Abstract
Health Information System (HIS) plays an important role in a country s health system. Within HIS hierarchy, the data is collected from the lowest level and aggregated to the upper levels. Subsequently, the data is expected to be analyzed to form useful information and to be passed back to the lower levels for decision making and action taking on field. Such process to pass back the information down to the lower level in this study is referred as feedback mechanism. The regularity and timelines of the feedback is crucial for health workers on the ground, because getting obsolete feedback information may lead to incorrect action. However, this feedback mechanism does not seem to happen regularly and timely, especially in underdeveloped countries due to limited infrastructure (e.g. road, landline phone, electrictity, Internet) as well as overburdened human resources which does not allow regular face to face feedback meeting to happen. On the other side, we have seen enormous penetration of mobile phone coverage which has surpassed landline phone coverage even in under-developed countries. Therefore, this thesis is motivated to study how wide mobile coverage can be utilized to bridge the gap in establishing regular and timely feedback mechanism by sending useful indicators via SMS down to health workers and evaluate how that impacts the way they work. To conduct the study, a pilot project was implemented in Uganda based on existing District Health Information Software 2 (DHIS2) system thatwas enhanced further with newly developed SMS feedback capability. The results showed that SMS feedback solution is feasible in such low resource context. It was also shown that the enhancement was able to complement the current irregular feedback mechanism with regular and timely SMS feedback automation. In addition, the SMS feedback solution has been positively perceived by the health workers in several aspects: raising awareness/knowledge of current performance, motivating them to improve further and helping them to make informed decision. The health workers recognized the SMS feedback as useful and even proposed more information to be included. It was seen as good starting point towards nurturing information culture.