The Countdown to 2030 Health Facility Data & Analysis Centre (DAC) is led by the African Population & Health Research Centre, in collaboration with the Institute for Global Public Health at the University of Manitoba and the Johns Hopkins University School of Public Health.

Monitoring the progress and performance of health services is a critical part of national plans and investment cases for women’s, children’s and adolescents’ health. The main activity of the Monitoring Health Services DAC is to analyze health facility routine data, including service provision and readiness in terms of health infrastructure, workforce and supplies. This involves the development and promotion of analytical methods and tools, technical advances and archiving of routine health facility data. In this webinar, the team presented an overview of existing methods.

Approach

Analysis of routine data generated through health facilities implies data quality assessment and transparent adjustments, estimation of target population sizes, analysis of coverage trends, use of summary measures, and assessment of districts’ performance.

The main source of data for the monitoring of health services is the routine health information system, which is managed by governments through ministries of health. All health facilities normally report on services such as outpatient visits, admissions, morbidity and mortality, births and immunizations. These data provide information on work volume and indirectly describe the epidemiological situation in the catchment populations. In most countries, such data are collected using a large number of registers and reporting forms, which are provided to district offices where the information is digitized. Many countries use the District Health Information System (DHIS2) to enter, compile, check and transmit the data to the national level. The routine health information system also includes information on health facilities such as numbers, type, and ownership, health workforce, medicines and commodities and other health system indicators.

Where feasible, the DAC will archive routine facility data and health system data from the Coutndown collaborating countries. If country agreement is obtained, the data will be in the public domain and accessible from an APHRC microdata portal. This may also include vital statistics data from birth and death registration systems, including the health and demographic surveillance systems in some collaborating countries.

Tools & Resources

Tools are available to:

  • compile data
  • check completeness and consistency
  • identifying extreme outliers,
  • correct the data. 

This article explains how to check data quality.

The following Stata do-files are are available to conduct the analysis:

The data quality check spreadsheet is available in an English version and a French version.

 

 

Stata code is available upon request for the analysis of health facility data, aimed at obtaining district, regional or provincial estimates of coverage of key indicators of reproductive, maternal, newborn and child health. Contact countdown@jhu.edu to request the code.

A two-part article series explains how to calculate the denominators for track indicators from Health Facility Data to assist in evaluating intervention coverage. Part 1 and Part 2 are available to read on our website. The French translations for part 1 and part 2 are also available.

The World Health Organization has developed guidance to support routine, annual and periodic independent assessments of facility-reported data with guidelines and tools. This includes a general guidance document that discusses key issues in the data quality assessment and analysis of mortality, morbidity, health service access, utilization and coverage, and health inputs for national and subnational planners and managers and a basic data quality review with three modules.

Health facility data from 12 African countries was analyzed to examined the impact of the Covid-19 pandemic on health services utilization, and the results were published in BMJ Global Health in 2022. Related resources include:

Webinars

This one-hour webinar reviews methodological issues around use of health facility and available tools to assist with using this data. Although this was an internal presentation for Countdown to 2030 consortium partners, it may be useful for other health evaluators who want to analyze health facility data from low and middle income countries.
Countdown to 2030 held this webinar was on Sept 2, 20201, to launch a journal supplement published in BMC Health Services Research.  
Cheikh Mbacké Faye
Sokhna Thiam
Martin Kavao Mutua
Moussa Bagayoko
Ties Boerma
Dessalegn Melesse
Agbessi Amouzou
Abdoulaye Maïga