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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.