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Table 2 Partnership Data Quality Approaches

From: Improving data quality across 3 sub-Saharan African countries using the Consolidated Framework for Implementation Research (CFIR): results from the African Health Initiative

Mozambique

 Description of data quality improvement strategy

   Introduction of simplified tools and strategies to strengthen the routine HMIS data system, with training and mentorship to district and facility managers provided to support the use of these strategies to improve health system performance.

   Activity

Description

    Data Quality Audits (DQA)

Annual DQAs are carried out in all districts in the intervention province of Sofala. Immediately after data collection, summary analyses are shared with district officials. Final written feedback is provided to all district and facility managers via a simplified, summary data quality ranking tool.

    Data Dashboards

Quarterly development of data dashboards to simplify data visualizations to drive resource allocation & decision-making

    Follow-up supportive supervision/ mentorship

Annual DQA results fed back to health facilities, districts and provinces and inform ongoing, targeted supportive supervision for sites with weaker clinical services, data quality and data utilization activities. Senior M&E mentor embedded within provincial health department.

    Monitoring & Evaluation Training

Adaptation of existing MOH monitoring and evaluation training module, targeting primary health care strengthening.

Quality improvement and operations research trainings with mentored support for subsequent applied research activities.

Site-level trainings on HMIS functioning and use & basic Excel utilization at regular intervals over the LOP

    District performance review and enhancement meetings (DPREM)

Meetings, targeting maternal child services, malaria and pharmacy, bring together health facility staff and district/provincial supervisors to review and analyze routine data.

Rwanda

 Description of data quality improvement strategy

   Expand levels of routine data assessment (to include community level health data collection) as well as the frequency of audits in order to better integrate assessment into practice, which will translate into better use of data for decision-making in program management and evaluation.

   Activity

Description

    Enhanced Electronic Medical Records (EMR)

Electronic medical records are supported in the intervention districts to improve the quality of routinely collected data.

    Data Quality Audits (DQA)

Quarterly DQAs facility reports versus HMIS data using patient registries, monthly reports and online HMIS data the project

Monthly DQA in 2 districts between household registers and the community info system data

Weekly data validation of IMB HIV EMR data

    Community level lot quality assurance sampling (LQAS)

Community level data is assessed quarterly for concordance and completeness using LQAS methods where data is randomly sampled and five key indicators are compared with the database

    Mentoring to enhance supervision in health centers (MESH) quality improvement efforts

LQAS methodology is used to assess the effect of supporting enhanced supervision and mentorship.

    Assessment of HMIS using WHO data quality report card

Annual consistency and internal validity assessment

    Data sharing and coordination meetings

Monthly data review meetings between project and district health staff

Zambia

 Description of data quality improvement strategy

   Introduction of quality improvement teams across the project area who train facility and community-based health workers on filling of clinical forms, competency in following treatment protocols, overseeing data collection and ensuring quality of data entry

   Activity

Description

    Promoting completeness of clinical forms

Streamlining of clinical guides, including for case management of regularly seen presentations during patient visits, appropriate documentation carried out to improve clinician understanding of MOH-approved treatment protocols and tracking of stock outs of essential medicines and supplies

    Expanded electronic medical record (EMR) system

Introduction of on-site, facility- and community-level electronic medical record system (EMR) in the target districts. This system automatically generates clinic, patient review, clinic performance, CHW performance (to track lost-to-follow-up patients), and HIS reports, using MOH data and shared with district level team to inform management decisions.

    Community-based DQA component

Introduction of data quality audit system for community health information system

Mentoring to develop and enhance good clinical skills and practices of MOH staff to improve key performance indicators related to clinical care quality

    Continuous, on-site mentoring of MOH staff

Streamlining of clinical guides, including for case management of regularly seen presentations during patient visits, appropriate documentation carried out to improve clinician understanding of MOH-approved treatment protocols and tracking of stock outs of essential medicines and supplies

Monthly, project and MOH staff assessed completeness of clinical forms, vital signs recorded, primary diagnosis made, case conclusion, accuracy of data entry by Clinic Supporters, successful referrals to the facility, and household surveys completed

    Community outreach

Active data collection at household level, patient follow up and referral system carried out by community health workers, monitored through LQAS.