Improving quality and use of routine health information system data in low- and middle-income countries: A scoping review

Lemma, Seblewengel; Janson, Annika; Persson, Lars‐Åke; Wickremasinghe, Deepthi; Källestål, Carina

doi:10.1371/journal.pone.0239683

Cited by 57 publications

(66 citation statements)

References 56 publications

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“…However, many health facilities in Ethiopia lack the necessary infrastructure, such as reliable electricity. Although some structural data quality problems can be expected to improve with the increasing use of information technology, other issues may remain [8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Routine health management information system data in Ethiopia: consistency, trends, and challenges

Adane

Adege²,

Ahmed³

et al. 2021

Global Health Action

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Background : Ethiopia is investing in the routine Health Management Information System. Improved routine data are needed for decision-making in the health sector. Objective : To analyse the quality of the routine Health Management Information System data and triangulate with other sources, such as the Demographic and Health Surveys. Methods : We analysed national Health Management Information System data on 19 indicators of maternal health, neonatal survival, immunization, child nutrition, malaria, and tuberculosis over the 2012–2018 time period. The analyses were conducted by 38 analysts from the Ministry of Health, Ethiopia, and two government agencies who participated in the Operational Research and Coaching for Analysts (ORCA) project between June 2018 and June 2020. Using a World Health Organization Data Quality Review toolkit, we assessed indicator definitions, completeness, internal consistency over time and between related indicators, and external consistency compared with other data sources. Results : Several services reported coverage of above 100%. For many indicators, denominators were based on poor-quality population data estimates. Data on individual vaccinations had relatively good internal consistency. In contrast, there was low external consistency for data on fully vaccinated children, with the routine Health Management Information System showing 89% coverage but the Demographic and Health Survey estimate at 39%. Maternal health indicators displayed increasing coverage over time. Indicators on child nutrition, malaria, and tuberculosis were less consistent. Data on neonatal mortality were incomplete and operationalised as mortality on day 0–6. Our comparisons with survey and population projections indicated that one in eight early neonatal deaths were reported in the routine Health Management Information System. Data quality varied between regions. Conclusions : The quality of routine data gathered in the health system needs further attention. We suggest regular triangulation with data from other sources. We recommend addressing the denominator issues, reducing the complexity of indicators, and aligning indicators to international definitions.

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Section: Introductionmentioning

confidence: 99%

Routine health management information system data in Ethiopia: consistency, trends, and challenges

Adane

Adege²,

Ahmed³

et al. 2021

Global Health Action

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“…Supervision, coaching and provision of regular feedback are well-studied approaches that may help staff improve their competence in RHIS-related duties [ 45 – 47 ]. A recent scoping review focusing mostly on African countries and summarizing the literature on interventions for improving RHIS data quality and data use found that successes at the health facility-level often involved a combination of technological interventions that facilitate RHIS-related duties (e.g., electronic data collection and management systems) with feedback and the capacity building mechanisms (training, coaching and supervision) [ 48 ]. In Senegal, a study that evaluated facility-level supply chain management for health commodities using available routine data, suggested a link between supervision and improved performance [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

Key informant perspectives on the challenges and opportunities for using routine health data for decision-making in Senegal

Muhoza

Saleem

Faye

et al. 2021

BMC Health Serv Res

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Background Increasing the performance of routine health information systems (RHIS) is an important policy priority both globally and in Senegal. As RHIS data become increasingly important in driving decision-making in Senegal, it is imperative to understand the factors that determine their use. Methods Semi-structured interviews were conducted with 18 high- and mid-level key informants active in the malaria, tuberculosis and HIV programmatic areas in Senegal. Key informants were employed in the relevant divisions of the Senegal Ministry of Health or nongovernmental / civil society organizations. We asked respondents questions related to the flow, quality and use of RHIS data in their organizations. A framework approach was used to analyze the qualitative data. Results Although the respondents worked at the strategic levels of their respective organizations, they consistently indicated that data quality and data use issues began at the operational level of the health system before the data made its way to the central level. We classify the main identified barriers and facilitators to the use of routine data into six categories and attempt to describe their interrelated nature. We find that data quality is a central and direct determinant of RHIS data use. We report that a number of upstream factors in the Senegal context interact to influence the quality of routine data produced. We identify the sociopolitical, financial and system design determinants of RHIS data collection, dissemination and use. We also discuss the organizational and infrastructural factors that influence the use of RHIS data. Conclusions We recommend specific prescriptive actions with potential to improve RHIS performance in Senegal, the quality of the data produced and their use. These actions include addressing sociopolitical factors that often interrupt RHIS functioning in Senegal, supporting and motivating staff that maintain RHIS data systems as well as ensuring RHIS data completeness and representativeness. We argue for improved coordination between the various stakeholders in order to streamline RHIS data processes and improve transparency. Finally, we recommend the promotion of a sustained culture of data quality assessment and use.

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“…As the epidemiological transition progresses in sub-Sahara Africa (SSA), life lived with disease, especially non-communicable disease, is increasing [ 3 ]. To understand the most pressing health needs of populations, it is key to also have reliable, accurate and consistent local burden of disease data [ 4 ]. Particularly, as the risk of climate change-induced extreme weather events increases, health effects are projected to increase dramatically in the next decades, especially in SSA [ 5 – 8 ].…”

Section: Introductionmentioning

confidence: 99%

“…Despite efforts such as the HDSS, it has to be noted, that reliable primary data on health and its environmental and social determinants are still limited and underutilized [ 1 , 16 , 17 ]. Resultantly secondary data from health services are potentially biased, incomplete and of low quality/validity [ 4 ]. Notably, self-reported research has generated many insights, including the HDSS, verbal autopsy amongst others, which proved to be an effective way of filling data gaps [ 1 , 18 ].…”

Section: Introductionmentioning

confidence: 99%

Feasibility, acceptability and validation of wearable devices for climate change and health research in the low-resource contexts of Burkina Faso and Kenya: Study protocol

et al. 2021

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As the epidemiological transition progresses throughout sub-Saharan Africa, life lived with diseases is an increasingly important part of a population’s burden of disease. The burden of disease of climate-sensitive health outcomes is projected to increase considerably within the next decades. Objectively measured, reliable population health data is still limited and is primarily based on perceived illness from recall. Technological advances like non-invasive, consumer-grade wearable devices may play a vital role in alleviating this data gap and in obtaining insights on the disease burden in vulnerable populations, such as heat stress on human cardiovascular response. The overall goal of this study is to investigate whether consumer-grade wearable devices are an acceptable, feasible and valid means to generate data on the individual level in low-resource contexts. Three hundred individuals are recruited from the two study locations in the Nouna health and demographic surveillance system (HDSS), Burkina Faso, and the Siaya HDSS, Kenya. Participants complete a structured questionnaire that comprises question items on acceptability and feasibility under the supervision of trained data collectors. Validity will be evaluated by comparing consumer-grade wearable devices to research-grade devices. Furthermore, we will collect demographic data as well as the data generated by wearable devices. This study will provide insights into the usage of consumer-grade wearable devices to measure individual vital signs in low-resource contexts, such as Burkina Faso and Kenya. Vital signs comprising activity (steps), sleep (duration, quality) and heart rate (hr) are important measures to gain insights on individual behavior and activity patterns in low-resource contexts. These vital signs may be associated with weather variables—as we gather them from weather stations that we have setup as part of this study to cover the whole Nouna and Siaya HDSSs—in order to explore changes in behavior and other variables, such as activity, sleep, hr, during extreme weather events like heat stress exposure. Furthermore, wearable data could be linked to health outcomes and weather events. As a result, consumer-grade wearables may serve as a supporting technology for generating reliable measurements in low-resource contexts and investigating key links between weather occurrences and health outcomes. Thus, wearable devices may provide insights to better inform mitigation and adaptation interventions in these low-resource settings that are direly faced by climate change-induced changes, such as extreme weather events.

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Improving quality and use of routine health information system data in low- and middle-income countries: A scoping review

Cited by 57 publications

References 56 publications

Routine health management information system data in Ethiopia: consistency, trends, and challenges

Routine health management information system data in Ethiopia: consistency, trends, and challenges

Key informant perspectives on the challenges and opportunities for using routine health data for decision-making in Senegal

Feasibility, acceptability and validation of wearable devices for climate change and health research in the low-resource contexts of Burkina Faso and Kenya: Study protocol

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