Health management information system (HMIS) data quality and associated factors in Massaguet district, Chad

Abstract Background Quality data from Health Management Information Systems (HMIS) are important for tracking the effectiveness of malaria control interventions. However, HMIS data in many resource-limited settings do not currently meet standards set by the World Health Organization (WHO). We aimed to assess HMIS data quality and associated factors in Chad. Methods A cross-sectional study was conducted in 14 health facilities in Massaguet district. Data on children under 15 years were obtained from the HMIS and from the external patient register covering the period January–December 2018. An additional questionnaire was administered to 16 health centre managers to collect data on contextual variables. Patient registry data were aggregated and compared with the HMIS database at district and health centre level. Completeness and accuracy indicators were calculated as per WHO guidelines. Multivariate logistic regressions were performed on the Verification Factor for attendance, suspected and confirmed malaria cases for three age groups (1 to < 12 months, 1 to < 5 years and 5 to < 15 years) to identify associations between health centre characteristics and data accuracy. Results Health centres achieved a high level of data completeness in HMIS. Malaria data were over-reported in HMIS for children aged under 15 years. There was an association between workload and higher odds of inaccuracy in reporting of attendance among children aged 1 to < 5 years (Odds ratio [OR]: 10.57, 95% CI 2.32–48.19) and 5– < 15 years (OR: 6.64, 95% CI 1.38–32.04). Similar association was found between workload and stock-outs in register books, and inaccuracy in reporting of malaria confirmed cases. Meanwhile, we found that presence of a health technician, and of dedicated staff for data management, were associated with lower inaccuracy in reporting of clinic attendance in children aged under five years. Conclusion Data completeness was high while the accuracy was low. Factors associated with data inaccuracy included high workload and the unavailability of required data collection tools. The results suggest that improvement in working conditions for clinic personnel may improve HMIS data quality. Upgrading from paper-based forms to a web-based HMIS may provide a solution for improving data accuracy and its utility for future evaluations of health interventions. Results from this study can inform the Ministry of Health and it partners on the precautions to be taken in the use of HMIS data and inform initiatives for improving its quality.

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Data Quality of the Routine Health Management Information System at the Primary Healthcare Facility and District Levels in Tanzania

10.21203/rs.3.rs-38381/v1 ◽

2020 ◽

Author(s):

SUSAN F. RUMISHA ◽

EMANUEL P. LYIMO ◽

IRENE R. MREMI ◽

PATRICK K. TUNGU ◽

VICTOR S. MWINGIRA ◽

...

Keyword(s):

Information System ◽

Data Quality ◽

Management Information System ◽

Health Management ◽

Health Centre ◽

Healthcare Facility ◽

Health Management Information System ◽

Management Information ◽

Service Areas

Abstract Background: Effective planning for disease prevention and control requiresaccurate, adequately-analysed, interpreted and communicated data. This study assessed the quality of routine Health Management Information System (HMIS) data at healthcare facility (HF) and district levels in Tanzania. Methods: HMIS tools used at primary health care facilities (dispensary, health centre, hospital) and district office were reviewed to assess their availability, completeness, and accuracy of collected data. The assessment involved seven health service areas namely, Outpatient department, Inpatient department, Antenatal care, Family Planning, Post-natal care, Labour and Delivery and Provider-initiated Testing and Counselling.Results: A total of 115 HFs in 11 districts were assessed. Registers (availability rate=91.1%; interquartile range (IQR):66.7%-100%) and reportforms (86.9%;IQR:62.2%-100%) were the most utilized tools. There was a limited use of tally-sheets (77.8%;IQR:35.6%-100%). Tools availability at dispensary was 91.1%, health-centre 82.2% and hospital 77.8%, and was poor in urban districts. The availability rate atthe district level was 65% (IQR:48%-75%). Reports were highly over-represented in comparison to registers’ records, with large differences observed at HF phase of the data journey and more profound in hospitals.Tool availability and data quality varied by service-areas, indicators, facility level, and districts, however, with a remarkable improvement over the years.Conclusion: There are high variations and improvements in the tool utilisation and data accuracy at facility and district levels. The routine HMIS is weak and data at district level inaccurately reflects what is available at the HFs. These results highlight the need to design tailored and inter-service strategies for improving data quality.

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Perceptions and experiences with District Health Information System software to collect and utilize health data in Bangladesh: A qualitative exploratory study

10.21203/rs.2.12293/v4 ◽

2020 ◽

Author(s):

Tahmina Begum ◽

Shaan Muberra Khan ◽

Bridgit Adamou ◽

Jannatul Ferdous ◽

Muhammad Masud Parvez ◽

...

Keyword(s):

Information System ◽

Data Quality ◽

Health Information ◽

Management Information System ◽

Program Effectiveness ◽

Health Management ◽

Quality Data ◽

Health Management Information System ◽

Management Information ◽

District Health

Abstract Background: Accurate and high-quality data are important for improving program effectiveness and informing policy. Bangladesh’s health management information system adopted the District Health Information Software, Version 2 (DHIS2) in 2009 to capture real-time health service utilization data. However, routinely collected data are being underused because of poor data quality. We aimed to understand the facilitators and barriers of implementing DHIS2 as a way to retrieve meaningful and accurate data for reproductive, maternal and child health (RMCAH) services. Methods: This qualitative study was conducted in two districts of Bangladesh from September 2017 to 2018. Data collection included key informant interviews (n=11), in-depth interviews (n=23), and focus group discussions (n=2). The study participants were individuals involved with DHIS2 implementation from the community level to the national level. The data were analyzed thematically.Results: DHIS2 could improve the timeliness and completeness of data reporting over time. The reported facilitating factors were strong government commitment, extensive donor support, and positive attitudes toward the technology among staffs. Quality checks and feedback loops at multiple levels of data gathering points were helpful to minimize data errors. Introducing a dashboard makes DHIS2 compatible to use as monitoring tool. However, the barriers to effective DHIS2 implementation were lack of human resources, slow Internet connectivity, frequent changes to of DHIS2 versions, and maintaining both manual and electronic system side-by-side. Data in DHIS2 remains incomplete because it does not capture data from private health facilities. Having two parallel management information systems reporting the same RMNCAH indicators threatens data quality and increases the reporting workload. Conclusion: The overall insights from this study are expected to contribute to the development of effective strategies for successful DHIS2 implementation and building responsive health management information system. Focused strategic direction is needed to sustain the achievements of digital data culture. Periodic refresher trainings, incentives for increased performance, and an automated single reporting system for multiple stakeholders could make the system more user-friendly. A national electronic health strategy and implementation framework can facilitate creating a culture of DHIS2 use for planning, setting priorities, and decision making among stakeholder groups.

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Perceptions and experiences with District Health Information System software to collect and utilize health data in Bangladesh: A qualitative exploratory study

10.21203/rs.2.12293/v3 ◽

2019 ◽

Author(s):

Tahmina Begum ◽

Shaan Muberra Khan ◽

Bridgit Adamou ◽

Jannatul Ferdous ◽

Muhammad Masud Parvez ◽

...

Keyword(s):

Information System ◽

Data Quality ◽

Health Information ◽

Management Information System ◽

Program Effectiveness ◽

Health Management ◽

Quality Data ◽

Health Management Information System ◽

Management Information ◽

District Health

Abstract Background: Accurate and high-quality data are important for improving program effectiveness and informing policy. Bangladesh’s health management information system adopted the District Health Information Software, Version 2 (DHIS2) in 2009 to capture real-time health service utilization data. However, routinely collected data are being underused because of poor data quality. We aimed to understand the facilitators and barriers of implementing DHIS2 as a way to retrieve meaningful and accurate data for reproductive, maternal and child health (RMCAH) services. Methods: This qualitative study was conducted in two districts of Bangladesh from September 2017 to 2018. Data collection included key informant interviews (n=11), in-depth interviews (n=23), and focus group discussions (n=2). The study participants were individuals involved with DHIS2 implementation from the community level to the national level. The data were analyzed thematically. Results: DHIS2 could improve the timeliness and completeness of data reporting over time. The reported facilitating factors were strong government commitment, extensive donor support, and positive attitudes toward the technology among staffs. Quality checks and feedback loops at multiple levels of data gathering points were helpful to minimize data errors. Introducing a dashboard makes DHIS2 compatible to use as monitoring tool. However, the barriers to effective DHIS2 implementation were lack of human resources, slow Internet connectivity, frequent changes to of DHIS2 versions, and maintaining both manual and electronic system side-by-side. Data in DHIS2 remains incomplete because it does not capture data from private health facilities. Having two parallel management information systems reporting the same RMNCAH indicators threatens data quality and increases the reporting workload. Conclusion: The overall insights from this study are expected to contribute to the development of effective strategies for successful DHIS2 implementation and building responsive health management information system. Focused strategic direction is needed to sustain the achievements of digital data culture. Periodic refresher trainings, incentives for increased performance, and an automated single reporting system for multiple stakeholders could make the system more user-friendly. A national electronic health strategy and implementation framework can facilitate creating a culture of DHIS2 use for planning, setting priorities, and decision making among stakeholder groups.

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Data quality of the routine health management information system at the primary healthcare facility and district levels in Tanzania

10.21203/rs.3.rs-31672/v1 ◽

2020 ◽

Author(s):

SUSAN F. RUMISHA ◽

EMANUEL P. LYIMO ◽

IRENE R. MREMI ◽

PATRICK K. TUNGU ◽

VICTOR S. MWINGIRA ◽

...

Keyword(s):

Information System ◽

Data Quality ◽

Management Information System ◽

Health Management ◽

Health Centre ◽

Healthcare Facility ◽

Health Management Information System ◽

Management Information ◽

Service Areas

Abstract Background Effective planning for disease prevention and control requires accurate, adequately-analysed, interpreted and communicated data. This study assessed the quality of routine Health Management Information System (HMIS) data at healthcare facility (HF) and district levels in Tanzania. Methods HMIS tools used at primary health care facilities (dispensary, health centre, hospital) and district office were reviewed to assess their availability, completeness, and accuracy of collected data. The assessment involved seven health service areas namely, Outpatient department, Inpatient department, Antenatal care, Family Planning, Post-natal care, Labour and Delivery and Provider-initiated Testing and Counselling. Results A total of 115 HFs in 11 districts were assessed. Registers (availability rate = 91.1%; interquartile range (IQR):66.7%-100%) and report forms (86.9%; IQR:62.2%-100%) were the most utilized tools. There was a limited use of tally-sheets (77.8%; IQR:35.6%-100%). Tools availability at dispensary was 91.1%, health-centre 82.2% and hospital 77.8%, and was poor in urban districts. The availability rate at the district level was 65% (IQR:48%-75%). Reports were highly over-represented in comparison to registers’ records, with large differences observed at HF phase of the data journey and more profound in hospitals. Tool availability and data quality varied by service-areas, indicators, facility level, and districts, however, with a remarkable improvement over the years. Conclusion There are high variations and improvements in the tool utilisation and data accuracy at facility and district levels. The routine HMIS is weak and data at district level inaccurately reflects what is available at the HFs. These results highlight the need to design tailored and inter-service strategies for improving data quality.

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Data quality of the routine health management information system at the primary healthcare facility and district levels in Tanzania

10.21203/rs.3.rs-38381/v3 ◽

2020 ◽

Author(s):

SUSAN F. RUMISHA ◽

EMANUEL P. LYIMO ◽

IRENE R. MREMI ◽

PATRICK K. TUNGU ◽

VICTOR S. MWINGIRA ◽

...

Keyword(s):

Data Quality ◽

Primary Healthcare ◽

Reporting System ◽

Health Management ◽

Healthcare Facility ◽

Data Accuracy ◽

District Level ◽

Management Information ◽

District Office

Abstract Background: Effective planning for disease prevention and control requires accurate, adequately-analysed, interpreted and communicated data. In recent years, efforts have been put in strengthening health management information systems (HMIS) in Sub-Saharan Africa to improve data accessibility to decision-makers. This study assessed the quality of routine HMIS data at primary healthcare facility (HF) and district levels in Tanzania. Methods: This cross-sectional study involved reviews of documents, systems and databases, and collection of primary data from facility registers, tally sheets and monthly summary reports. Thirty-four indicators from Outpatient, Inpatient, Antenatal care, Family Planning, Post-natal care, Labour and Delivery, and Provider-Initiated Testing and Counselling service areas were assessed. Indicator records were tracked and compared across the process of data collection, compilation and submission to the district office. Monthly report forms submitted by facilities to the district were also reviewed. The availability and utilization of HMIS tools were assessed, while completeness and data accuracy levels were quantified for each phase of the reporting system. Results: A total of 115 HFs (including hospitals, health centres, dispensaries) in 11 districts were involved. Registers (availability rate=91.1%; interquartile range (IQR):66.7%-100%) and report forms (86.9%; IQR:62.2%-100%) were the most utilized tools. There was a limited use of tally-sheets (77.8%; IQR:35.6%-100%). Tools availability at the dispensary was 91.1%, health centre 82.2% and hospital 77.8%. The availability rate at the district level was 65% (IQR:48%-75%). Wrongly filled or empty cells in registers and poor adherence to the coding procedures were observed. Reports were highly over-represented in comparison to registers’ records, with large differences observed at the HF phase of the reporting system. The OPD and IPD areas indicated the highest levels of mismatch between data source and district office. Indicators with large number of clients, multiple variables, disease categorization, or those linked with dispensing medicine performed poorly. Conclusion: There are high variations in the tool utilisation and data accuracy at facility and district levels. The routine HMIS is weak and data at district level inaccurately reflects what is available at the source. These results highlight the need to design tailored and inter-service strategies for improving data quality.

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Cash Transfers for Improved Maternal and Child Health Data: A Pilot Study Supporting Health Management Information System in Malawi

10.21203/rs.3.rs-728453/v1 ◽

2021 ◽

Author(s):

Mariame O. Ouedraogo ◽

Madalitso Tolani ◽

Janet Mambulasa ◽

Katie McLaughlin ◽

Diego G. Bassani ◽

...

Keyword(s):

Data Quality ◽

Management Information System ◽

Health Management ◽

Cash Transfers ◽

Health Management Information System ◽

Management Information ◽

Pilot Intervention ◽

And Child Health ◽

Mch Data

Abstract Background The health management information system (HMIS) is an integral component of a strong health care system. Despite its importance for decision-making, the quality of HMIS data remains of concern in low- and middle-income countries. To address challenges with the quality of maternal and child health (MCH) data gathered within Malawi's HMIS, we designed a pilot study consisting of performing regular cash transfers to district-level HMIS offices. We hypothesized that providing regular cash transfers to HMIS offices would empower staff to establish strategies and priorities based on local context, consequently obtaining and maintaining accurate, timely, and complete MCH data. Methods The pilot intervention was implemented in Mwanza district, while Chikwawa, Neno, and Ntchisi districts served as control sites. The intervention consisted of providing cash transfers to Mwanza's HMIS office following the submission of detailed budgets and lists of planned activities with their respective targets and outputs. In the control districts, we performed regular interviews with the HMIS officers to track the HMIS-related activities. We evaluated the intervention by comparing data quality between the post-intervention and pre-intervention periods in the intervention and control districts. Additionally, we conducted interviews with Mwanza's HMIS office staff to determine the acceptability and appropriateness of the intervention. Results Following the 10-month intervention period, we observed improvements in MCH data quality in the intervention district (Mwanza). The availability and completeness of MCH data collected in the registers increased by 22% and 18%, respectively. The consistency of MCH data between summary reports and electronic HMIS improved from 73–94%. The qualitative interviews confirmed that, despite some challenges, the intervention was well received by the participating HMIS office. Participants preferred our strategy to other conventional ways of supporting HMIS that fail to give HMIS offices the independence to make decisions. Conclusions This pilot intervention demonstrated an alternative approach to support HMIS offices in their daily efforts to improve data quality. Given the Ministry of Health (MoH)'s interest in strengthening its HMIS, our intervention provides a strategy that the MoH and local and international partners could consider to rapidly improve HMIS data with minimal oversight.

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Level of data quality from Health Management Information Systems in a resources limited setting and its associated factors, eastern Ethiopia

SA Journal of Information Management ◽

10.4102/sajim.v18i1.612 ◽

2016 ◽

Vol 18 (1) ◽

Cited By ~ 2

Author(s):

Kidist Teklegiorgis ◽

Kidane Tadesse ◽

Gebremeskel Mirutse ◽

Wondwossen Terefe

Keyword(s):

Information System ◽

Data Quality ◽

Health Management ◽

Health Facilities ◽

Health Management Information System ◽

Department Heads ◽

Management Information ◽

Cross Sectional ◽

Eastern Ethiopia ◽

Limited Setting

Background: A Health Information System (HIS) is a system that integrates data collection, processing, reporting, and use of the information necessary for improving health service effectiveness and efficiency through better management at all levels of health services. Despite the credible use of HIS for evidence-based decision-making, countries with the highest burden of ill health and the most in need of accurate and timely data have the weakest HIS in the vast majority of world’s poorest countries. Although a Health Management Information System (HMIS) forms a backbone for strong health systems, most developing countries still face a challenge in strengthening routine HIS. The main focus of this study was to assess the current HIS performance and identify factors affecting data quality in a resource-limited setting, such as Ethiopian health facilities.Methods: A cross-sectional study was conducted by using structured questionnaires in Dire Dawa Administration health facilities. All unit and/or department heads from all government health facilities were selected. The data was analysed using STATA version 11. Frequency and percentages were computed to present the descriptive findings. Association between variables was computed using binary logistic regression.Results: Over all data quality was found to be 75.3% in unit and/or departments. Trained staff to fill format, decision based on supervisor directives and department heads seek feedback were significantly associated with data quality and their magnitudes were (AOR = 2.253, 95% CI [1.082, 4.692]), (AOR = 2.131, 95% CI [1.073, 4.233]) and (AOR = 2.481, 95% CI [1.262, 4.876]), respectively.Conclusion: Overall data quality was found to be below the national expectation level. Low data quality was found at health posts compared to health centres and hospitals. There was also a shortage of assigned HIS personnel, separate HIS offices, and assigned budgets for HIS across all units and/or departments.

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