The need to use routine health facility data for decision-making is stronger than ever, and advances in analytic methods have made the data easier to interpret, according to series of articles published this month in the BMC journal Health Services Research. Countdown to 2030 announced the journal supplement with a webinar on September 2, 2021.
“Health facility data analysis is a very critical part of country progress and performance monitoring and reviews, particularly at the local level, but also at the national level,” said Dr. Ties Boerma, who is the project director of Countdown to 2030. “But quality issues have really hampered the use of many data. So one really needs a systematic approach to data quality assessment, adjustment and analysis to help overcome some of these problems.”
The supplement is a culmination of work that began with four multi-country workshops organized by Countdown and the African Population and Health Research Center (APHRC) in 2018, then expanded to include more than 150 analysts and 40 countries, with collaboration from the World Health Organization (WHO), UNICEF and the West African Health Organization. It includes 10 papers and two commentaries and was edited by Dr. Agbessi Amouzo of Johns Hopkins University, Dr. Cheikh Faye of APHRC, Dr. Kaspar Wyss of the University of Basel and the Swiss Tropical and Public Health Institute, and Boerma.
During the webinar, Dr. Benson Droti from WHO AFRO said that African countries have seen tremendous improvements in data quality and completeness during the past decade and 43 out of 47 African countries are implementing DHIS2.
“The quality of the data should not limit us from using the data,” Droti said. “We should rather strengthen our skills to deal with the data quality problems, including adjusting the data for limited reporting by private facilities.”
Similarly, in his closing remarks, Cheikh Faye from APHRC said, “We have a lot of capacity in dealing with any other type of data … It is important to determine how to strengthen capacity in countries to be using these types of data.”
Dr. Theresa Diaz from WHO said, “COVID-19 really showed us the weakness of many countries’ health information systems.” The pandemic also created an urgency around the demand for information. However, key gaps remain in funding, leadership, local capacity, standards for analysis, and packaging the information for key action for health information systems in many countries.
Dr. Peter Waiswa from Makerere University agreed that COVID-19 had increased demand for and use of health facility data and gave examples from his current work in Uganda.
Dr. Peter Hansen from the Global Financing Facility said that both supply of and demand for routine health data have reached a tipping point as a result of the pandemic, with improved data quality and completeness and improved functionality of data systems.
“There are growing needs and demands for timely data for decision-making. I think it’s imperative on us to find ways to be responsive to that demand,” Hansen said. “We all know that decision-makers need to be able to make decisions in real time, in highly dynamic contexts, but the data and information that they have are anything but real time, often with very serious lags in them.”
Dr. Kaspar Wyss from the Swiss Centre for International Health noted that it is important to be aware of the reporting burdens being placed on frontline health workers, as described in one paper in the supplement. “The time a health worker uses for reporting is not here for health service delivery, so there are trade-offs.”
In a commentary in the supplement, Amouzou and co-authors wrote that strong data systems must be developed through country leadership and ownership, responsiveness to emerging needs, balancing the need for both routine health system data and population-based data.
For more information about this topic: