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The information system is defined
“as the main provider of information in support of decision-making in health
policy at both central and local levels as well as for result evaluation” by
the White Chart of Governance (Ngafeeson, M.,
2014).

“Generally-speaking, challenges
stem from the interaction of technical, human, and organizational factors
affecting the adoption and use of these healthcare systems.”

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·        
Since institutions, such as the Ministry of
Health, its subordinated institutions, the National Health Insurance House,
Institutes of Public Health, and Institutes of Medical Research and Education,
have their own information system it leads to double reporting and incoherence
of some definitions and coding. For example, the data reported to the District
Health Insurance House does not respect the format of current national
regulations and the same indicator has two different values when reported
through two different channels.

·        
Many IT specialists left their positions for
better paid ones and there were also reductions of staff which together led to
serious deficiencies in implementing the health information system.

·        
Mismanagement of the implementation process:
they were missing a realistic implementation plan, being neglected the cultural
environment with its features yielded a misperception. A rejection attitude was
generated from the users’ side when trying to implement the SIUI system since
the use of the DRG reporting was not considered.

·        
Personnel training was ignored. Only a quarter
of the GPs had medical informatics courses which also caused difficulties.

·        
User Acceptance: the lack of integration of
previous systems, mainly the non-compliance with the Diagnosis Related Groups
(DRG) reporting system; the unfriendly interfaces have increased dramatically
the time for filling in all the forms; the data transfer from the previous
patient databases was deficient; the system does not cover all particular
cases; the training was insignificant, the help module is poor and is far from
providing the needed assistance.

“The implementation of an efficient
HIS is a necessary, beneficial and obligatory process. Since 1990, the
development of an information system in reporting and processing of health
related data at national and district level has been a matter of permanent
concern.”

This system could be a better
instrument for good governance, responsive to the needs of modern Public Health
as expressed by different audiences and initiatives.

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