Article Text
Abstract
Health facility data are a critical source of local and continuous health statistics. Countries have introduced web-based information systems that facilitate data management, analysis, use and visualisation of health facility data. Working with teams of Ministry of Health and country public health institutions analysts from 14 countries in Eastern and Southern Africa, we explored data quality using national-level and subnational-level (mostly district) data for the period 2013–2017. The focus was on endline analysis where reported health facility and other data are compiled, assessed and adjusted for data quality, primarily to inform planning and assessments of progress and performance. The analyses showed that although completeness of reporting was generally high, there were persistent data quality issues that were common across the 14 countries, especially at the subnational level. These included the presence of extreme outliers, lack of consistency of the reported data over time and between indicators (such as vaccination and antenatal care), and challenges related to projected target populations, which are used as denominators in the computation of coverage statistics. Continuous efforts to improve recording and reporting of events by health facilities, systematic examination and reporting of data quality issues, feedback and communication mechanisms between programme managers, care providers and data officers, and transparent corrections and adjustments will be critical to improve the quality of health statistics generated from health facility data.
- routine health information systems
- data quality assessment
- DHIS2
- Eastern and Southern Africa
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Footnotes
Handling editor Seye Abimbola
Collaborators This paper was based on the country work and analyses in conjunction with a workshop conducted in Naivasha, Kenya, 27–30 November 2018. The Countdown to 2030 collaboration for Eastern and Southern Africa is led by African Population and Health Research Centre and involves academic institutions (Johns Hopkins University, University of Manitoba), the WHO and the UNICEF, and included participation from 14 countries in the subregion. Eswatini, Ethiopia and South Africa also participated in the project but were not able to compile the required data sets for the analysis in time. The following participants worked on data preparation and analyses in the workshop:
Botswana: Mooketsi M. Molefi (University of Botswana), Judith Letebele (Ministry of Health), Balekane Sitibi (Ministry of Health); Burundi: Jean Marie Ntibazomumpa (Ministry of Health), Joël Nibogora (Ministry of Health), Prosper Niyongabo (National Institute of Public Health for Research and Training); Eritrea: Amanuel Kifle (Ministry of Health); Eswatini: Sibusiso Charles Mamba (Ministry of Health); Ethiopia: Wubegzier Mekonnen Ayele (Addis Ababa University); DR Congo: Espoir Bwenge Malembaka (Ecole Régionale de Santé Publique, Université Catholique de Bukavu, Bukavu), Robert Banywesize (South Kivu Provincial Health Division, Bukavu); Kenya: Anne Khasakhala (University of Nairobi), Anthony Ngugi (Aga Khan University), Helen Kiarie (Ministry of Health), Valeria Makory (Ministry of Health), Leonard Cosmas (WHO); Lesotho: Lebohang Rantsatsi (Ministry of Health); Malawi: Simeon Yosefe (Ministry of Health), Golden Chanansi (Ministry of Health), Kondwani Chavula (Save the children), Monica Patricia Malata (University of Malawi); Mozambique: Gerito Augusto (Instituto Superior De Ciencias De Saude (ISCISA), Cesarino Tivane (Ministry of Health), Catarina Barrula (Ministry of Health), Cláudio Muianga (WHO); Namibia: Ezekiel Muyenga KAMBONGI Ministry of Health), Matheus Shiindi Ministry of Health); Rwanda: Pacifique Mukashema (Ministry of Health), Ntawuyirusha Emmanuel (Ministry of Health); South Africa: Innocent Maposa (Wits School of Public Health), Mamothena Carol Mothupi (University of the Western Cape); South Sudan: Augustino Ting Mayai (The University of Juba/Sudd Institute), Victor Misaka (Ministry of Health), Edward Ladu (Ministry of Health); Tanzania: Josephine Shabani (Ifakara Health Institute), Dhamira Mongi (Ministry of Health), Prisca Jackson (Ministry of Health), David Edward Lenga (Ministry of Health), Daudi Simba (Muhimbili University of Health and Allied Sciences); Uganda: Geraldine Agiraembabazi (Makerere University), Paul Mubiri (Makerere University), Jimmy Ogwal (Ministry of Health), Stephen Akena Bwoye (Ministry of Health); Zambia: Elizabeth Mwauluka (Ministry of Health), Mbonyiwe Jojo (Ministry of Health), Choolwe Jacobs (University of Zambia, School of Public Health); Zimbabwe: Rugare Abigail Kangwende (Ministry of Health), Lloyd Machacha (Ministry of Health), Vasco Chikwasha (University of Zimbabwe).
Contributors AM and TB conceptualised the study and the methodology. TB wrote the first draft and AM was involved in drafting the manuscript and for data analysis. SSJ, MKKM, TAP, CMT, GA, DYM, CD, KLS, CMF, KV, KPO, AA and BSP contributed to the overall conceptualisation, provided guidance on the methodology and critical review on the manuscript. The staff from institutions involved in the Countdown to 2030 collaboration for Eastern and Southern Africa contributed in data preparation and analysis. All the authors have been involved in editing the paper, read and approved the final version.
Funding The analysis workshop and interaction with countries were funded by the WHO through a grant from NORAD and the Countdown to 2030 for Women’s, Children’s and Adolescents’ Health through a grant from the Bill and Melinda Gates foundation (OPP1148933).
Disclaimer This paper expresses the views of the authors and does not necessarily represent the official views of their respective institutions. The funders have no involvement in the study design, implementation or decision to submit the paper for publication.
Competing interests None declared.
Patient consent for publication Not required.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.