scholarly journals Producing routine malaria data: an exploration of the micro-practices and processes shaping routine malaria data quality in frontline health facilities in Kenya

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
George Okello ◽  
Sassy Molyneux ◽  
Scholastica Zakayo ◽  
Rene Gerrets ◽  
Caroline Jones

Abstract Background Routine health information systems can provide near real-time data for malaria programme management, monitoring and evaluation, and surveillance. There are widespread concerns about the quality of the malaria data generated through routine information systems in many low-income countries. However, there has been little careful examination of micro-level practices of data collection which are central to the production of routine malaria data. Methods Drawing on fieldwork conducted in two malaria endemic sub-counties in Kenya, this study examined the processes and practices that shape routine malaria data generation at frontline health facilities. The study employed ethnographic methods—including observations, records review, and interviews—over 18-months in four frontline health facilities and two sub-county health records offices. Data were analysed using a thematic analysis approach. Results Malaria data generation was influenced by a range of factors including human resource shortages, tool design, and stock-out of data collection tools. Most of the challenges encountered by health workers in routine malaria data generation had their roots in wider system issues and at the national level where the framing of indicators and development of data collection tools takes place. In response to these challenges, health workers adopted various coping mechanisms such as informal task shifting and use of improvised tools. While these initiatives sustained the data collection process, they also had considerable implications for the data recorded and led to discrepancies in data that were recorded in primary registers. These discrepancies were concealed in aggregated monthly reports that were subsequently entered into the District Health Information Software 2. Conclusion Challenges to routine malaria data generation at frontline health facilities are not malaria or health information systems specific; they reflect wider health system weaknesses. Any interventions seeking to improve routine malaria data generation must look beyond just malaria or health information system initiatives and include consideration of the broader contextual factors that shape malaria data generation.

Author(s):  
Louise Biddle ◽  
Kayvan Bozorgmehr ◽  
Rosa Jahn

Ensuring the health of migrants and access to appropriate health services presents a challenge to health systems in the age of global migration. Reliable and timely information is key to decision-making in all sectors of the health system to ensure that health system goals are met. Such information is even more important among a mobile, sometimes rapidly changing, dynamic and heterogeneous migrant population. While health information systems (HIS) are crucial for effective functioning of other health system blocks as well as for evidence-informed decision-making, they are often sidelined in health system policy and development. Looking across the World Health Organization (WHO) European Region, HIS for migrants are deficient both in their overall availability and their integration into regular monitoring structures. Less than half of the 53 member states routinely report health data for refugees and migrants. Most of the routinely collected data on migrant and refugee health can be identified in countries with strong population-based records, with some good practice examples of well-integrated and high-quality health monitoring surveys, disease-specific registries, and “parallel” HIS in migrant-specific settings. Overall, however, HIS in the WHO European Region are not able to provide data of sufficient quality and comparability to be well integrated into regular health monitoring structures. The reasons for this can be highlighted by five key barriers to improved information systems for migrant health: barriers in recording data, standardizing data collection, harmonizing migrant indicators, producing high-quality data, and sharing information. Better integration can be achieved through increased multilateral collaboration for the harmonization of indicators, strengthening of governance frameworks for data-sharing and protection measures, and the increased use of currently underutilized data collection mechanisms, including health monitoring surveys and medical records from refugee reception facilities. These steps will remain essential for the adequate planning and provision of needs-based care for refugees and migrants.


Author(s):  
Emily J See ◽  
Aminu K Bello ◽  
Adeera Levin ◽  
Meaghan Lunney ◽  
Mohamed A Osman ◽  
...  

Abstract Background Health information systems (HIS) are fundamental tools for the surveillance of health services, estimation of disease burden and prioritization of health resources. Several gaps in the availability of HIS for kidney disease were highlighted by the first iteration of the Global Kidney Health Atlas. Methods As part of its second iteration, the International Society of Nephrology conducted a cross-sectional global survey between July and October 2018 to explore the coverage and scope of HIS for kidney disease, with a focus on kidney replacement therapy (KRT). Results Out of a total of 182 invited countries, 154 countries responded to questions on HIS (85% response rate). KRT registries were available in almost all high-income countries, but few low-income countries, while registries for non-dialysis chronic kidney disease (CKD) or acute kidney injury (AKI) were rare. Registries in high-income countries tended to be national, in contrast to registries in low-income countries, which often operated at local or regional levels. Although cause of end-stage kidney disease, modality of KRT and source of kidney transplant donors were frequently reported, few countries collected data on patient-reported outcome measures and only half of low-income countries recorded process-based measures. Almost no countries had programs to detect AKI and practices to identify CKD-targeted individuals with diabetes, hypertension and cardiovascular disease, rather than members of high-risk ethnic groups. Conclusions These findings confirm significant heterogeneity in the global availability of HIS for kidney disease and highlight important gaps in their coverage and scope, especially in low-income countries and across the domains of AKI, non-dialysis CKD, patient-reported outcomes, process-based measures and quality indicators for KRT service delivery.


2021 ◽  
Author(s):  
Xavier Bosch-Capblanch ◽  
David O’Donnell ◽  
L Kendall Krause ◽  
Christian Auer ◽  
Angela Oyo-Ita ◽  
...  

Abstract BackgroundHealth Information Systems are crucial to provide data for decision-making and data demands are constantly growing. However, the link between data and decisions is not always rational nor linear and the management of data ends up overloading frontline health workers, who may have to compromise the health care. Despite limited evidence, there is an increasing push for the digitalisation of Health Information Systems, which faces enormous challenges, particularly in remote, rural settings in low- and middle-income countries. Paper-based tools will continue to be used and this warrants efforts to make them more responsive to local needs. Paper Health Information Systems (PHISICC) is a transdisciplinary, multi-country research initiative to create and test innovative paper-based Health Information Systems in three Sub-Saharan African countries.MethodsThe PHISICC initiative is taking place in remote, rural settings, in Côte d’Ivoire, Mozambique and Nigeria, through partnership with Ministries of Health and research institutions. We began with research syntheses to acquire the most up to date knowledge on Health Information Systems. These were coupled with field work in the three countries to understand the current design, patterns and contexts of use, and health care worker perspectives. Frontline health workers, with designers and researchers, used co-creation methods to produce the new PHISICC tools. This suite of tools is being tested in the three countries. Throughout the project, we have engaged with a wide range of stakeholders and have kept the highest scientific standards to keep it relevant to health policy in each of the three countries.DiscussionWe have deployed a comprehensive research approach to ensure the robustness and future policy uptake of the finding. Beyond the resulting paper-based tool design innovations, our process itself was innovative. Rather than emphasizing the data management compliance aspects we focused instead on frontline health workers’ decision-making; by tackling the whole scope of health care areas in Primary Health Care rather than incremental improvement to existing tools, we developed an entirely new design approach and language for a suite of tools in Primary Health Care. The initiative is being tested in remote, rural areas where the most vulnerable live.


2021 ◽  
Author(s):  
Xavier Bosch-Capblanch ◽  
David O'Donnell ◽  
L Kendall Krause ◽  
Christian Auer ◽  
Angela Oyo-Ita ◽  
...  

Abstract BackgroundHealth Information Systems (HIS) are crucial to provide data for decision-making and data demands are constantly growing. However, the link between data and decisions is not always rational nor linear and the management of data ends up overloading frontline health workers, who may have to compromise the health care. Despite limited evidence, there is an increasing push for HIS digitalisation, which faces enormous challenges, particularly in remote, rural settings in low- and middle-income countries. Paper-based tools will continue to be used and this warrants efforts to make them more responsive to local needs. Paper Health Information Systems (PHISICC) is a transdisciplinary, multi-country research initiative to create and test innovative paper-based HIS in three Sub-Saharan African countries.MethodsThe PHISICC initiative is taking place in remote, rural settings, in Côte d’Ivoire, Mozambique and Nigeria, through partnership with Ministries of Health and research institutions. We began with research syntheses to acquire the most up to date knowledge on HIS. These were coupled with field work in the three countries to understand the current design, patterns and contexts of use, and health care worker perspectives. Frontline health workers, with designers and researchers, used co-creation methods to produce the new PHISICC tools. This suite of tools is being tested in the three countries. Throughout the project we have engaged with a wide range of stakeholders and have kept the highest scientific standards to keep it relevant to health policy in each of the three countries.DiscussionWe have deployed a comprehensive research approach to ensure the robustness and future policy uptake of the finding. Beyond the resulting paper-based tool design innovations, our process itself was innovative. Rather than emphasizing the data management compliance aspects we focused instead on frontline health workers’ decision-making; by tackling the whole scope of health care areas in PHC rather than incremental improvement to existing tools, we developed an entirely new design approach and language for a suite of tools in Primary Health Care. The initiative is being tested in remote, rural areas where the most vulnerable live.


2009 ◽  
Vol 18 (1) ◽  
pp. 12-16 ◽  
Author(s):  
David M. Ndetei ◽  
Rachel Jenkins

AbstractThe aims are to examine the challenges and opportunities in the implementation of mental health information systems (MHIS) in developing countries as suggested by the World Health Organization (WHO) and explored by Gulbinat et al. (2008). Special recommendations for developing countries are: 1) MHIS should be linked to the general medical information system; 2) there is need for adoption, adaptation and validation of preferably self-administered instruments that are appropriate for different levels within the health care system; 3) developing countries must adopt innovative and “unconventional” approaches through utilization of community members, traditional doctors/healers and mid-cadre health workers, in addition to general doctors, for the delivery of mental health services.


2019 ◽  
Vol 26 (1) ◽  
pp. 664-682 ◽  
Author(s):  
Hong Chen ◽  
Ping Yu ◽  
David Hailey ◽  
Tingru Cui

This study identifies essential components in the data collection process for public health information systems based on appraisal and synthesis of the reported factors affecting this process in the literature. Extant process assessment instruments and studies of public health data collection from electronic databases and the relevant institutional websites were reviewed and analyzed following a five-stage framework. Four dimensions covering 12 factors and 149 indicators were identified. The first dimension, data collection management, includes data collection system and quality assurance. The second dimension, data collector, is described by staffing pattern, skill or competence, communication and attitude toward data collection. The third, information system, is assessed by function and technology support, integration of different data collection systems, and device. The fourth dimension, data collection environment, comprises training, leadership, and funding. With empirical testing and contextual analysis, these essential components can be further used to develop a framework for measuring the quality of the data collection process for public health information systems.


2018 ◽  
Author(s):  
Heru Santoso Wahito Nugroho

In the current global era, most health information systems have been implemented with the support of information and communication technology. This has an impact on the enforcement of dual duties for health professionals as health workers and as operators of health information systems. This 'new task addition' will lead to increased efforts to be able to operate the information system properly. For some health professionals, this will feel burdensome, which can ultimately lead to user resistance, either actively or passively. Both types of resistance must be given serious attention because it often leads to failure in the implementation of new information systems. If not properly anticipated, then this will grow worse. In order for this to be prevented, the effort that must be done by the organization is always to improve and maintain organizational support for the users.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
K Bozorgmehr ◽  
R Jahn ◽  
L Biddle ◽  
S Rohleder ◽  
S Puthopparambil

Abstract This presentation discusses the findings of a Health Evidence Network synthesis report on availability and integration of refugee and migrant health data in health information systems in the WHO European Region. Based on an analysis of 41 full-text studies and 696 abstracts, the report found that refugee and migrant health data were available in less than half of the Region's Member States, and that data availability and integration, data collection systems, as well as indicators on migration varied markedly between states. From these findings, the report derived key policy considerations regarding the strengthening and harmonization of migrant health data collection, as well as governance and monitoring of health information systems.


2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Xavier Bosch-Capblanch ◽  
David O’Donnell ◽  
L. Kendall Krause ◽  
Christian Auer ◽  
Angela Oyo-Ita ◽  
...  

Abstract Background Health information systems are crucial to provide data for decision-making and demand for data is constantly growing. However, the link between data and decisions is not always rational or linear and the management of data ends up overloading frontline health workers, which may compromise quality of healthcare delivery. Despite limited evidence, there is an increasing push for the digitalization of health information systems, which poses enormous challenges, particularly in remote, rural settings in low- and middle-income countries. Paper-based tools will continue to be used in combination with digital solutions and this calls for efforts to make them more responsive to local needs. Paper-based Health Information Systems in Comprehensive Care (PHISICC) is a transdisciplinary, multi-country research initiative to create and test innovative paper-based health information systems in three sub-Saharan African countries. Methods/Design The PHISICC initiative is being carried out in remote, rural settings in Côte d’Ivoire, Mozambique and Nigeria through partnership with ministries of health and research institutions. We began with research syntheses to acquire the most up-to-date knowledge on health information systems. These were coupled with fieldwork in the three countries to understand the current design, patterns and contexts of use, and healthcare worker perspectives. Frontline health workers, with designers and researchers, used co-creation methods to produce the new PHISICC tools. This suite of tools is being tested in the three countries in three cluster-randomized controlled trials. Throughout the project, we have engaged with a wide range of stakeholders and have maintained the highest scientific standards to ensure that results are relevant to the realities in the three countries. Discussion We have deployed a comprehensive research approach to ensure the robustness and future policy uptake of findings. Besides the innovative PHISICC paper-based tools, our process is in itself innovative. Rather than emphasizing the technical dimensions of data management, we focused instead on frontline health workers’ data use and decision-making. By tackling the whole scope of primary healthcare areas rather than a subset of them, we have developed an entirely new design and visual language for a suite of tools across healthcare areas. The initiative is being tested in remote, rural areas where the most vulnerable live.


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