School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada.
Department of Health Behavior and Society, Public Health Faculty, Jimma University, Jimma, Oromiya, Ethiopia.
PLoS One. 2019 Mar 11;14(3):e0213600. doi: 10.1371/journal.pone.0213600. eCollection 2019.
Health management information system (HMIS) data are important for guiding the attainment of health targets in low- and middle-income countries. However, the quality of HMIS data is often poor. High-quality information is especially important for populations experiencing high burdens of disease and mortality, such as pregnant women, newborns, and children. The purpose of this study was to assess the quality of maternal and child health (MCH) data collected through the Ethiopian Ministry of Health's HMIS in three districts of Jimma Zone, Oromiya Region, Ethiopia over a 12-month period from July 2014 to June 2015. Considering data quality constructs from the World Health Organization's data quality report card, we appraised the completeness, timeliness, and internal consistency of eight key MCH indicators collected for all the primary health care units (PHCUs) located within three districts of Jimma Zone (Gomma, Kersa and Seka Chekorsa). We further evaluated the agreement between MCH service coverage estimates from the HMIS and estimates obtained from a population-based cross-sectional survey conducted with 3,784 women who were pregnant in the year preceding the survey, using Pearson correlation coefficients, intraclass correlation coefficients (ICC), and Bland-Altman plots. We found that the completeness and timeliness of facility reporting were highest in Gomma (75% and 70%, respectively) and lowest in Kersa (34% and 32%, respectively), and observed very few zero/missing values and moderate/extreme outliers for each MCH indicator. We found that the reporting of MCH indicators improved over time for all PHCUs, however the internal consistency between MCH indicators was low for several PHCUs. We found poor agreement between MCH estimates obtained from the HMIS and the survey, indicating that the HMIS may over-report the coverage of key MCH services, namely, antenatal care, skilled birth attendance and postnatal care. The quality of MCH data within the HMIS at the zonal level in Jimma, Ethiopia, could be improved to inform MCH research and programmatic efforts.
健康管理信息系统（HMIS）数据对于指导中低收入国家实现卫生目标非常重要。然而，HMIS 数据的质量往往很差。对于那些疾病和死亡率负担沉重的人群，如孕妇、新生儿和儿童来说，高质量的信息尤为重要。本研究旨在评估埃塞俄比亚吉姆马地区奥罗米亚州三个区在 2014 年 7 月至 2015 年 6 月期间通过埃塞俄比亚卫生部 HMIS 收集的母婴健康（MCH）数据的质量。考虑到世界卫生组织数据质量报告卡中的数据质量构建，我们评估了为吉姆马区三个区（戈马、克萨和塞卡切科萨）所有初级卫生保健单位（PHCU）收集的八项关键 MCH 指标的完整性、及时性和内部一致性。我们还通过 Pearson 相关系数、组内相关系数（ICC）和 Bland-Altman 图，评估了 HMIS 中 MCH 服务覆盖率估计值与在调查前一年怀孕的 3784 名妇女进行的基于人群的横断面调查获得的估计值之间的一致性。我们发现，戈马的设施报告完整性和及时性最高（分别为 75%和 70%），克萨最低（分别为 34%和 32%），每个 MCH 指标的零/缺失值和中度/极端异常值很少。我们发现，所有 PHCU 的 MCH 指标报告随着时间的推移都有所改善，但是几个 PHCU 的 MCH 指标之间的内部一致性较低。我们发现 HMIS 获得的 MCH 估计值与调查结果之间的一致性较差，表明 HMIS 可能高估了关键 MCH 服务的覆盖率，即产前护理、熟练接生和产后护理。埃塞俄比亚吉姆马地区区域一级 HMIS 中的 MCH 数据质量可以提高，以为 MCH 研究和规划工作提供信息。
