PDF(Pubmed)
Abstract：
BACKGROUND: Health-facility data serves as a primary source for monitoring service provision and guiding the attainment of health targets. District Health Information Software (DHIS2) is a free open software predominantly used in low and middle-income countries to manage the facility-based data and monitor program wise service delivery. Evidence suggests the lack of quality in the routine maternal and child health information, however there is no robust analysis to evaluate the extent of its inaccuracy. We aim to bridge this gap by accessing the quality of DHIS2 data reported by health facilities to monitor priority maternal, newborn and child health indicators in Lumbini Province, Nepal.
METHODS: A facility-based descriptive study design involving desk review of Maternal, Neonatal and Child Health (MNCH) data was used. In 2021/22, DHIS2 contained a total of 12873 reports in safe motherhood, 12182 reports in immunization, 12673 reports in nutrition and 12568 reports in IMNCI program in Lumbini Province. Of those, monthly aggregated DHIS2 data were downloaded at one time and included 23 priority maternal and child health related data items. Of these 23 items, nine were chosen to assess consistency over time and identify outliers in reference years. Twelve items were selected to examine consistency between related data, while five items were chosen to assess the external consistency of coverage rates. We reviewed the completeness, timeliness and consistency of these data items and considered the prospects for improvement.
RESULTS: The overall completeness of facility reporting was found within 98% to 100% while timeliness of facility reporting ranged from 94% to 96% in each Maternal, Newborn and Child Health (MNCH) datasets. DHIS2 reported data for all 9 MNCH data items are consistent over time in 4 of 12 districts as all the selected data items are within ±33% difference from the provincial ratio. Of the eight MNCH data items assessed, four districts reported ≥5% monthly values that were moderate outliers in a reference year with no extreme outliers in any districts. Consistency between six-pairs of data items that are expected to show similar patterns are compared and found that three pairs are within ±10% of each other in all 12 districts. Comparison between the coverage rates of selected tracer indicators fall within ±33% of the DHS survey result.
CONCLUSIONS: Given the WHO data quality guidance and national benchmark, facilities in the Lumbini province well maintained the completeness and timeliness of MNCH datasets. Nevertheless, there is room for improvement in maintaining consistency over time, plausibility and predicted relationship of reported data. Encouraging the promotion of data review through the data management committee, strengthening the system inbuilt data validation mechanism in DHIS2, and promoting routine data quality assessment systems should be greatly encouraged.
METHODS: A facility-based descriptive study design involving desk review of Maternal, Neonatal and Child Health (MNCH) data was used. In 2021/22, DHIS2 contained a total of 12873 reports in safe motherhood, 12182 reports in immunization, 12673 reports in nutrition and 12568 reports in IMNCI program in Lumbini Province. Of those, monthly aggregated DHIS2 data were downloaded at one time and included 23 priority maternal and child health related data items. Of these 23 items, nine were chosen to assess consistency over time and identify outliers in reference years. Twelve items were selected to examine consistency between related data, while five items were chosen to assess the external consistency of coverage rates. We reviewed the completeness, timeliness and consistency of these data items and considered the prospects for improvement.
RESULTS: The overall completeness of facility reporting was found within 98% to 100% while timeliness of facility reporting ranged from 94% to 96% in each Maternal, Newborn and Child Health (MNCH) datasets. DHIS2 reported data for all 9 MNCH data items are consistent over time in 4 of 12 districts as all the selected data items are within ±33% difference from the provincial ratio. Of the eight MNCH data items assessed, four districts reported ≥5% monthly values that were moderate outliers in a reference year with no extreme outliers in any districts. Consistency between six-pairs of data items that are expected to show similar patterns are compared and found that three pairs are within ±10% of each other in all 12 districts. Comparison between the coverage rates of selected tracer indicators fall within ±33% of the DHS survey result.
CONCLUSIONS: Given the WHO data quality guidance and national benchmark, facilities in the Lumbini province well maintained the completeness and timeliness of MNCH datasets. Nevertheless, there is room for improvement in maintaining consistency over time, plausibility and predicted relationship of reported data. Encouraging the promotion of data review through the data management committee, strengthening the system inbuilt data validation mechanism in DHIS2, and promoting routine data quality assessment systems should be greatly encouraged.
摘要：
背景：医疗机构数据是监测服务提供和指导实现健康目标的主要来源。地区卫生信息软件（DHIS2）是一个免费的开放软件，主要用于低收入和中等收入国家，用于管理基于设施的数据并监控计划明智的服务交付。证据表明，常规母婴健康信息缺乏质量，然而，没有可靠的分析来评估其不准确的程度。我们的目标是通过获取医疗机构报告的DHIS2数据的质量来弥合这一差距，以监测优先孕产妇，蓝毗尼省的新生儿和儿童健康指标，尼泊尔。
方法：基于设施的描述性研究设计，涉及对产妇，使用新生儿和儿童健康(MNCH)数据。在2021/22年度，DHIS2共包含12873份关于安全孕产的报告，12182份免疫报告，蓝毗尼省的营养报告为12673，IMNCI计划报告为12568。其中,每月一次下载DHIS2汇总数据,其中包括23个与母婴健康相关的优先数据项.在这23个项目中，选择9个用于评估随时间的一致性,并确定参考年中的异常值.选择了12个项目来检查相关数据之间的一致性，同时选择了五个项目来评估覆盖率的外部一致性。我们审查了完整性，这些数据项的及时性和一致性，并考虑了改进的前景。
结果：发现设施报告的总体完整性在98％至100％之间，而每个产妇的设施报告及时性在94％至96％之间。新生儿和儿童健康(MNCH)数据集。DHIS2报告的所有9个MNCH数据项的数据在12个地区中的4个地区中随着时间的推移是一致的，因为所有选定的数据项与省级比率相差在±33％以内。在评估的八个MNCH数据项中，四个地区报告的月值≥5%,在参考年为中度异常值,任何地区均无极端异常值.比较了预期显示相似模式的六对数据项之间的一致性，发现在所有12个地区中，三对数据项彼此相差在±10％以内。选定示踪指标的覆盖率之间的比较在DHS调查结果的±33％范围内。
结论：根据世卫组织数据质量指南和国家基准，蓝毗尼省的设施很好地维护了MNCH数据集的完整性和及时性。然而，随着时间的推移，在保持一致性方面还有改进的空间，报告数据的合理性和预测关系。鼓励通过数据管理委员会促进数据审查，应大力加强DHIS2中系统内置的数据验证机制，并推广常规数据质量评估系统。
方法：基于设施的描述性研究设计，涉及对产妇，使用新生儿和儿童健康(MNCH)数据。在2021/22年度，DHIS2共包含12873份关于安全孕产的报告，12182份免疫报告，蓝毗尼省的营养报告为12673，IMNCI计划报告为12568。其中,每月一次下载DHIS2汇总数据,其中包括23个与母婴健康相关的优先数据项.在这23个项目中，选择9个用于评估随时间的一致性,并确定参考年中的异常值.选择了12个项目来检查相关数据之间的一致性，同时选择了五个项目来评估覆盖率的外部一致性。我们审查了完整性，这些数据项的及时性和一致性，并考虑了改进的前景。
结果：发现设施报告的总体完整性在98％至100％之间，而每个产妇的设施报告及时性在94％至96％之间。新生儿和儿童健康(MNCH)数据集。DHIS2报告的所有9个MNCH数据项的数据在12个地区中的4个地区中随着时间的推移是一致的，因为所有选定的数据项与省级比率相差在±33％以内。在评估的八个MNCH数据项中，四个地区报告的月值≥5%,在参考年为中度异常值,任何地区均无极端异常值.比较了预期显示相似模式的六对数据项之间的一致性，发现在所有12个地区中，三对数据项彼此相差在±10％以内。选定示踪指标的覆盖率之间的比较在DHS调查结果的±33％范围内。
结论：根据世卫组织数据质量指南和国家基准，蓝毗尼省的设施很好地维护了MNCH数据集的完整性和及时性。然而，随着时间的推移，在保持一致性方面还有改进的空间，报告数据的合理性和预测关系。鼓励通过数据管理委员会促进数据审查，应大力加强DHIS2中系统内置的数据验证机制，并推广常规数据质量评估系统。
