NDOH data review: How is NDOH looking at the data? What are the tools?

Data use innovative and best practices meeting

1

06 September 2017

Southern Sun Hotel, Pretoria

Dr Zukiswa Pinini

Introduction

The ultimate objective of a routine health information system (RHIS) is to produce information for taking action in the program. “Are we doing things right?” “Are we doing the right things?”.

Department of Health is concerned about suboptimal use of routine data to identify performance gaps, make plans, and monitor progress, by province district and facility staff.

DHMIS policy

National DOH

Provide formal quarterly feedback on analysed data (sharing of reports, tables, graphs) to Provincial DoHs with regards to how they

compare with other Provinces on data quality and programme performance.

Apart from the formal feedback channels mentioned above, monthly informal feedback must be provided to relevant stakeholders on

observations in terms of data quality and programme performance to optimise data

management, data/information quality and program progress.

Province DOH

Provide formal quarterly feedback on analysed data to Districts with regards to how they

compare with their peers on data quality and programme performance

Apart from the formal feedback channels mentioned above, monthly informal feedback must be provided to relevant stakeholders on

observations in terms of data quality and programme performance to optimise data

management, data/information quality and program progress.

District DOH

Provide formal quarterly feedback to sub-districts and health establishments with regards to how they compare with their peers on data

quality and programme performance.

Apart from the formal feedback channels mentioned above, monthly informal feedback must be provided to relevant stakeholders on

observations in terms of data quality and programme performance to optimise data

management, data/information quality and program progress

Purpose of data review and use

• Data review and use guides program operations, track performance, learn from past results, and improve accountability.

• Data review and use efforts are also aimed at improving monitoring and evaluation (M&E) systems and inform policy and programmatic decision making.

Data review

Dashboards

• HIV/AIDS/STI dashboard indicators National feedback per province

• Districts Implementation Plans (DIPs) dashboard reports

Data quality assurance (DQA) visits

• To assess the quality of data & performance reported at facility level

Data completeness & consistency review

report

• Data analysis for completeness, consistency, accuracy, and timeliness.

• Monthly & Quarterly

A. National HIV/AIDS/STI dashboard indicators feedback per province

Agree on selected

data elements

Set targets

Review data

against targets

Provide feedback to province &

district

B. Districts Implementation Plans (DIPs) dashboard reports

Agree on selected

data elements

Set targets

Review data

against targets

Provide feedback to province &

district

Outputs

Performance indicator

Total Q1 Q1 Actual % Total Q1 Q1 Actual % Total Q1 Q1 Actual %

Male condoms distributed 79 628 469 19 907 117 15 717 402 79 57 708 205 14 427 051 4 910 500 34 15 112 784 3 778 196 2 459 114 65

Female condoms distributed 1 719 335 429 833 131 838 31 1 140 135 285 033 85 280 30 323 008 80 752 96 950 120

MMCs performed 72 580 25 403 9 909 39 50 847 17 796 4 820 27 13 177 4 611 2 212 48

Clients tested (including antenatal) 967 495 241 873 188 304 78 671 378 167 844 244 102 145 182 692 45 673 61 574 135

HIV test client 15 years and older (incl ANC) 967 495 241 873 148 062 61 671 378 167 844 203 076 121 182 692 45 673 74 124 162

HIV positive clients started on IPT 56 780 14 195 8 135 57 43 420 10 855 5 130 47 13 360 3 340 1 577 47

Pillar 2: Case Identification HIV test positive client 15 years and older (incl ANC) 80 840 20 210 17 288 86 61 819 15 454 17 552 114 20 210 5 053 4 807 95

HIV test positive child 19-59 months 71 110 17 778 82 0 49 346 12 337 38 0 13 427 3 357 26 1

HIV test positive child 5-14 years 10 054 2 514 649 26 7 050 1 762 219 12 1 845 461 71 15

Antenatal clients initiated on ART 16 252 4 063 3 169 78 12 252 3 063 2 398 78 2 576 644 410 64

Adult started on ART during this month - naïve 208 552 20 855 14 627 70 107 630 10 745 12 125 113 37 263 3 726 3 610 97

New patients started on treatment 85 541 21 385 15 216 71 43 463 10 865 12 443 115 16 333 4 083 3 711 91

Patients on ART remaining in care 420 781 356 625 288 157 81 280 701 248 103 226 506 91 90 273 78 023 71 315 91

Adult remaining on ART – total 408 800 346 233 279 364 81 276 974 244 739 233 739 96 82 274 71 093 69 062 97

Child under 15 years remaining on ART - total 11 981 2 996 8 793 293 3 727 934 7 233 774 8 000 2 000 2 253 113

HIV positive clients screened for TB 121 037 30 259 41 099 136 92 557 23 139 26 486 114 28 479 7 119 14 328 201

SEDIBENG

Pillar 1: Prevention

Pillar 3: Treatment Initiation

Pillar

Pillar 4: Retention and

Treatment Success

2017/2018 2017/2018 2017/2018

COJ EKURHULENI

C. Data quality assurance (DQA) visits

• Purpose of DQA is to trace and verification process of figures (agreed period) recorded in registers, monthly input forms & DHIS national data file

• To assess the quality of data & performance reported.

• Data Audit Tool (Excel spreadsheet): adaptation of the RIPDA tool mimics audit procedures of performance information conducted by AGSA

RIPDA report month from ________ to __________ (Date from when to when selected when generating the report the ____ will be filled in)

Organisaion Unit: (Selection made which facility to run the report for or all facilit ies)

Partner: (Auto-displayed based on data captured)

Priority Facility Type: Non-DDC (Auto-displayed based on data captured)

Month (Auto-displayed based on data captured)

Source Monthly summary DHIS Absolute deviation Error Margin Absolute deviation Error Margin

Inpts, OPD & Expenditure

HIV(7)

Total clients remaining on ART at end of the month #DIV/0! #DIV/0! #DIV/0! #DIV/0!

Total clients started on ART during this month - naïve #DIV/0! #DIV/0! #DIV/0! #DIV/0!

HIV test client 15-49 years (excl ANC) #DIV/0! #DIV/0! #DIV/0! #DIV/0!

Medical male circumcision performed #DIV/0! #DIV/0! #DIV/0! #DIV/0!

Male condoms distributed #DIV/0! #DIV/0! #DIV/0! #DIV/0!

HIV+ clients screened for TB #DIV/0! #DIV/0! #DIV/0! #DIV/0!

TB/HIV (3)

Client 5 years and older screened for TB #DIV/0! #DIV/0! #DIV/0! #DIV/0!

TB client 5 years and older start on treatment #DIV/0! #DIV/0! #DIV/0! #DIV/0!

TB/HIV co-infected client on ART mm #DIV/0! #DIV/0! #DIV/0! #DIV/0!

Reproductive Health (7) CYPR

DQA Indictaors to be assessed: October - December 2015:Total = 30

Source v.s DHIS DHIS v.s Monthly summary

C. Data quality assurance (DQA) visits

D. Data completeness & consistency review report

• How • Outcome

• What • Frequency

Monthly &

Quarterly

Completeness, Consistency, Accuracy &

timeliness

Data analysis at facility, district,

province and national levels

DHIS data & provide

feedback to province

Sum of EntryNumber dPeriod

Prov Dis/Metro Fac DataElementName Oct-16 Nov-16 Dec-16 Jan-17 Feb-17 Grand Total

Limpopo Mopani DM Bolobedu Clinic Total clients remaining on ART at end of the month 398 403 407 408 1 616

Duiw elskloof Clinic Total clients remaining on ART at end of the month 449 453 453 454 466 2 275

Evuxakeni Hosp Total clients remaining on ART at end of the month 20 20 18 17 75

Kgapane Hosp Total clients remaining on ART at end of the month 352 357 352 1 061

Makhuva Clinic Total clients remaining on ART at end of the month 471 466 477 481 1 895

Sekhukhune DM Matsageng Clinic Total clients remaining on ART at end of the month 613 624 548 635 2 420

Tsw aing Clinic Total clients remaining on ART at end of the month 113 115 118 125 471

2 373 1 485 1 101 -1272

Feedback

Quarterly provincial reviews/Conditional

grant reviews

Sharing of reports through

teleconference

Sharing of reports through emails

Observation

• Data review process for HIV & AIDS and STIs have highlighted the need to create engagement opportunities for relevant stakeholders to better access, analyze and derive value from health data.

• Inadequate involvement of programme managers at district, provincial and national level in data validation, analysis, reporting, feedback and use.

• Concerns that district and facility staff rarely used routine data to identify performance gaps, make plans, and monitor progress.

THANK YOU