Exploring data quality and use of the routine health information system in Ethiopia: a mixed-methods study

Objective A routine health information system (RHIS) enables decision making in the healthcare system. We aimed to analyse data quality at the district and regional level and explore factors and perceptions affecting the quality and use of routine data.Design This was a mixed-methods study. We used...

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Main Authors: Joanna Schellenberg, Della Berhanu, Lars Åke Persson, Misrak Getnet, Joanna Busza, Tsion Tsegaye, Kalkidan Mekete, Magdelawit Mengesha, Abyot Adane, Tewabe M Adege, Mesoud M Ahmed, Habtamu A Anteneh, Emiamrew S Ayalew, Netsanet Berhanu, Tesfahun Bishaw, Eshetu Cherinet, Mamo Dereje, Tsega H Desta, Abera Dibabe, Heven S Firew, Freweini Gebrehiwot, Etenesh Gebreyohannes, Zenebech Gella, Addis Girma, Zuriash Halefom, Sorsa F Jama, Annika Janson, Binyam Kemal, Abiy Kiflom, Yidnekachew D Mazengiya, Meresha W Nega, Israel A Otoro, Tefera Taddele, Gulilat Tefera, Admasu Teketel, Miraf Tesfaye, Kidist Woldesenbet, Yakob Wondarad, Zemzem M Yusuf, Kidist Zealiyas, Mebratom H Zeweli, Seblewengel Lemma
Format: Article
Language:English
Published: BMJ Publishing Group 2021-12-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/11/12/e050356.full
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author Joanna Schellenberg
Della Berhanu
Lars Åke Persson
Misrak Getnet
Joanna Busza
Tsion Tsegaye
Kalkidan Mekete
Magdelawit Mengesha
Abyot Adane
Tewabe M Adege
Mesoud M Ahmed
Habtamu A Anteneh
Emiamrew S Ayalew
Netsanet Berhanu
Tesfahun Bishaw
Eshetu Cherinet
Mamo Dereje
Tsega H Desta
Abera Dibabe
Heven S Firew
Freweini Gebrehiwot
Etenesh Gebreyohannes
Zenebech Gella
Addis Girma
Zuriash Halefom
Sorsa F Jama
Annika Janson
Binyam Kemal
Abiy Kiflom
Yidnekachew D Mazengiya
Meresha W Nega
Israel A Otoro
Tefera Taddele
Gulilat Tefera
Admasu Teketel
Miraf Tesfaye
Kidist Woldesenbet
Yakob Wondarad
Zemzem M Yusuf
Kidist Zealiyas
Mebratom H Zeweli
Seblewengel Lemma
author_facet Joanna Schellenberg
Della Berhanu
Lars Åke Persson
Misrak Getnet
Joanna Busza
Tsion Tsegaye
Kalkidan Mekete
Magdelawit Mengesha
Abyot Adane
Tewabe M Adege
Mesoud M Ahmed
Habtamu A Anteneh
Emiamrew S Ayalew
Netsanet Berhanu
Tesfahun Bishaw
Eshetu Cherinet
Mamo Dereje
Tsega H Desta
Abera Dibabe
Heven S Firew
Freweini Gebrehiwot
Etenesh Gebreyohannes
Zenebech Gella
Addis Girma
Zuriash Halefom
Sorsa F Jama
Annika Janson
Binyam Kemal
Abiy Kiflom
Yidnekachew D Mazengiya
Meresha W Nega
Israel A Otoro
Tefera Taddele
Gulilat Tefera
Admasu Teketel
Miraf Tesfaye
Kidist Woldesenbet
Yakob Wondarad
Zemzem M Yusuf
Kidist Zealiyas
Mebratom H Zeweli
Seblewengel Lemma
author_sort Joanna Schellenberg
collection DOAJ
description Objective A routine health information system (RHIS) enables decision making in the healthcare system. We aimed to analyse data quality at the district and regional level and explore factors and perceptions affecting the quality and use of routine data.Design This was a mixed-methods study. We used the WHO toolkit for analysing data quality and interviewed staff at the point of data generation and along with the flow of data. Data were analysed using the Performance of Routine Information System Management framework.Setting This study was performed in eight districts in four regions of Ethiopia. The study was nested within a 2-year programme of the Operational Research and Coaching for government Analysts.Participants We visited 45 health posts, 1 district hospital, 16 health centres and 8 district offices for analysis of routine RHIS data and interviewed 117 staff members for the qualitative assessment.Outcome measures We assessed availability of source documents, completeness, timeliness and accuracy of reporting of routine data, and explored data quality and use perceptions.Results There was variable quality of both indicator and data element. Data on maternal health and immunisation were of higher quality than data on child nutrition. Issues ranged from simple organisational factors, such as availability of register books, to intricate technical issues, like complexity of indicators and choice of denominators based on population estimates. Respondents showed knowledge of the reporting procedures, but also demonstrated limited skills, lack of supportive supervision and reporting to please the next level. We saw limited examples of the use of data by the staff who were responsible for data reporting.Conclusion We identified important organisational, technical, behavioural and process factors that need further attention to improve the quality and use of RHIS data in Ethiopia.
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spelling doaj-art-518d69affabb40a38fb19010364ac8c12024-12-10T02:50:10ZengBMJ Publishing GroupBMJ Open2044-60552021-12-01111210.1136/bmjopen-2021-050356Exploring data quality and use of the routine health information system in Ethiopia: a mixed-methods studyJoanna Schellenberg0Della Berhanu1Lars Åke Persson2Misrak Getnet3Joanna Busza4Tsion Tsegaye5Kalkidan Mekete6Magdelawit Mengesha7Abyot Adane8Tewabe M Adege9Mesoud M Ahmed10Habtamu A Anteneh11Emiamrew S Ayalew12Netsanet Berhanu13Tesfahun Bishaw14Eshetu Cherinet15Mamo Dereje16Tsega H Desta17Abera Dibabe18Heven S Firew19Freweini Gebrehiwot20Etenesh Gebreyohannes21Zenebech Gella22Addis Girma23Zuriash Halefom24Sorsa F Jama25Annika Janson26Binyam Kemal27Abiy Kiflom28Yidnekachew D Mazengiya29Meresha W Nega30Israel A Otoro31Tefera Taddele32Gulilat Tefera33Admasu Teketel34Miraf Tesfaye35Kidist Woldesenbet36Yakob Wondarad37Zemzem M Yusuf38Kidist Zealiyas39Mebratom H Zeweli40Seblewengel Lemma4117 Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UKLondon School of Hygiene and Tropical Medicine, Faculty of Infectious and Tropical Diseases, London, UKLondon School of Hygiene & Tropical Medicine, London, UKHealth Systems Directorate, Ethiopian Public Health Institute, Addis Ababa, EthiopiaCentre for Evaluation, London School of Hygiene & Tropical Medicine, London, UKEthiopian Procurement and Supply Agency, Addis Ababa, Ethiopia6College of Medicine and Health Sciences, Hawassa University, EthiopiaMaternal and Child Health Directorate, Federal Ministry of Health, Addis Ababa, EthiopiaEthiopian Pharmaceutical Supply Agency, Addis Ababa, EthiopiaEthiopia Ministry of Health, Addis Ababa, EthiopiaEthiopia Ministry of Health, Addis Ababa, EthiopiaEthiopia Ministry of Health, Addis Ababa, EthiopiaEthiopia Ministry of Health, Addis Ababa, EthiopiaEthiopia Ministry of Health, Addis Ababa, EthiopiaEthiopia Ministry of Health, Addis Ababa, EthiopiaEthiopia Ministry of Health, Addis Ababa, EthiopiaEthiopia Ministry of Health, Addis Ababa, EthiopiaEthiopia Ministry of Health, Addis Ababa, EthiopiaEthiopia Ministry of Health, Addis Ababa, EthiopiaEthiopian Public Health Institute, Addis Ababa, EthiopiaEthiopian Public Health Institute, Addis Ababa, EthiopiaEthiopia Ministry of Health, Addis Ababa, EthiopiaEthiopia Ministry of Health, Addis Ababa, EthiopiaEthiopia Ministry of Health, Addis Ababa, EthiopiaEthiopia Ministry of Health, Addis Ababa, EthiopiaEthiopia Ministry of Health, Addis Ababa, EthiopiaLondon School of Hygiene & Tropical Medicine, London, UKEthiopia Ministry of Health, Addis Ababa, EthiopiaEthiopian Pharmaceutical Supply Agency, Addis Ababa, EthiopiaEthiopia Ministry of Health, Addis Ababa, EthiopiaEthiopia Ministry of Health, Addis Ababa, EthiopiaEthiopia Ministry of Health, Addis Ababa, EthiopiaEthiopian Public Health Institute, Addis Ababa, EthiopiaEthiopian Pharmaceutical Supply Agency, Addis Ababa, EthiopiaEthiopian Pharmaceutical Supply Agency, Addis Ababa, EthiopiaEthiopia Ministry of Health, Addis Ababa, EthiopiaEthiopia Ministry of Health, Addis Ababa, EthiopiaEthiopia Ministry of Health, Addis Ababa, EthiopiaEthiopia Ministry of Health, Addis Ababa, EthiopiaEthiopian Public Health Institute, Addis Ababa, EthiopiaEthiopia Ministry of Health, Addis Ababa, EthiopiaLondon School of Hygiene & Tropical Medicine, London, UKObjective A routine health information system (RHIS) enables decision making in the healthcare system. We aimed to analyse data quality at the district and regional level and explore factors and perceptions affecting the quality and use of routine data.Design This was a mixed-methods study. We used the WHO toolkit for analysing data quality and interviewed staff at the point of data generation and along with the flow of data. Data were analysed using the Performance of Routine Information System Management framework.Setting This study was performed in eight districts in four regions of Ethiopia. The study was nested within a 2-year programme of the Operational Research and Coaching for government Analysts.Participants We visited 45 health posts, 1 district hospital, 16 health centres and 8 district offices for analysis of routine RHIS data and interviewed 117 staff members for the qualitative assessment.Outcome measures We assessed availability of source documents, completeness, timeliness and accuracy of reporting of routine data, and explored data quality and use perceptions.Results There was variable quality of both indicator and data element. Data on maternal health and immunisation were of higher quality than data on child nutrition. Issues ranged from simple organisational factors, such as availability of register books, to intricate technical issues, like complexity of indicators and choice of denominators based on population estimates. Respondents showed knowledge of the reporting procedures, but also demonstrated limited skills, lack of supportive supervision and reporting to please the next level. We saw limited examples of the use of data by the staff who were responsible for data reporting.Conclusion We identified important organisational, technical, behavioural and process factors that need further attention to improve the quality and use of RHIS data in Ethiopia.https://bmjopen.bmj.com/content/11/12/e050356.full
spellingShingle Joanna Schellenberg
Della Berhanu
Lars Åke Persson
Misrak Getnet
Joanna Busza
Tsion Tsegaye
Kalkidan Mekete
Magdelawit Mengesha
Abyot Adane
Tewabe M Adege
Mesoud M Ahmed
Habtamu A Anteneh
Emiamrew S Ayalew
Netsanet Berhanu
Tesfahun Bishaw
Eshetu Cherinet
Mamo Dereje
Tsega H Desta
Abera Dibabe
Heven S Firew
Freweini Gebrehiwot
Etenesh Gebreyohannes
Zenebech Gella
Addis Girma
Zuriash Halefom
Sorsa F Jama
Annika Janson
Binyam Kemal
Abiy Kiflom
Yidnekachew D Mazengiya
Meresha W Nega
Israel A Otoro
Tefera Taddele
Gulilat Tefera
Admasu Teketel
Miraf Tesfaye
Kidist Woldesenbet
Yakob Wondarad
Zemzem M Yusuf
Kidist Zealiyas
Mebratom H Zeweli
Seblewengel Lemma
Exploring data quality and use of the routine health information system in Ethiopia: a mixed-methods study
BMJ Open
title Exploring data quality and use of the routine health information system in Ethiopia: a mixed-methods study
title_full Exploring data quality and use of the routine health information system in Ethiopia: a mixed-methods study
title_fullStr Exploring data quality and use of the routine health information system in Ethiopia: a mixed-methods study
title_full_unstemmed Exploring data quality and use of the routine health information system in Ethiopia: a mixed-methods study
title_short Exploring data quality and use of the routine health information system in Ethiopia: a mixed-methods study
title_sort exploring data quality and use of the routine health information system in ethiopia a mixed methods study
url https://bmjopen.bmj.com/content/11/12/e050356.full
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