“Every day they keep adding new tools but they don’t take any away”: Producing indicators for intermittent preventive treatment for malaria in pregnancy (IPTp) from routine data in Kenya

et al. 2020

Preprint

Background: Accurate and high-quality data are important for improving program effectiveness and informing policy.In 2009 Bangladesh’s health management information system (HMIS) adopted the District Health Information Software, Version 2 (DHIS2) to capture real-time health service utilization data. However, routinely collected data are being underused because of poor data quality and reporting. We aimed to understand the facilitators and barriers to implementing DHIS2 as a way to retrieve meaningful and accurate data for reproductive, maternal, newborn, child, and adolescent health (RMNCAH) 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 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 technology among staff. Quality checks and feedback loops at multiple levels of data gathering points are helpful for minimizing data errors. Introducing a dashboard makes DHIS2 compatible to use as a monitoring tool. Barriers to effective DHIS2 implementation were lack of human resources, slow Internet connectivity, frequent changes to DHIS2 versions, and maintaining both manual and electronic system side-by-side. The data in DHIS2 remains incomplete because it does not capture data from private health facilities. Having two parallel HMIS 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 a responsive HMIS. 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.

Section: Discussionmentioning

confidence: 99%

Perceptions and experiences with district health information system software to collect and utilize health data in Bangladesh: A qualitative exploratory study

et al. 2020

Preprint

“…The importance of an automated system in DHIS2 has been mentioned by studies in Africa. They found that the automated reporting system could minimize reporting time and increase the completeness and accuracy of MNCH data in their contexts (28,29) .…”

Section: Discussionmentioning

confidence: 99%

“…This data availability allows the health system to address broader contextual factors like human resource shortages or stock outs, which can act as hindrances to achieving high-quality RMNCAH data. (15,29) .…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2020

Preprint

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.

“…The importance of automated system in the DHIS2 has been mentioned by the other African studies. According to those studies, the automated reporting system could minimize the reporting time and also increased the completeness and accuracy of MNCH data in their context (31,32) Although data accuracy and completeness remain an issue, users were encouraged to use DHIS2. To increase the use of DHIS2, MIS division of Bangladesh has started to announce and reward best performing district on annual basis.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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

et al. 2019

Preprint

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.