Voices from the grassroots
Chongsuvivatwong, V.; Nitimanop, P.
International Journal of Epidemiology 20(4): 1133-1136
1991
ISSN/ISBN: 0300-5771 PMID: 1800414 DOI: 10.1093/ije/20.4.1133Document Number: 251796
In Thailand where 80% of the population resides in rural areas, most health data are collected from the lowest level of the health service. In planning an efficient health system, it is essential to consider the basic dynamics of running the system and the opinions of local information users/collectors, and to identify items of information that are in greatest need of improvement. The report describes a study which evaluated the opinion of health workers and the cost effectiveness of report forms from which health statistics are compiled. A consortium of workers designed and tested questionnaires to allow grading of opinion with regard to time spent, reliability, relevancy, duplication and the possible value of 37 items of data ranging from maternal and child health to disease surveillance, outpatient department attendance, etc. Out of 8041 health centres and rural hospitals, 787 were randomly selected to receive the questionnaires, some 54% participated. The grades were summed such that the highest score reflects highest utility. The ratio between utility and time spent on each item was computed. Mean time spent on health information was 53 man-hours per month. Utility score correlates well with time spent (Rp 0.058, P=0.002). However, utility/time ratio has a negative statistically significant correlation with time spent (Rp=-0.63, P<0.0001). The occasional report requested by administrators has the lowest utility/time ratio. It is concluded that peripheral health workers can help in the actual design and performance of research relating to health information. Time spent on health information is high. As time spent increases, the cost-effectiveness tends to decrease.