Self-efficacy and competence gaps in health information management: A mixed-methods assessment among healthcare professionals

The effectiveness of routine health information systems (RHIS) depends significantly on the self-efficacy and actual competence of healthcare professionals in managing health information. Despite investments in health information infrastructure, gaps between perceived abilities and actual skills continue to undermine system performance.

This study assessed self-efficacy levels and competence gaps among healthcare professionals in RHIS tasks within Cape Coast Metropolis, Ghana.

A mixed-methods cross-sectional study was conducted among 265 healthcare professionals across 13 health facilities in the Metropolis. Self-efficacy was measured using a validated 7-item scale with responses ranging from 0 to 100. Actual competence was assessed through standardised paper-and-pencil tests across five RHIS task domains: data quality checking (verifying accuracy, completeness, and timeliness), statistical calculations (computing rates and percentages), data plotting and visualisation, interpretation of findings, and information utilisation for decision-making. Knowledge of RHIS rationale and problem-solving skills were also evaluated. Descriptive statistics, correlation analysis, and gap analysis were performed on the data.

The mean self-efficacy score was 36.8% (95% confidence interval (CI) ± 2.22), with perceived confidence in calculating RHIS tasks showing the highest level (39.8%) and using data to make decisions showing the lowest (33.8%). Actual competence averaged 19.9% (95% CI ± 10.6), with calculation skills achieving the highest performance (28.1%) and plotting skills the lowest (11.9%). Significant gaps existed between self-efficacy and actual competence across all domains, with the largest gap in plotting (26%) and smallest in calculations (11.7%). Only 25% demonstrated adequate knowledge of data collection rationale, and fewer than 4% demonstrated adequate problem-solving skills.

Substantial gaps exist between healthcare professionals' perceived self-efficacy and actual competence in health information management tasks in Cape Coast Metropolis. Persistent overconfidence, weak problem-solving skills, and limited understanding of data collection rationale collectively undermine RHIS performance.Implications for health information management practice:Targeted, practical capacity-building programmes addressing both technical skills and self-assessment accuracy are urgently needed in Cape Coast Metropolis and comparable low- and middle-income countries settings.