertheless, in practice, information is often neglected and not used efficiently or at all for decision-making at health institutions. To solve this problem the Ministry of Health in Zambia initiated facility trainings on 8th of May 2017 to implement electronic data entry and analysis at the facility level. This study shows that facility level workers, in fact, make decisions and data-driven actions and discusses in details their everyday work routine in terms of informed decision-making and the decisions themselves. The empirical evidence for this study was collected during training workshops using qualitative and quantitative methods concurrently. Data collection techniques involved observations, interviews/conversations, questionnaires, and tests. The gathered data was structured and analyzed through the application of a theoretical framework that segregates health information processes into managerial, administrative and clinical functions. Existing literature discusses challenges related to evidence-based decision-making in low-recourse setting and solutions to overcome these. This thesis reveals similar issues in Zambia and therefore suggests recommendations for improvements. In addition, the study provides rich insights on how facility staff perceive changes to their information-oriented work and the introduction of computers and the DHIS2 software.