Effect of Augmented Capacity Development Interventions (ACDI) on Information Utilization for Decision-Making in the Routine Health Information System in Public Health Institutions of Gofa Zone, Southern Ethiopia: A Cluster Randomized Controlled Trial.

Abstract

Background: Many health systems fail to fully link evidence to decisions and suffer from inadequate ability to respond to priority health needs. Routine data use capacity-building efforts are poorly implemented, lacking integration, quality training, and adequate support.

Objective: This study was aimed to evaluate the effect of Augmented Capacity Development Interventions (ACDI) strategies on information utilization for decision-making in the Routine Health Information System (RHIS).

Methods: A two-arm parallel-group cluster randomized controlled trial was conducted across clusters of public health institutions. Baseline data were collected in April 2023, an eight-month intervention was implemented from July 2023 to February 2024, and end-line data were collected in April 2024. Training, supportive supervision, mentorship, recognition, and monitoring and evaluation were the ACDI strategies implemented in this study. The study involved 72 health institutions and 304 health workers. A general linear mixed model analysis was used to assess the effect of the intervention on information utilization.

Results: The proportion of participants with good information utilization increased significantly from 55.2% at baseline to 82.3% at the end-line among the intervention groups. The ACDI intervention has a significant effect on information utilization (β = 0.19, 95% CI: 0.05, 0.33, P = .006). Moreover, availability of internet service (β = 0.21, 95% CI: 0.04, 0.38; P = .017), culture of information utilization (β = 0.12; 95% CI: 0.02, 0.22; P = .018), ease or skill of data management (β = 0.31, 95% CI: 0.23, 0.39; P < .001) and timeliness of reports (β = 0.27; 95% CI: 0.13, 0.40; P < .001) were predictors that increased information utilization in intervention health institutions as compared to control institutions.

Conclusion: This study demonstrated that the implementation of ACDI led to a significant improvement in information utilization. These results suggest that the intervention effectively improved information use in the RHIS and support adopting this approach in similar settings.

Trial registration id: PACTR202212472091194, registered on 14 December 2022.