Strengthening district-based health reporting through the district health management information software system: the Ugandan experience.

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Abstract

Untimely, incomplete and inaccurate data are common challenges in planning, monitoring and evaluation of health sector performance, and health service delivery in many sub-Saharan African settings. We document Uganda's experience in strengthening routine health data reporting through the roll-out of the District Health Management Information Software System version 2 (DHIS2).

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Design and implementation of a health management information system in Malawi: issues, innovations and results.

Ferdinand M Khunga, Jaap Koot, Thokozani C Sambakunsi … (2005)

As in many developing countries, lack of reliable data and grossly inadequate appreciation and use of available information in planning and management of health services were two main weaknesses of the health information systems in Malawi. Malawi began strengthening its health management information system with an analysis of the strengths and weaknesses of existing information systems, sharing findings with all stakeholders. All were agreed on the need for reformation of various, vertical programme-specific information systems into a comprehensive, integrated, decentralized and action-oriented simple system. As a first step towards conceptualization and design of the system, a minimum set of indicators was identified and a strategy was formulated for establishing a system in the country. The design focused only on the use of information in planning, management and the improvement of quality and coverage of services. All health and support personnel were trained, employing a training of trainers cascade approach. Information management and use was incorporated into the pre-service training curriculum and the job description of all health workers and support personnel. Quarterly feedback, supportive supervision visits and annual reviews were institutionalized. Civil society organizations were involved in monitoring coverage of health services at local levels. A mid-term review of the achievements of the health information system judged it to be one of the best in Africa. For the first time in Malawi, the health sector has information by facility by month. Yet very little improvement has been noted in use of information in rationalizing decisions. The conclusion is that, no matter how good the design of an information system, it will not be effective unless there is internal desire, dedication and commitment of leadership to have an effective and efficient health service management system.

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Assessing the quality of data aggregated by antiretroviral treatment clinics in Malawi

Simon Makombe, Mindy Hochgesang, Andreas Jahn … (2008)

PROBLEM: As national antiretroviral treatment (ART) programmes scale-up, it is essential that information is complete, timely and accurate for site monitoring and national planning. The accuracy and completeness of reports independently compiled by ART facilities, however, is often not known. APPROACH: This study assessed the quality of quarterly aggregate summary data for April to June 2006 compiled and reported by ART facilities ("site report") as compared to the "gold standard" facility summary data compiled independently by the Ministry of Health supervision team ("supervision report"). Completeness and accuracy of key case registration and outcome variables were compared. Data were considered inaccurate if variables from the site reports were missing or differed by more than 5% from the supervision reports. Additionally, we compared the national summaries obtained from the two data sources. LOCAL SETTING: Monitoring and evaluation of Malawi's national ART programme is based on WHO's recommended tools for ART monitoring. It includes one master card for each ART patient and one patient register at each ART facility. Each quarter, sites complete cumulative cohort analyses and teams from the Ministry of Health conduct supervisory visits to all public sector ART sites to ensure the quality of reported data. RELEVANT CHANGES: Most sites had complete case registration and outcome data; however many sites did not report accurate data for several critical data fields, including reason for starting, outcome and regimen. The national summary using the site reports resulted in a 12% undercount in the national total number of persons on first-line treatment. Several facility-level characteristics were associated with data quality. LESSONS LEARNED: While many sites are able to generate complete data summaries, the accuracy of facility reports is not yet adequate for national monitoring. The Ministry of Health and its partners should continue to identify and support interventions such as supportive supervision to build sites' capacity to maintain and compile quality data to ensure that accurate information is available for site monitoring and national planning.

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Author and article information

Journal

Journal ID (iso-abbrev): BMC Med Inform Decis Mak

Title: BMC medical informatics and decision making

Publisher: Springer Science and Business Media LLC

ISSN (Electronic): 1472-6947

ISSN (Print): 1472-6947

Publication date (Electronic): May 13 2014

Volume: 14

Affiliations

[1 ] Makerere University School of Public Health-U,S, Centers for Diseases Control and Prevention (MakSPH-CDC) Fellowship Program, P,O, Box 7072 Kampala, Uganda. vmicheal@yahoo.com.

Article

Publisher Item ID: 1472-6947-14-40

DOI: 10.1186/1472-6947-14-40

PMC ID: 4030005

PubMed ID: 24886567

SO-VID: 18260af7-ebee-4453-8375-d8d6320aa85f

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