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Abstract：
BACKGROUND: Routine health facility data provides the opportunity to monitor progress in quality and uptake of health care continuously. Our study aimed to assess the reliability and usefulness of emergency obstetric care data including temporal and regional variations over the past five years in Tanzania Mainland.
METHODS: Data were compiled from the routine monthly district reports compiled as part of the health management information systems for 2016-2020. Key indicators for maternal and neonatal care coverage, emergency obstetric and neonatal complications, and interventions indicators were computed. Assessment on reliability and consistency of reports was conducted and compared with annual rates and proportions over time, across the 26 regions in of Tanzania Mainland and by institutional delivery coverage.
RESULTS: Facility reporting was near complete with 98% in 2018-2020. Estimated population coverage of institutional births increased by 10% points from 71.2% to 2016 to 81.7% in 2020 in Tanzania Mainland, driven by increased use of dispensaries and health centres compared to hospitals. This trend was more pronounced in regions with lower institutional birth rates. The Caesarean section rate remained stable at around 10% of institutional births. Trends in the occurrence of complications such as antepartum haemorrhage, premature rupture of membranes, pre-eclampsia, eclampsia or post-partum bleeding were consistent over time but at low levels (1% of institutional births). Prophylactic uterotonics were provided to nearly all births while curative uterotonics were reported to be used in less than 10% of post-partum bleeding and retained placenta cases.
CONCLUSIONS: Our results show a mixed picture in terms of usefulness of the District Health Information System(DHIS2) data. Key indicators of institutional delivery and Caesarean section rates were plausible and provide useful information on regional disparities and trends. However, obstetric complications and several interventions were underreported thus diminishing the usefulness of these data for monitoring. Further research is needed on why complications and interventions to address them are not documented reliably.
METHODS: Data were compiled from the routine monthly district reports compiled as part of the health management information systems for 2016-2020. Key indicators for maternal and neonatal care coverage, emergency obstetric and neonatal complications, and interventions indicators were computed. Assessment on reliability and consistency of reports was conducted and compared with annual rates and proportions over time, across the 26 regions in of Tanzania Mainland and by institutional delivery coverage.
RESULTS: Facility reporting was near complete with 98% in 2018-2020. Estimated population coverage of institutional births increased by 10% points from 71.2% to 2016 to 81.7% in 2020 in Tanzania Mainland, driven by increased use of dispensaries and health centres compared to hospitals. This trend was more pronounced in regions with lower institutional birth rates. The Caesarean section rate remained stable at around 10% of institutional births. Trends in the occurrence of complications such as antepartum haemorrhage, premature rupture of membranes, pre-eclampsia, eclampsia or post-partum bleeding were consistent over time but at low levels (1% of institutional births). Prophylactic uterotonics were provided to nearly all births while curative uterotonics were reported to be used in less than 10% of post-partum bleeding and retained placenta cases.
CONCLUSIONS: Our results show a mixed picture in terms of usefulness of the District Health Information System(DHIS2) data. Key indicators of institutional delivery and Caesarean section rates were plausible and provide useful information on regional disparities and trends. However, obstetric complications and several interventions were underreported thus diminishing the usefulness of these data for monitoring. Further research is needed on why complications and interventions to address them are not documented reliably.
摘要：
背景：常规卫生机构数据提供了持续监测质量和医疗保健使用进展的机会。我们的研究旨在评估坦桑尼亚大陆过去五年来紧急产科护理数据的可靠性和有用性，包括时间和区域变化。
方法：数据来自作为2016-2020年健康管理信息系统一部分编制的常规月度地区报告。孕产妇和新生儿护理覆盖率的关键指标，急诊产科和新生儿并发症，并计算了干预指标。对报告的可靠性和一致性进行了评估，并与一段时间内的年度比率和比例进行了比较，在坦桑尼亚大陆的26个地区和机构交付覆盖率。
结果：设施报告在2018-2020年接近完成，达到98%。在坦桑尼亚大陆，机构出生人口的估计覆盖率从2016年的71.2%增加到2020年的81.7%，增加了10%，与医院相比，药房和保健中心的使用有所增加。这一趋势在机构出生率较低的地区更为明显。剖腹产率保持稳定，约为机构分娩的10％。产前出血等并发症的发生趋势，胎膜早破,先兆子痫,子痫或产后出血在一段时间内是一致的,但水平较低(1%的机构分娩).几乎所有分娩都提供了预防性子宫收缩剂，而据报道，不到10％的产后出血和胎盘保留病例使用了治愈性子宫收缩剂。
结论：我们的研究结果表明，就地区卫生信息系统（DHIS2）数据的有用性而言，情况好坏参半。机构分娩率和剖腹产率的关键指标似乎是合理的，并提供了有关区域差异和趋势的有用信息。然而,产科并发症和一些干预措施被漏报,因此降低了这些数据用于监测的有用性.需要进一步研究为什么不能可靠地记录并发症和解决并发症的干预措施。
方法：数据来自作为2016-2020年健康管理信息系统一部分编制的常规月度地区报告。孕产妇和新生儿护理覆盖率的关键指标，急诊产科和新生儿并发症，并计算了干预指标。对报告的可靠性和一致性进行了评估，并与一段时间内的年度比率和比例进行了比较，在坦桑尼亚大陆的26个地区和机构交付覆盖率。
结果：设施报告在2018-2020年接近完成，达到98%。在坦桑尼亚大陆，机构出生人口的估计覆盖率从2016年的71.2%增加到2020年的81.7%，增加了10%，与医院相比，药房和保健中心的使用有所增加。这一趋势在机构出生率较低的地区更为明显。剖腹产率保持稳定，约为机构分娩的10％。产前出血等并发症的发生趋势，胎膜早破,先兆子痫,子痫或产后出血在一段时间内是一致的,但水平较低(1%的机构分娩).几乎所有分娩都提供了预防性子宫收缩剂，而据报道，不到10％的产后出血和胎盘保留病例使用了治愈性子宫收缩剂。
结论：我们的研究结果表明，就地区卫生信息系统（DHIS2）数据的有用性而言，情况好坏参半。机构分娩率和剖腹产率的关键指标似乎是合理的，并提供了有关区域差异和趋势的有用信息。然而,产科并发症和一些干预措施被漏报,因此降低了这些数据用于监测的有用性.需要进一步研究为什么不能可靠地记录并发症和解决并发症的干预措施。
