Strengthening routine health data analysis in Ethiopia: the Operational Research and Coaching for Analysts (ORCA) experience

Abstract

Many routine health information systems (RHIS) show persistent gaps between recording and reporting data and their effective use in solving problems. Strengthening RHIS has become a global priority to track and address national health goals. In Ethiopia, the Ministry of Health and Bill & Melinda Gates Foundation introduced the Operational Research and Coaching for Analysts (ORCA) capacity development project, co-designed with the London School of Hygiene & Tropical Medicine, which delivered training, coaching and mentoring support. We present the development, experiences, and perceptions of ORCA as a mechanism to enhance data quality, analysis, interpretation and use. ORCA integrated capacity development activities into national data analysts’ routine workload over a period of 2 years. Participating analysts were drawn from across the Ministry of Health directorates and two of its closely aligned agencies: the Ethiopian Public Health Institute and the Ethiopian Pharmaceutical Supply Agency. We used mixed methods (knowledge questionnaire, semi-structured interviews, programme records) to document the fidelity, feasibility, reach, and acceptability of ORCA and identify early signs of improved knowledge and changing institutional practices. Thirty-six participants completed the programme. Working in interdisciplinary groups on specific national health indicators, they received training workshops and support for study design, fieldwork, and analysis to build skills in assessing data quality and interpreting findings relevant to policy. Personal development grants and laptops provided incentives for sustained engagement. Participants appreciated ORCA’s applied and practical approach as well as good communication from administrators and clear links to national strategy. They also expressed frustration with delays, difficulties prioritising project work over routine responsibilities, and lack of formal accreditation. Knowledge and analytic skills increased and participants were able to integrate experiences from the project into their future work. Health system managers saw potential in longer-term improvements in data analysis and application to policy, although no clear changes were observed yet.

Routine Health Information Systems in the European Context: A Systematic Review of Systematic Reviews

“…In these, HISs have been used for much longer than in other nations of the world [ 61 ]. Nevertheless, RHISs continue to display a gap between recording, reporting, and the effective use of data; therefore, strengthening RHISs has become a global priority for tracking and addressing national health goals [ 62 ]. The operations of RHISs in low-income countries fall below the globally expected standard due to the production and use of poor quality data, or to not using high-quality data to make informed decisions [ 63 , 64 ].…”

“…RHIS data from the research and health policy community in Mozambique will help build sustainable long-term capabilities to manage and evaluate health conditions effectively [ 68 ]. In Ethiopia, the Ministry of Health and the Bill & Melinda Gates Foundation (Bill & Melinda Gates Foundation) launched “Operational Research and Coaching for Analysts” (ORCA) as a method for developing data collection and reporting [ 62 ].…”

Health information system concept in health services in the national health insurance (JKN) era in Indonesia: An environment and one health approach

“…Another article mentions the role of doctors have in implementing health information systems (HR) in health services by improving the quality of health information systems as an effort to improve health services ( 36 ). Health information technology is indeed not the only effort to complete an information system, but it needs other components such as timely, complete, and accurate data as well as support from organizations such as feedback on reports and so on ( 37 ). This all will certainly affect the quality of information system data ( 38 ).…”

Lessons Learned From the Capacity-Building and Mentorship Program to Improve Health Information Systems in 11 Districts of Ethiopia

“…Following the nationwide transition from a fragmented electronic health management information system (HMIS) to a unified, web-based District Health Information System 2 (DHIS2), intensive trainings were provided to health workers on HMIS indicator definition, data capturing, and reporting. 9 , 21 The deployment of a standardized electronic data aggregation and reporting system and accompanying capacity-building activities have facilitated observed improvements in reporting completeness. Other studies have also shown that data reporting improves after an electronic, web-based HMIS platform is introduced in-country.…”

“…These findings are consistent with previous studies’ observations of the limited data analysis, interpretation, and problem-solving skills among health workers and how this, in turn, hinders information use at the point of care. 17 , 21 , 28 This implies that capacity-building interventions are needed to improve the analytical skills of health workers and health facility managers. Integrating simple digital data analysis tools and dashboards as part of the CBMP intervention package, along with targeted skill development, would help address this gap.…”