Effective Implementation Strategies for Community Health Information System in Urban Settings of Ethiopia

Abstract Background: The Urban Community Health Information System (UCHIS) in Ethiopia aims to collect, document, and exchange data at the community level to enable health system managers and health workers to make evidence-based decisions and improve health outcomes. The system, which was recently launched, faces several challenges that hinder the full integration of the new information system into the national health system. Thus, this study aimed to produce a compile refined implementation strategies that could guide effective service delivery, adoption, and sustainability of UCHIS in Ethiopia and evaluate the feasibility and significant of these strategies. Methods: This study employed a qualitative research design utilizing key informant interviews and iterative consultation workshops conducted in eight major cities of Ethiopia from March 22 to May 2022. First, we conducted qualitative interviews with 28 experts, including implementers, policymakers, academicians, and implementation researchers. We then invited these experts to participate in iterative consultative workshops to refine the list of strategies and rate them based on their importance and feasibility using a four-level Likert scale. Results: The qualitative analysis identified six major themes related to the challenges and opportunities for the adoption of UCHIS: (1) the existing approach and workflow of UCHIS; (2) readiness for implementation; (3) human resources; (4) mentorship and supportive supervision; (5) community sensitization and advocacy toward UCHIS, and (6) challenges to the implementation of UCHIS. We developed 63 strategies under eight domains that could improve the implementation, adoption, and sustainability of UCHIS in Ethiopia. Of the 63 strategies, 47 were rated as highly important and highly feasible, while 19 were rated as highly important but less feasible. Conclusion: This study provides a valuable resource for prioritizing implementation strategies for the effective adoption of UCHIS in Ethiopia. The findings of this study should be used to guide the development and implementation of a national plan for the adoption of UCHIS. Prioritized strategies should be tested and compared in terms of improving the adoption of UCHIS in Ethiopia and other low- and middle-income countries. [Ethiop. J. Health Dev. 2024; 38(SI-2)] Keywords: community health information system, implementation strategies, feasibility and importance of implementation strategies, evidence-based guidance, urban CHIS, Ethiopia.