Table 2 Emerging themes, sub-themes and categories by cadre of health professionals
Facility managers (FMs) | Sub-district/district/provincial/health information managers | M&E and PMTCT program managers |
|---|---|---|
1. Use of information | ||
 • Selective use for reporting | • Selective use of information for monitoring outcomes for political purposes; reporting and campaigns; | • Selective use for reporting • Inadequate use of data for planning purposes |
|  | • Different perspective on data-use |  |
2. Barriers to information-use | ||
 • Lack of trust in the data |  | • Data not trusted |
 • Willingness and attitude of users  • Lack of culture of information-use | • Lack of skill to interpret data for planning • Lack of culture of information-use | • Packaging of information • Lack of culture of information-use |
 • Ripple effect of lack of staff at facility level |  | • Lack of skills to use data |
 • Timeliness of feedback on information |  | • Lack of accountability for accurate data |
3. Data quality issues | ||
 • Perceptions of ‘poor-quality data’  • Inaccurate information provided by patient | • Perceptions of ‘poor-quality data’ | • Staff at different levels involved in several registers for one program |
|  |  | • Cooperation between staff at facility level |
4. Reasons for poor data quality  a) Human resources | ||
 • Staff attitude of non-care | • Staff attitude of non-care | • Three data-collection tools for one program |
 • Human error in data collection  • Work overload/staff turnover  • Lack of trained data capturers/clerks | • Clinicians unprepared/lack of skill for data collection • Staff rotation and turnover • Lack of feedback/data interrogation | • Follow up issues: results not captured • Migration of parents/mothers • Access to/tracing all babies born into the cohort |
 • Lack of ownership of RHIS process  • Limitations of supervisory visits/monthly audit | • Lack of numeracy skills | • Lack of feedback/data interrogation • Lack of accountability |
b) Equipment | ||
 • Lack of resources and equipment for recording |  |  |
c) Validation issues | ||
 • Lack of skills for validation | • Lack of validation at facility level, burden on higher levels • Snowball effect of non-validation at facility level • Extent of validating and coordinating overwhelming at district level | • No proper data validation at sub-district level |
d) Training | ||
|  | • Structure and content of training should be interactive and experiential in nature | • Experiential training/applied learning based on adult learning principles as preferred option which should be relevant, participatory, learner-centered, ownership |
|  | • Staff turnover challenge in training | |