Original articles

An evaluation of the District Health Information System in rural South Africa

Anupam Garrib, Norah Stoops, Andrew McKenzie, Linda Dlamini, Thiloshini Govender, Jon Rohde, Kobus Herbst


Introduction and objectives
Reliable health information is essential for the planning and management of locally responsive health services. The District Health Information System is a national system that collects routine health service utilisation data monthly from all public health care facilities. As part of a larger study on improving information systems for primary care, we aimed to describe the functioning of the DHIS in 10 rural clinics in KwaZulu-Natal; to assess data quality, and utilisation for facility management. Perceptions of work burden and usefulness of the system to clinic staff were also explored.

Semi-structured key informant interviews were conducted with clinic managers, supervisors, and district information staff. Data collected over a 12-month period for each clinic were assessed for missing data, data out of minimum and maximum ranges, and validation rule violations.

The study found a high perceived work burden associated with data collection and collation. Some data collation tools were not being used as intended. While there was good understanding of the data collection and collation process, there was little analysis, interpretation or utilization of data. Feedback to clinics occurred rarely. In the 10 clinics 2.5% of data values were missing, and 25% of data were outside expected ranges without an explanation provided.

The culture of information use essential to an information system having an impact at the local level is not strong in these clinics or at the sub-district level. Further training and support is required for the DHIS to function as intended.

Authors' affiliations

Anupam Garrib, Africa Centre for Health and Population Studies

Norah Stoops, Health Information Systems Programme

Andrew McKenzie, Health Information Systems Programme

Linda Dlamini, Africa Centre for Health and Population Studies

Thiloshini Govender, KwaZulu-Natal Provincial Department of Health

Jon Rohde, Management Sciences for Health

Kobus Herbst, Africa Centre for Health and Population Studies

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Information systems; DHIS; rural

Cite this article

South African Medical Journal 2008;98(7):549.

Article History

Date submitted: 2007-09-09
Date published: 2008-07-09

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