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 | ||