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Akeju D, Ziegler F, Dandadzi A, Nabirye E, Namisango E, Namukwaya E, Adejoh SO, Okunade K, Fu Y, Ebenso B, Nkhoma K, Allsop M. The use of and need for data and information by health professionals supporting the delivery of palliative cancer care services in sub-Saharan Africa: A qualitative study. Health Informatics J 2022; 28:14604582221139054. [PMID: 36515494 DOI: 10.1177/14604582221139054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
PURPOSE The ability to develop and evaluate approaches to the management of advanced cancer in sub-Saharan Africa is limited by the lack of local, reliable and valid data to ensure that practice is evidence-based, replicable and reflects the needs of the population served. METHODS A secondary qualitative analysis of in-depth interviews with 59 health professionals delivering palliative cancer care in Nigeria, Uganda and Zimbabwe were conducted to determine the use and needs for data and information for patient care and service delivery. Framework analysis was used, informed by a conceptual model for data use in low and middle-income countries. RESULTS Three meta-themes include: (1) Current practice in data gathering and use; (2) Gaps for capturing, storing information and supporting communication, and; (3) Needs and opportunities for data use. Deficits in current data access and use were identified, alongside targets for improving the quality, accessibility and utility of data to inform the development of palliative cancer care. CONCLUSIONS The availability and use of relevant and reliable data relating to the current provision of palliative cancer care are requisite for the contextually appropriate and effective development of health services. The requirements and constraints articulated by participants can guide future development and optimisation of digital health approaches for palliative cancer care in the participating countries, with relevance to the wider sub-Saharan Africa region.
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Affiliation(s)
- David Akeju
- Department of Sociology, 70670University of Lagos, Nigeria
| | | | - Adlight Dandadzi
- Clinical Trials Research Centre, 108329University of Zimbabwe, Harare, Zimbabwe
| | - Elizabeth Nabirye
- Department of Internal Medicine, 58588Makerere University, Kampala, Uganda
| | - Eve Namisango
- 108118African Palliative Care Association, Kampala, Uganda
| | | | - Samuel O Adejoh
- Department of Social Work, 70670University of Lagos, Nigeria
| | | | - Yu Fu
- Population Health Sciences Institute, 5994Newcastle University, UK
| | - Bassey Ebenso
- Nuffield Centre for International Health and Development, 4468University of Leeds, UK
| | - Kennedy Nkhoma
- Florence Nightingale Faculty of Nursing Midwifery and Palliative Care, Cicely Saunders Institute, 4616King's College London, London, UK
| | - Matthew Allsop
- Academic Unit of Palliative Care, Leeds Institute of Health Sciences, 4468University of Leeds, UK
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Lundin R, Mariani I, Peven K, Day LT, Lazzerini M. Quality of routine health facility data used for newborn indicators in low- and middle-income countries: A systematic review. J Glob Health 2022. [PMCID: PMC9031513 DOI: 10.7189/jogh.12.04019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Background High-quality data are fundamental for effective monitoring of newborn morbidity and mortality, particularly in high burden low- and middle-income countries (LMIC). Methods We conducted a systematic review on the quality of routine health facility data used for newborn indicators in LMIC, including measures employed. Five databases were searched from inception to February 2021 for relevant observational studies (excluding case-control studies, case series, and case reports) and baseline or control group data from interventional studies, with no language limits. An adapted version (19-point scale) of the Critical Appraisal Tool to assess the Quality of Cross-Sectional Studies (AXIS) was used to assess methodological quality, and results were synthesized using descriptive analysis. Results From the 19 572 records retrieved, 34 studies in 16 LMIC countries were included. Methodological quality was high (>14/19) in 32 studies and moderate (10-14/19) in two. Studies were mostly from African (n = 30, 88.2%) and South-East Asian (n = 24, 70.6%) World Health Organization (WHO) regions, with very few from Eastern Mediterranean (n = 2, 5.9%) and Western Pacific (n = 1, 2.9%) ones. We found that only data elements used to calculate neonatal indicators had been assessed, not the indicators themselves. 41 data elements were assessed, most frequently birth outcome. 20 measures of data quality were used, most along three dimensions: 1) completeness and timeliness, 2) internal consistency, and 3) external consistency. Data completeness was very heterogeneous across 26 studies, ranging from 0%-100% in routine facility registers, 0%-100% in patient case notes, and 20%-68% in aggregate reports. One study reported on the timeliness of aggregate reports. Internal consistency ranged from 0% to 96.2% in four studies. External consistency (21 studies) varied widely in measurement and findings, with specificity (6.4%-100%), sensitivity (23.6%-97.6%), and percent agreement (24.6%-99.4%) most frequently reported. Conclusions This systematic review highlights a gap in the published literature on the quality of routine LMIC health facility data for newborn indicators. Robust evidence is crucial in driving data quality initiatives at national and international levels. The findings of this review indicate that good quality data collection is achievable even in high-burden LMIC settings, but more efforts are needed to ensure uniformly high data quality for neonatal indicators.
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Affiliation(s)
- Rebecca Lundin
- Institute for Maternal and Child Health – IRCCS “Burlo Garofolo” – WHO Collaborating Centre for Maternal and Child Health, Trieste, Italy
| | - Ilaria Mariani
- Institute for Maternal and Child Health – IRCCS “Burlo Garofolo” – WHO Collaborating Centre for Maternal and Child Health, Trieste, Italy
| | - Kimberly Peven
- London School of Hygiene & Tropical Medicine, London, UK
| | - Louise T Day
- London School of Hygiene & Tropical Medicine, London, UK
| | - Marzia Lazzerini
- Institute for Maternal and Child Health – IRCCS “Burlo Garofolo” – WHO Collaborating Centre for Maternal and Child Health, Trieste, Italy
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Saigí-Rubió F, Pereyra-Rodríguez JJ, Torrent-Sellens J, Eguia H, Azzopardi-Muscat N, Novillo-Ortiz D. Routine Health Information Systems in the European Context: A Systematic Review of Systematic Reviews. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4622. [PMID: 33925384 PMCID: PMC8123776 DOI: 10.3390/ijerph18094622] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 04/20/2021] [Accepted: 04/22/2021] [Indexed: 11/20/2022]
Abstract
(1) Background: The aim of this study is to provide a better understanding of the requirements to improve routine health information systems (RHISs) for the management of health systems, including the identification of best practices, opportunities, and challenges in the 53 countries and territories of the WHO European region. (2) Methods: We conducted an overview of systematics reviews and searched the literature in the databases MEDLINE/PubMed, Cochrane, EMBASE, and Web of Science electronic databases. After a meticulous screening, we identified 20 that met the inclusion criteria, and RHIS evaluation results were presented according to the Performance of Routine Information System Management (PRISM) framework. (3) Results: The reviews were published between 2007 and 2020, focusing on the use of different systems or technologies and aimed to analyze interventions on professionals, centers, or patients' outcomes. All reviews examined showed variability in results in accordance with the variability of interventions and target populations. We have found different areas for improvement for RHISs according to the three determinants of the PRISM framework that influence the configuration of RHISs: technical, organizational, or behavioral elements. (4) Conclusions: RHIS interventions in the European region are promising. However, new global and international strategies and the development of tools and mechanisms should be promoted to highly integrate platforms among European countries.
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Affiliation(s)
- Francesc Saigí-Rubió
- Faculty of Health Sciences, Universitat Oberta de Catalunya (UOC), 08018 Barcelona, Spain; (F.S.-R.); (H.E.)
- Interdisciplinary Research Group on ICTs, 08035 Barcelona, Spain;
| | | | - Joan Torrent-Sellens
- Interdisciplinary Research Group on ICTs, 08035 Barcelona, Spain;
- Faculty of Economics and Business, Universitat Oberta de Catalunya (UOC), 08035 Barcelona, Spain
| | - Hans Eguia
- Faculty of Health Sciences, Universitat Oberta de Catalunya (UOC), 08018 Barcelona, Spain; (F.S.-R.); (H.E.)
- SEMERGEN New Technologies Working Group, 28009 Madrid, Spain
| | - Natasha Azzopardi-Muscat
- Division of Country Health Policies and Systems, Regional Office for Europe, World Health Organization, 2100 Copenhagen, Denmark;
| | - David Novillo-Ortiz
- Division of Country Health Policies and Systems, Regional Office for Europe, World Health Organization, 2100 Copenhagen, Denmark;
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Venkateswaran M, Mørkrid K, Abu Khader K, Awwad T, Friberg IK, Ghanem B, Hijaz T, Frøen JF. Comparing individual-level clinical data from antenatal records with routine health information systems indicators for antenatal care in the West Bank: A cross-sectional study. PLoS One 2018; 13:e0207813. [PMID: 30481201 PMCID: PMC6258527 DOI: 10.1371/journal.pone.0207813] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 11/05/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND In most low- and middle-income settings, national aggregate health data is the most consistently available source for policy-making and international comparisons. In the West Bank, the paper-based health information system with manual aggregations is transitioning to an individual-level data eRegistry for maternal and child health at the point-of-care. The aim of this study was to explore beforehand how routine health information systems indicators for antenatal care can change with the introduction of the eRegistry. METHODS Data were collected from clinical antenatal paper records of pregnancy enrollments for 2015 from 17 primary healthcare clinics, selected by probability sampling from five districts in the West Bank. We used the individual-level data from clinical records to generate routinely reported health systems indicators. We weighted the data to produce population-level estimates, and compared these indicators with aggregate routine health information systems reports. RESULTS Antenatal anemia screening at 36 weeks was 20% according to the clinical records data, compared to 52% in the routine reports. The clinical records data showed considerably higher incidences of key maternal conditions compared to the routine reports, including fundal height discrepancy (20% vs. 0.01%); Rh-negative blood group (6.8% vs. 1.4%); anemia with hemoglobin<9.5 g/dl (6% vs. 0.6%); and malpresentation at term (1.3% vs. 0.03%). Only about a sixth of cases with these conditions were referred according to guidelines to designated referral clinics. CONCLUSIONS Differences between indicators from the clinical records data and routine health information systems reports can be attributed to human error, inconsistent denominators, and complexities of data processes. Key health systems indicators were prone to underestimations since their registration was dependent on referral of pregnant women. With a transition to individual-level data, as in the eRegistry under implementation, the public health authorities will be able to generate reliable health systems indicators reflective of the population's health status.
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Affiliation(s)
- Mahima Venkateswaran
- Global Health Cluster, Division for Health Services, Norwegian Institute of Public Health, Oslo, Norway
- Centre for Intervention Science in Maternal and Child Health (CISMAC), University of Bergen, Bergen, Norway
| | - Kjersti Mørkrid
- Global Health Cluster, Division for Health Services, Norwegian Institute of Public Health, Oslo, Norway
| | - Khadija Abu Khader
- Palestinian National Institute of Public Health, World Health Organization, Ramallah, Palestine
| | - Tamara Awwad
- Palestinian National Institute of Public Health, World Health Organization, Ramallah, Palestine
| | - Ingrid K. Friberg
- Global Health Cluster, Division for Health Services, Norwegian Institute of Public Health, Oslo, Norway
| | - Buthaina Ghanem
- Palestinian National Institute of Public Health, World Health Organization, Ramallah, Palestine
| | | | - J. Frederik Frøen
- Global Health Cluster, Division for Health Services, Norwegian Institute of Public Health, Oslo, Norway
- Centre for Intervention Science in Maternal and Child Health (CISMAC), University of Bergen, Bergen, Norway
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Yugbaré Belemsaga D, Goujon A, Tougri H, Coulibaly A, Degomme O, Duysburgh E, Temmerman M, Kouanda S. Integration of maternal postpartum services in maternal and child health services in Kaya health district (Burkina Faso): an intervention time trend analysis. BMC Health Serv Res 2018; 18:298. [PMID: 29685138 PMCID: PMC5914017 DOI: 10.1186/s12913-018-3098-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Accepted: 04/05/2018] [Indexed: 11/17/2022] Open
Affiliation(s)
- Danielle Yugbaré Belemsaga
- Biomedical and Public Health Department, Institut de Recherche en Sciences de la Santé, 03 B.P 7192, Ouagadougou 03, Burkina Faso. .,Wittgenstein Centre for Demography and Global Human Capital (IIASA, VID/OAW, WU), Vienna, Austria.
| | - Anne Goujon
- Wittgenstein Centre for Demography and Global Human Capital (IIASA, VID/OAW, WU), Vienna, Austria
| | - Halima Tougri
- Biomedical and Public Health Department, Institut de Recherche en Sciences de la Santé, 03 B.P 7192, Ouagadougou 03, Burkina Faso
| | - Abou Coulibaly
- Biomedical and Public Health Department, Institut de Recherche en Sciences de la Santé, 03 B.P 7192, Ouagadougou 03, Burkina Faso
| | - Olivier Degomme
- International Centre for Reproductive Health, Faculty of Medicine and Health Sciences, Department of Uro-Gynaecology, Ghent University, Ghent, Belgium
| | - Els Duysburgh
- International Centre for Reproductive Health, Faculty of Medicine and Health Sciences, Department of Uro-Gynaecology, Ghent University, Ghent, Belgium
| | - Marleen Temmerman
- International Centre for Reproductive Health, Faculty of Medicine and Health Sciences, Department of Uro-Gynaecology, Ghent University, Ghent, Belgium.,Centre of Excellence in Women and Child Health, Aga Khan University, Nairobi, Kenya
| | - Seni Kouanda
- Biomedical and Public Health Department, Institut de Recherche en Sciences de la Santé, 03 B.P 7192, Ouagadougou 03, Burkina Faso.,African Institute of Public Health, Ouagadougou, Burkina Faso
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O'Hagan R, Marx MA, Finnegan KE, Naphini P, Ng'ambi K, Laija K, Wilson E, Park L, Wachepa S, Smith J, Gombwa L, Misomali A, Mleme T, Yosefe S. National Assessment of Data Quality and Associated Systems-Level Factors in Malawi. GLOBAL HEALTH: SCIENCE AND PRACTICE 2017; 5:367-381. [PMID: 28963173 PMCID: PMC5620335 DOI: 10.9745/ghsp-d-17-00177] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Accepted: 07/18/2017] [Indexed: 11/15/2022]
Abstract
BACKGROUND Routine health data can guide health systems improvements, but poor quality of these data hinders use. To address concerns about data quality in Malawi, the Ministry of Health and National Statistical Office conducted a data quality assessment (DQA) in July 2016 to identify systems-level factors that could be improved. METHODS We used 2-stage stratified random sampling methods to select health centers and hospitals under Ministry of Health auspices, included those managed by faith-based entities, for this DQA. Dispensaries, village clinics, police and military facilities, tertiary-level hospitals, and private facilities were excluded. We reviewed client registers and monthly reports to verify availability, completeness, and accuracy of data in 4 service areas: antenatal care (ANC), family planning, HIV testing and counseling, and acute respiratory infection (ARI). We also conducted interviews with facility and district personnel to assess health management information system (HMIS) functioning and systems-level factors that may be associated with data quality. We compared systems and quality factors by facility characteristics using 2-sample t tests with Welch's approximation, and calculated verification ratios comparing total entries in registers to totals from summarized reports. RESULTS We selected 16 hospitals (of 113 total in Malawi), 90 health centers (of 466), and 16 district health offices (of 28) in 16 of Malawi's 28 districts. Nearly all registers were available and complete in health centers and district hospitals, but data quality varied across service areas; median verification ratios comparing register and report totals at health centers ranged from 0.78 (interquartile range [IQR]: 0.25, 1.07) for ARI and 0.99 (IQR: 0.82, 1.36) for family planning to 1.00 (IQR: 0.96, 1.00) for HIV testing and counseling and 1.00 (IQR: 0.80, 1.23) for ANC. More than half (60%) of facilities reported receiving a documented supervisory visit for HMIS in the prior 6 months. A recent supervision visit was associated with better availability of data (P=.05), but regular district- or central-level supervision was not. Use of data by the facility to track performance toward targets was associated with both improved availability (P=.04) and completeness of data (P=.02). Half of facilities had a full-time statistical clerk, but their presence did not improve the availability or completeness of data (P=.39 and P=.69, respectively). CONCLUSION Findings indicate both strengths and weaknesses in Malawi's HMIS performance, with key weaknesses including infrequent data quality checks and unreliable supervision. Efforts to strengthen HMIS in low- and middle-income countries should be informed by similar assessments.
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Affiliation(s)
- Richael O'Hagan
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Melissa A Marx
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Karen E Finnegan
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Patrick Naphini
- Central Monitoring and Evaluation Division, Ministry of Health, Lilongwe, Malawi
| | | | | | - Emily Wilson
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Lois Park
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | | | | | - Amos Misomali
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Simeon Yosefe
- Central Monitoring and Evaluation Division, Ministry of Health, Lilongwe, Malawi
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