Browsing by Author "Mboro, Gilbert Nzomo"

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    Use of routine health information for decision making among health workers at coast general hospital, Mombasa County, Kenya
    (2017-10) Mboro, Gilbert Nzomo
    Health workers collect and report data routinely on all their activities. Studies show that very little of this vast amount of information is used by those who are collecting the data and by local health management at health facility or County levels. Ideally, local data should be collected, analysed and used in order to support local health management, health promotion and prevention and to improve local health service delivery. Significant resources have been invested on HMIS but we are unsure whether the available routine health information is used for decision making. This study aimed at assessing technical, organizational and behavioural factors that influenced information use among health workers at Coast General Hospital (CGH), Mombasa County, Kenya. The Study design utilized was descriptive cross sectional. Probability, simple random sampling was used as this avoided bias. Self-administered questionnaire, key informant interview guide and focus group discussion guide were tools used to collect data. A total of 236 health workers participated in the study. Quantitative data was analysed using Statistical Package for Social Science (SPSS) version 20 and qualitative using QSR international NVivo11. Descriptive statistics and chi-square test to determine significant association was done and results presented in tables, graphs and charts. The results showed 69.6% use of routine health information for decision making with 30.0%% reporting having received minimal training on information management areas. Highest education level attained by health worker, professional training and accessibility to resources like computer had statistical significant association to information use for decision making (p < 0.05). Inadequate support from the immediate supervisor 124 (52.5%) compounded by unclear roles and responsibilities 107 (45.4%) were reported as hindrance to information use. In conclusion the study demonstrates partial use of routine health information for decision making with interplay of technical, organizational, and behavioural determinants. In the view of the findings, this study recommends need for County HMT in conjunction with the national level to provide training to improve health workers’ skills with specific focus on information use through on- job trainings mentorship and enhance organizational context by providing resources that supports information use with targeted regular review meetings, feedback coupled with support supervision are also recommended.
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    Using Scorecard to Improve Reproductive, Maternal, Neonatal, Child and Adolescent Health Performance Indicators in Public Primary Health Facilities, Kenya
    (science Publishing Group, 2025-06) Mboro, Gilbert Nzomo; Otieno, George Ochieng; Rucha,Kenneth Kibaara; Ogol, Japheth Ouma; Owino, Erick; Oganga, Clement
    The study investigated factors associated with the use of scorecards to improve RMNCAH performance indicators in public primary care health facilities in Kwale and Kilifi counties. It employed a mixed-methods quasi-experimental research design and randomly sampled 119 participants. The investigators collected data through questionnaires, key informant interviews and FGD. Nurses employed scorecards more frequently than RCOs (p = 0.007), and the intervention group contained a higher percentage of healthcare workers between 30 and 39 years old (p = 0.004). Rural facilities had the highest scorecard usage (p = 0.034). Facility type, sex, and staff size were not significantly associated with scorecard use. At baseline, 74% of intervention facilities monitored RMNCAH indicators compared to 99% of control facilities (p = 0.134). However, by the endline, all intervention facilities (100%) monitored RMNCAH performance, while the control facilities decreased to 98%. In addition, at baseline majority of facilities in the intervention group (76%) monitored performance monthly, compared to 56% in the control group (p = 0.006). By the endline, 92% of intervention facilities monitored monthly, while only 53% of control facilities did so (p = 0.001). Regarding the analysis of RMNCAH data, at baseline, 85% of intervention facilities analyzed RMNCAH data compared to 93% in the control group. However, by the endline, 95% of facilities in both groups were analyzing data, hence data analysis is generally well-integrated in both settings (p = 0.000). The study revealed that at baseline, most HCWs in the intervention group (73%) had a low rating for behavioral factors, but this decreased significantly to just 5% at endline (Chi-Square = 21.68, p < 0.001). The study established that behavioral change interventions improved healthcare workers' (HCWs) engagement with performance monitoring tools, and high behavioral ratings rose from 27% to 95% in the intervention group. However, 63% of HCWs in the control group rated behavioral factors as low at endline. The intervention group experienced an increase in staff involvement in performance review meetings from baseline to the endline of the study period (Chi-Square = 16.00, p = 0.220). Involved representatives rose from 47% to 97% at endline. DDIU training coverage within the intervention group grew from 84% to 97% (Chi-Square = 21.01, p = 0.030) while the control group maintained its 84% rate. The adoption of scorecards for RMNCAH monitoring required education, experience, training, a positive assessment of facility performance and strong leadership combined with perceived facility competence.