The Information on Decision-making in Health: From Predictable to Unpredictable

Abstract

This study’s aim is to identify the information needs, sources, seeking behaviour and uses of information by health managers involved with decision-making in public health. An exploratory, qualitative and comparative study was performed to analyse the municipal and state spheres of public health administration in Brazil and the Department of Informatics of the National Health System at the federal level. Nine health managers were interviewed at different hierarchy levels. It was verified that the decision is subsidised by technical, scientific information and appropriation of experiences from different sources. The flow of information is bottom-up, associated with the flow of documents that feed the health information systems. There is a need for predictable and unpredictable information, originating mainly from the press and the Public Ministry. The municipal sphere is better structured to handle information than the state sphere. Unpredictable information needs to interfere with the routine of health management work activities and impact health managers’ decision-making. Information is seldom used in this decision-making process, with the weakness of the health information systems being pointed out as the main cause. The production of information for decision-making needs to be systematised to support decisions, making a synthesis of the different sources of existing information systems.