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Literature on health management information systems' development emphasizes the need of feeding data back to the providing level. It is assumed that the feedback of compiled reporting data to their actual producers will improve decision making in health unit management and the quality of reported data by making the reporting staff understand their value. However, this strategy can only be successful, when the presentation of data is adapted to the needs and abilities of the targeted staff.
This study analyzes the statistical abilities of health unit and district health team staff in Kabarole District, Western Uganda, to have an orientation on how to present feedback data. A questionnaire with four basic types of statistical presentation techniques (table, line graph, bar graph, scatter diagraph, pie chart) in different difficulty levels was presented to 85 health workers (14 district health team staff, 71 health unit staff). Different levels of statistical analysis (reading a single value, seeing a context, understanding a fractional indicator) were tested. Semi-structured interviews were used to follow up reasons for wrong results and to assess the general appreciation of data.
Single values in standard presentations were generally well read. Adding complexity such as a second scale or multiple data series resulted in a decline of correct answers for some presentation techniques. For most staff it was not possible to assess a presentation at a glance. The concept of fractional indicators (e.g. health unit visits per patient per year) proved to be to difficult. However, the interest in the feedback data was perceived as being high.
The results confirm the rule of the thumb "Keep it simple and straightforward" of health management information system design. A suitable combination of training and ability adapted presentations is unavoidable to ensure the use of feedback data.
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