The Role of Health Information Systems (HIS) Utilization on Administrative Performance in Conflict-Affected Public Hospitals: The Case of Yemen
DOI:
https://doi.org/10.65693/jas.2026.v1i1.2Keywords:
Health Information System. Administrative Performance. Conflict-Affected. Public Hospitals. YemenAbstract
Abstract
Objective: This study aimed to examine the relationship between HIS utilization and administrative performance in major public hospitals in Sana'a, Yemen, and to identify which dimensions of utilization (e.g., data quality, frequency of use, or mere availability) are the strongest predictors of overall administrative performance, integrating the conceptual lenses of Information Use Theory and the PRISM Framework.
Methods: A quantitative cross-sectional study was conducted in three major public referral hospitals in Sana'a: Al-Thawra General Hospital, Al-Jamhuri Teaching Hospital, and Kuwait University Hospital. The sample comprised N=180 administrative staff routinely interacting with HIS, with 60 participants drawn from each hospital. Internal reliability was confirmed using Cronbach’s alpha (alpha > 0.77) for all measures. Data were analyzed using Pearson correlation and Multiple Linear Regression to determine the strength and predictive hierarchy of the relationships.
Results: Overall, HIS utilization was moderate (Mean = 3.38, SD = 0.63), with data integration (Mean = 3.14, SD = 0.72) recording the lowest score. A strong, statistically significant positive correlation was found between overall HIS utilization and administrative performance (r = 0.56, p < 0.001). The regression model explained 39% of the variance in administrative performance (R2 = 0.39, p < 0.001). The strongest predictors were Data Quality and Accuracy (beta = 0.33, p < 0.001) and Frequency of System Use (beta = 0.28, p < 0.01), while the effect of system availability alone was weak.
Conclusion: Improving administrative performance in conflict-affected public hospitals hinges not on the installation or availability of HIS, but on fostering behavioral and operational reliability. The focus must shift from infrastructural inputs to data governance and user support to ensure information is trusted and routinely integrated into decision-making, which is supported by Information Use Theory within a resource-constrained environment.
Keywords: Health Information System. Administrative Performance. Conflict-Affected. Public Hospitals. Yemen.
References
1. AbouZahr, C., & Boerma, T. (2005). Health information systems: The foundations of public health. Bulletin of the World Health Organization, 83(8), 578–583.
2. Al-Akwa, S., Al-Ataki, A., Al-Awadhi, A., Abdulmoghani, I., Al-Madoumi, I., Al-Wesabi, M., Al-Samei, A., Al-Hajjaji, B., Al-Doais, T., Salem, R., Jarwash, F., Al-Nofeesh, M., Al-Azizi, J., & Al-Nazari, M. (2024). The Role of Governance in Improving the Quality of Healthcare Services in Yemeni Hospitals: (A Case Study of the Republican Teaching Hospital Authority). Institutional Repository for Scientific Scholarship at 21 September University for Medical and Applied Sciences, 5(1), 1-133. https://doi.org/10.65693/irss.2024.v5i1.39
3. Al-sabri, A., Sha'aban, S., kamil, B., sharoh, L., Mahdi, R., Mufaddal, N., Al-zomani, S., Al-sohili, W., Abdullah, S., Al-jaberi, W., & Al-Wesabi, M. (2026). The Role of Digital Transformation in Improving the Efficiency of Health and Administrative Services (A Field Study in Yemeni Private Hospitals for Amanat Al-Asimah – Sana’a. Institutional Repository for Scientific Scholarship at 21 September University for Medical and Applied Sciences, 7(1), 1-115. https://doi.org/10.65693/irss.2026.v7i1.58
4. Al-Saleet, J. M., Al-Wasabi, M. M., Jowah, H. M. (2025, August 19). Impact of total quality management on healthcare service quality in Yemeni hospitals: A cross-sectional study [Preprint]. Research Square. https://doi.org/10.21203/rs.3.rs-7115768/v1
5. Alsalit, G. M., Al-Wesabi, M. M., Jowah, H. M. (2026, February 18). Drivers of healthcare quality in a conflict-affected setting: A cross-sectional study on total quality management implementation in Yemen [Preprint]. Research Square. https://doi.org/10.21203/rs.3.rs-8835527/v1
6. Alvarez, R., & Kendall, M. (2023). Routine health information system data use: Lessons from low and middle-income country contexts. Bulletin of the World Health Organization, 101(12), 801–807.(https://doi.org/10.2471/BLT.23.290636)
7. Al-Wesabi, M. (2020). The reality of the Yemeni health sector and the role of September 21 University for Medical and Applied Sciences in reforming it and building the modern Yemeni state (M. Dael, Trans.). Institutional Repository for Scientific Scholarship at 21 September University for Medical and Applied Sciences, 1(1), 106-133. https://doi.org/10.65693/irss.2020.v1i1.47
8. Al-wesabi, Muneer. (2012). The Role of Quality Systems in Improving the Performance of Healthcare Facilities in Yemen: A Case Study of the 48 Model Hospital. https://doi.org/10.13140/RG.2.2.12720.32009
9. Al-wesabi, Muneer. (2017). The Effect of Health Human Resources Development on the Efficacy of Applying Accreditation Standards in Yemeni Hospitals: A Field Study. https://doi.org/10.13140/RG.2.2.28658.67527
10. alwsaby, M. (2017). The Relationship Between Human Resources Development and the Efficacy of Applying Accreditation Standards in Private and Public Yemeni Hospitals in the Capital City, Sana’a (Z. Murad, Trans.). Institutional Repository for Scientific Scholarship at 21 September University for Medical and Applied Sciences, 1(1), 75-94. https://ojs.21umas.edu.ye/irss/article/view/46
11. Aqil, A., Lippeveld, T., & Hozumi, D. (2009). PRISM framework: A paradigm shift for designing, strengthening, and evaluating routine health information systems. Health Policy and Planning, 24(3), 217–228. https://doi.org/10.1093/heapol/czp002
12. Arnett, J. J. (2000). Emerging adulthood: a theory of development from the late teens through the twenties. American Psychologist, 55(5), 469–483.
13. Braa, J., Heywood, A., & Sahay, S. (2012). Improving quality and use of data through data-use workshops: Zanzibar, United Republic of Tanzania. Bulletin of the World Health Organization, 90(5), 379–384.
14. Dattalo, P. (2008). Determining sample size: Balancing power, precision, and practicality. Oxford University Press.
15. Faul, F., Erdfelder, E., Lang, A. G., & Buchner, A. (2007). G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods, 39(2), 175–191.
16. Kruk, M. E., Gage, A. D., Arsenault, C., Jordan, K., Kraja, B., Lam, F., et al. (2018). High-quality health systems in the Sustainable Development Goals era: time for a revolution. The Lancet Global Health, 6(11), e1196–e1252. https://doi.org/10.1016/S2214-109X(18)30386-3
17. Lippeveld, T., Sauerborn, R., & Bodart, C. (2000). Design and implementation of health information systems. World Health Organization.
18. Mekonnen, A., & Deribe, K. (2019). Determinants of routine health information utilization among health centers in East Gojjam Zone, Northwest Ethiopia. Journal of Public Health and Epidemiology, 11(4), 86–95.
19. Qabban, K. A., Al-Wesabi, M. M. (2025). The Impact of Career Development on Improving Nursing Performance in Yemen Hospitals - Sana’a. Sana’a University Journal of Human Sciences, 4(11), 277-317. https://doi.org/10.59628/jhs.v4i11.1809
20. Qabban, K. A., Al-Wesabi, M. M., & Jowah, H. M. (2026). Association between Joint Commission International patient-centered standards and self-reported nursing performance in Sana′a, Yemen hospitals. Journal of Nursing Management, 2026, Article 8353270. https://doi.org/10.1155/jonm/8353270
21. Qabban, K. A., Al-Wesabi, M. M., Jowah, H. M. (2025, May 7). Impact of Joint Commission International patient-centered standards on nursing performance in Sana'a, Yemen hospitals [Preprint]. Research Square. https://doi.org/10.21203/rs.3.rs-6372401/v1
22. Sahay, S., Nielsen, P., & Latifov, M. (2018). Grand challenges of public health information systems in developing countries: Lessons from case studies. Information Polity, 23(2), 177–194. https://doi.org/10.3233/IP-170068
23. Sfantou, D. F., Laliotis, A., Patelarou, A. E., Sifaki-Pistolla, D., Matalliotakis, M., & Patelarou, E. (2017). Importance of leadership style towards quality of care measures in healthcare settings: a systematic review. Healthcare, 5(4), 73. https://doi.org/10.3390/healthcare5040073
24. Shamlan, M. A. M., & Al-Wesabi, M. M. M. (2026, May 26). Clinical governance and healthcare quality in conflict-affected settings: A cross-sectional study of hospitals in Yemen [Preprint]. Research Square. https://doi.org/10.21203/rs.3.rs-9442217/v1
25. Tannor, E. K., Amuasi, J., Busse, R., Opoku, D., Ofori, E., Gyan, K. F., Aikins, M., Hutton Mensah, K., Opare Addo, P., & Quentin, W. (2024). The impact of COVID-19 on health service utilization in sub-Saharan Africa—a scoping review. BMC Global and Public Health, 24(1), 55.
26. UNICEF. (2025). UNICEF digital health and information systems 2024 annual report. UNICEF.(https://www.unicef.org/digitalimpact/media/956/file/UNICEF%20Digital%20Health%20and%20Information%20Systems%202024%20Annual%20Report.pdf.pdf)
27. Wilson, T. D. (1997). Information needs and uses: fifty years of progress? In Information science in transition: Proceedings of the ASIS 1997 Annual Conference (pp. 1–9). Information Science.
28. World Bank. (2024). Yemen Country Climate and Development Report – Policy Note. World Bank. https://hdl.handle.net/10986/42274
29. World Health Organization. (2018). Digital health interventions: Classification of digital health interventions v1.0. World Health Organization.
30. World Health Organization. (2019). Global health threats 2019. World Health Organization.
31. World Health Organization. (2021). Global strategy on digital health 2020–2025. World Health Organization. https://www.who.int/publications/i/item/9789240020924
32. World Health Organization. (2022). Digital health in fragile and conflict-affected settings. World Health Organization. https://www.who.int/publications/i/item/9789240061590
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