29th March 2018
In many countries, the quality of data gathered at health facilities and capacity to analyse and use this data remains inadequate to support decision-making that will accelerate Universal Health Coverage. A number of partners, programmes and countries have been trying to address this problem through fragmented efforts such as single disease-focused facility surveys and parallel data systems. Now, HDC partners have come together to establish a harmonized approach to strengthening facility-based data quality, analysis and use.
This has resulted in the development of international standards for data collection at health facilities, including core indicators to guide collection of the most pertinent data, methods for ensuring data quality, and guidelines for analysing data. This package of standards includes programme-specific modules for collecting and analysing data on HIV, tuberculosis, malaria, immunization, and mortality and morbidity. Additional modules on maternal and child health, non-communicable diseases, neglected tropical diseases, nutrition, birth registration and surveillance are forthcoming.
This is the first time that data collection and analysis standards that are applicable across multiple health programmes have been developed. This will also enable cross-cutting analysis of data across programmes that are targeting overlapping patient populations. For example, as HIV patients are often also afflicted with tuberculosis, programme managers find it useful to analyse both sets of data together.
How can countries access these standards and guidelines? A growing number of countries are adopting web-based facility data reporting programs such as District Health Information System 2 (DHIS 2), to replace paper-based data collection. Using DHIS 2 as a common data platform, a “DHIS 2 health app” has been developed as a free downloadable plug-in that provides easy access to all of the programme-specific modules as well as the data quality review toolkit and recommended indicators.
As more countries adopt the use of common data standards, reliable comparisons of health trends across countries will also become possible. As a result, this harmonized approach will strengthen health data for use at all levels, whether it be by a local hospital manager, a national decision-maker, or a global donor.
This approach was introduced in a multi-country workshop, organized by WHO and financially supported by The Global Fund and Gavi, that took place 27 February-2 March 2018 in Athens, Greece. Participants included country teams from Malawi, Myanmar, Pakistan, Tanzania, Uganda and Zimbabwe (comprising focal points for HIV, TB, malaria, immunization and HMIS); regional experts, independent consultants, DHIS2 expert users; HDC partners (BMGF, CDC, CHAI, GAVI, TGF, UNAIDS, UNICEF, USAID, University of Oslo), and WHO HQ, regional and country offices.
Going forward, next steps include implementation of the approach in countries and documentation of best practices and enabling factors such as governance mechanisms, infrastructure and human resource capacity. These experiences will inform efforts to scale up the approach in a greater number of countries.