Barriers and facilitators to the use of the mental health information system in Ghana: A qualitative study amongst users at the Accra Psychiatric Hospital

[摘要] ENGLISH ABSTRACT : One of the most successful modes of record-keeping and data collection is the use of health management information systems, where patient information and management plans are uniformly entered into a database to streamline the information and for ease of further patient management. For mental healthcare, a mental health information system (MHIS) has been found most successful. A properly established and operational MHIS is crucial in developing equitable and appropriate mental health care systems. Despite the obvious benefits of having a well-structured MHIS, its existence does not guarantee efficient use. There are a number of potential problems which may arise in the implementation of the MHIS, especially in poorly-resourced contexts. All of these problems may result in poor quality data being generated through the system, thereby compromising the use and efficiency of the MHIS. Staff motivation to provide accurate data for entry will also be affected. Until 2010, the system of keeping patient records and information in the Accra Psychiatric Hospital was old and outdated. In light of this and other factors, the Mental Health and Poverty Project (MHaPP) undertook a complete reforming of the mental health information systems in three psychiatric hospitals in Ghana in 2010. Although much was written on the implementation of the information systems, little is known about the current state of the system in Ghana four years after it was implemented. In view of this the present study sought to explore the experiences of users at the Accra Psychiatric Hospital in using the new MHIS, and to ascertain what their perceptions are of areas for improvement in the current system. A mixed methods approach was adopted. First, an audit was undertaken of usage of the MHIS. Second, participants' knowledge of the system and its use, as well as the influence of institutional processes on work were explored through the use of observations and semi-structured in-depth interviews. Data was analyzed using an interpretative phenomenological approach. Participants in the study were in three categories: prescriber, administrator, and records clerk. The final sample consisted of seven prescribers, one administrator and one records clerk. Participants reported increased workload, inadequate logistic support and staff shortages as the barriers to the effective use of the MHIS. Recommendations for improving the system included revising the form and migrating to a fully computerized system. These are discussed with reference to both micro and macro level institutional structures.

[发布机构] Stellenbosch University