Health systems research

Cultural barriers to the use of routine health information in decision making in rural Burkina Faso

Investigator:
Jaakko Yrjö-Koskinen has a medical degree, and he studied health services management at the London School of Hygiene and Tropical Medicine. Besides working in the clinical field in his native country Finland, he has extensive experience acting as a public health and health management adviser in Mozambique and Angola. His main area of interest is the development of management in sub-Saharan Africa. His current research on the cultural barriers to information use in decision making in Burkina Faso is part of his studies for the doctoral degree.

Summary:
Well functioning health information systems are considered to be indispensable for the efficient use of scarce resources and for transparent decision making. While governments in a number of low- and middle-income countries have made concerted efforts to develop their national health information systems, an increase in the availability of timely, reliable and relevant information has in many cases not resulted in more evidence-based and performance-oriented decision making. There is growing recognition of the importance of values as a factor determining health information system performance. Yet cultural constraints to information use in decision making are still poorly understood.

The increasing demands for information in the health sector have recently led to the launching of an international initiative – the Health Metrics Network – to assist developing countries in strengthening national health information systems. However, the efforts to promote evidence-based decision making at all levels of the health system risk being frustrated by cultural barriers to information use. There is therefore a need for more research on the influence of culture on decision making particularly in sub-Saharan Africa where progress towards the achievement of the health-related Millennium Development Goals has been slow.

A study is planned to identify cultural factors influencing the use of routine health information in decision making within the government health services in rural Burkina Faso. The objectives of the study are to:

1.       Assess the use of routine health information in planning and management;

2.       Identify cultural constraints to the use of information in decision making; and

3.       Explore, together with local health authorities, potential strategies for overcoming cultural barriers to information use.

Methodology:
The study is planned to be conducted in the Nouna Health District in northwestern Burkina Faso. The use of routine health information in the management of health services will be assessed by reviewing documents and statistics, and by analyzing the extent to which problems signalled by the routine health data has led to action. In addition, the process of formulation of annual plans will be observed. Cultural constraints to the use of information in decision making will be explored by interviewing managers at the District Health Department and health facilities, and their views will be elicited regarding potential strategies for overcoming cultural barriers to evidence-based decision making.