RESUMEN
DHIS2 is a web-based platform primarily used in developing countries, ensuring reliable data and aiding decentralized decision-making. The Ministry of Health and Population has greatly emphasized using DHIS2 for data entry and reporting. However, studies regarding health workers' experiences on DHIS2 and the utilization of data at the local level remain limited. Therefore, this study aims to investigate the usage and practical experience of DHIS2 at the local levels of Gandaki province, Nepal. An exploratory qualitative study was conducted in the Gandaki province from February to August 2023. We conducted twenty in-depth interviews among the DHIS2 users at local levels, health posts, and provincial health directorate using in-depth interview guidelines. The study participants were selected purposively. Thematic analysis was conducted to analyze the data, and NVivo was used to facilitate data analysis. Health professionals demonstrated dedication and commitment to use DHIS2 for reporting. DHIS2 has facilitated timely reporting, data storage, data analysis and visualization, feedback and communication mechanisms, and service delivery. Users' self-motivation and support from the local and provincial levels and regular review and program-specific review meetings were major facilitators for DHIS2 use. Similarly, technical issues, poor internet connectivity, power outages, and inexperienced health professionals were the significant challenges to using DHIS2. The basic and refresher training needed improvement at all levels, and learning materials were unavailable in health facilities. In addition, the data utilization at the local level in various actions was unsatisfactory despite sufficient data. Health professionals have been facilitated by DHIS2 in various actions. Capacity building of health professionals on data analysis and interpretations, continued onsite coaching, reliable internet connectivity, availability of learning materials, and improved server capacity are needed to enhance the performance of DHIS2 at the local level.
RESUMEN
Meat hygiene refers to all conditions and measures necessary to ensure safety and suitability of meat at all stages of the food chain. Inadequate hygiene practices allow consumers to be exposed to pathogens causing public health problems. Inadequate facilities and hygiene practices in meat shops results in meat contamination. The study aimed to identify factors associated with meat hygiene practices among meat handlers in the Metropolitan City of Kathmandu, Nepal. A cross-sectional study was designed with a semi-structured questionnaire and observation checklist that collected information about hygiene practices from 320 consenting meat-handlers by interviewer-administered technique. Data was entered in EpiData and analyzed using IBM SPSS version 21. Descriptive statistics of frequency distribution were used to report meat hygiene-practices and other independent variables, with multivariate logistic regression to establish predictors of meat hygiene-practices at 5% level of significance. The study revealed that less than half (44.4%) of the meat handlers had satisfactory meat hygiene practices. The adjusted regression analysis showed, strong evidence (p<0.01) of association of higher education level (AOR = 2.8, 95% CI = 1.7-4.5), other occupational involvement (AOR = 2.2, 95% CI = 1.9-2.4), and being officially registered (AOR = 2.8, 95% CI = 1.2-6.8) with meat hygiene practices. However, there was fair evidence (p<0.05) of association between shorter duration of meat being processed to sale (AOR = 0.57, P = 0.042) and meat hygiene practices. In this study, the satisfactory meat hygiene practices of meat handlers was low. The educational level, registration status of shops, involvement in other jobs, and awareness on meat hygiene were identified as key factors associated with meat hygiene practices. Thus, these factors need to be considered while developing programs to improve meat hygiene practices among the meat handlers. Meat handlers should be provided with training and orientation program for improving the meat hygiene practices.
