The Influence of Parallel Reporting Systems on Data Quality and Information Use in Northwest Ethiopia: A Qualitative Study

Abstract

Background: Ethiopia utilises the district health information system for health information management. However, the lower level health structure seems inaccurate in comparison to the parallel reporting system, with limited evidence on its effect on data quality and information use. Therefore, the present study aimed to assess the influence of a parallel reporting system on data quality and information use at the lower level structures of the Amhara region, Northwest Ethiopia.
Methods: The study was conducted in five districts of the Amhara region using an explanatory case study design. Twenty respondents were interviewed from the 1st – 30th April 2021, using a semi-structured key informant interview (KII) guide with multiple probes to explore relevant information. The data was transcribed into English and transferred to the Open-Code 4.02 software for analysis. Textual data were coded, and themes were identified from the synthesis. Inductive thematic analysis was applied to identify the relationships among the emerging themes in order to draw a relevant conclusion.
Results: Five themes were emerged from the analysis, including the current practice of parallel reporting, a program area of parallel reporting, the influence of parallel reporting, reasons for parallel reporting, and means to avoid parallel reporting. Likewise, parallel reporting was done at the district level and at the point of service delivery. The respondents described maternal and child health programs often using parallel reporting. Parallel reporting was described as having undesirable impacts on routinely collected health data quality and use. Moreover, it increases the work burden; and affects service quality, the the satisfaction levels of clients and staff, and the overall efficiency. The main reasons for practicing parallel reporting were: missing important data elements in DHIS2, single language, varying stakeholders’ interests, and lack of conducting a partner forum.
Conclusion and implication: Against the national health information system’s guiding principles and vision, parallel reporting is practiced at the lower health system levels for various programs. Therefore, a corrective measure should be taken to achieve the country’s information revolution (IR) agenda. To avoid parallel reporting mechanisms, it is recommended that regular partner forums at the district level must be strengthened, important data elements should be incorporated into the DHIS 2, and additional language platforms should be be included in the DHIS2 system.