Department of Global Health, Research School of Population Health, College of Health and Medicine, The Australian National University, 62 Mills Road, Canberra, ACT 2601, Australia.
National Centre of Epidemiology and Population Health, Research School of Population Health, College of Health and Medicine, The Australian National University, Canberra, Australia.
Malar J. 2020 Oct 17;19(1):372. doi: 10.1186/s12936-020-03442-y.
District Health Information Systems 2 (DHIS2) is used for supporting health information management in 67 countries, including Solomon Islands. However, there have been few published evaluations of the performance of DHIS2-enhanced disease reporting systems, in particular for monitoring infectious diseases such as malaria. The aim of this study was to evaluate DHIS2 supported malaria reporting in Solomon Islands and to develop recommendations for improving the system.
The evaluation was conducted in three administrative areas of Solomon Islands: Honoria City Council, and Malaita and Guadalcanal Provinces. Records of nine malaria indicators including report submission date, total malaria cases, Plasmodium falciparum case record, Plasmodium vivax case record, clinical malaria, malaria diagnosed with microscopy, malaria diagnosed with (rapid diagnostic test) (RDT), record of drug stocks and records of RDT stocks from 1st January to 31st December 2016 were extracted from the DHIS2 database. The indicators permitted assessment in four core areas: availability, completeness, timeliness and reliability. To explore perceptions and point of view of the stakeholders on the performance of the malaria case reporting system, focus group discussions were conducted with health centre nurses, whilst in-depth interviews were conducted with stakeholder representatives from government (province and national) staff and World Health Organization officials who were users of DHIS2.
Data were extracted from nine health centres in Honoria City Council and 64 health centres in Malaita Province. The completeness and timeliness from the two provinces of all nine indicators were 28.2% and 5.1%, respectively. The most reliable indicator in DHIS2 was 'clinical malaria' (i.e. numbers of clinically diagnosed malaria cases) with 62.4% reliability. Challenges to completeness were a lack of supervision, limited feedback, high workload, and a lack of training and refresher courses. Health centres located in geographically remote areas, a lack of regular transport, high workload and too many variables in the reporting forms led to delays in timely reporting. Reliability of reports was impacted by a lack of technical professionals such as statisticians and unavailability of tally sheets and reporting forms.
The availability, completeness, timeliness and reliability of nine malaria indicators collected in DHIS2 were variable within the study area, but generally low. Continued onsite support, supervision, feedback and additional enhancements, such as electronic reporting will be required to further improve the malaria reporting system.
DHIS2（District Health Information Systems 2）被用于支持 67 个国家的卫生信息管理，包括所罗门群岛。然而，针对 DHIS2 增强型疾病报告系统的性能评估，尤其是针对疟疾等传染病监测的评估，发表的文献很少。本研究旨在评估所罗门群岛的 DHIS2 支持疟疾报告系统，并为改进该系统提出建议。
评估在所罗门群岛的三个行政区域进行：霍尼亚拉市议会、马莱塔省和瓜达尔卡纳尔省。从 DHIS2 数据库中提取了 2016 年 1 月 1 日至 12 月 31 日期间的九个疟疾指标的记录，包括报告提交日期、总疟疾病例数、恶性疟原虫病例记录、间日疟原虫病例记录、临床疟疾、显微镜诊断的疟疾、（快速诊断测试）（RDT）诊断的疟疾、药物库存记录和 RDT 库存记录。这些指标允许从四个核心领域进行评估：可用性、完整性、及时性和可靠性。为了探讨利益相关者对疟疾报告系统绩效的看法，与卫生中心护士进行了焦点小组讨论，同时与政府（省和国家）工作人员和世界卫生组织官员等 DHIS2 用户进行了深入访谈。
从霍尼亚拉市议会的 9 个卫生中心和马莱塔省的 64 个卫生中心提取了数据。两个省的所有九个指标的完整性和及时性分别为 28.2%和 5.1%。DHIS2 中最可靠的指标是“临床疟疾”（即临床诊断的疟疾病例数），可靠性为 62.4%。完整性方面的挑战包括缺乏监督、反馈有限、工作量大、缺乏培训和进修课程。地理位置偏远的卫生中心、定期交通不便、工作量大以及报告表中的变量过多，导致报告延迟。报告的可靠性受到缺乏技术专业人员（如统计学家）以及缺乏计数表和报告表的影响。
在所研究的地区内，DHIS2 中收集的九个疟疾指标的可用性、完整性、及时性和可靠性各不相同，但总体上较低。需要持续的现场支持、监督、反馈以及额外的增强功能，例如电子报告，以进一步改进疟疾报告系统。
