Commitment Levels of Health Care Providers in Using the District Health Information System and the Associated Factors for Decision Making in Resource-Limited Settings: Cross-sectional Survey Study

BACKGROUND: Changing the culture of information use, which is one of the transformation agendas of the Ministry of Health of Ethiopia, cannot become real unless health care providers are committed to using locally collected data for evidence-based decision making. The commitment of health care providers has paramount influence on district health information system 2 (DHIS2) data utilization for decision making. Evidence is limited on health care providers’ level of commitment to using DHIS2 data in Ethiopia. Therefore, this study aims to fill this evidence gap. OBJECTIVE: This study aimed to assess the levels of commitment of health care providers and the factors influencing their commitment levels in using DHIS2 data for decision making at public health care facilities in the Ilu Aba Bora zone of the Oromia national regional state, Ethiopia in 2020. METHODS: The cross-sectional quantitative study supplemented by qualitative methods was conducted from February 26, 2020 to April 17, 2020. A total of 264 participants were approached. SPSS version 20 software was used for data entry and analysis. Descriptive and analytical statistics, including bivariable and multivariable analyses, were performed. Thematic analysis was conducted for the qualitative data. RESULTS: Of the 264 respondents, 121 (45.8%, 95% CI 40.0%-52.8%) respondents showed high commitment levels to use DHIS2 data. The variables associated with the level of commitment to use DHIS2 data were found to be provision of feedback for DHIS2 data use (adjusted odds ratio [AOR] 1.85, 95% CI 1.02-3.33), regular supervision and managerial support (AOR 2.84, 95% CI 1.50-5.37), information use culture (AOR 1.92, 95% CI 1.03-3.59), motivation to use DHIS2 data (AOR 1.80, 95% CI 1.00-3.25), health needs (AOR 3.96, 95% CI 2.11-7.41), and competency in DHIS2 tasks (AOR 2.41, 95% CI 1.27-4.55). CONCLUSIONS: In general, less than half of the study participants showed high commitment levels to use DHIS2 data for decision making in health care. Providing regular supportive supervision and feedback and increasing the motivation and competency of the health care providers in performing DHIS2 data tasks will help in promoting their levels of commitment that can result in the cultural transformation of data use for evidence-based decision making in health care.