埃塞俄比亚常规健康管理信息系统数据:一致性、趋势和挑战。

Routine health management information system data in Ethiopia: consistency, trends, and challenges.

机构信息

Ethiopian Pharmaceutical Supply Agency , Addis Ababa, Ethiopia.

Ministry of Health , Addis Ababa, Ethiopia.

出版信息

Glob Health Action. 2021 Jan 1;14(1):1868961. doi: 10.1080/16549716.2020.1868961.

Abstract

: Ethiopia is investing in the routine Health Management Information System. Improved routine data are needed for decision-making in the health sector. : To analyse the quality of the routine Health Management Information System data and triangulate with other sources, such as the Demographic and Health Surveys. : We analysed national Health Management Information System data on 19 indicators of maternal health, neonatal survival, immunization, child nutrition, malaria, and tuberculosis over the 2012-2018 time period. The analyses were conducted by 38 analysts from the Ministry of Health, Ethiopia, and two government agencies who participated in the Operational Research and Coaching for Analysts (ORCA) project between June 2018 and June 2020. Using a World Health Organization Data Quality Review toolkit, we assessed indicator definitions, completeness, internal consistency over time and between related indicators, and external consistency compared with other data sources. : Several services reported coverage of above 100%. For many indicators, denominators were based on poor-quality population data estimates. Data on individual vaccinations had relatively good internal consistency. In contrast, there was low external consistency for data on fully vaccinated children, with the routine Health Management Information System showing 89% coverage but the Demographic and Health Survey estimate at 39%. Maternal health indicators displayed increasing coverage over time. Indicators on child nutrition, malaria, and tuberculosis were less consistent. Data on neonatal mortality were incomplete and operationalised as mortality on day 0-6. Our comparisons with survey and population projections indicated that one in eight early neonatal deaths were reported in the routine Health Management Information System. Data quality varied between regions. : The quality of routine data gathered in the health system needs further attention. We suggest regular triangulation with data from other sources. We recommend addressing the denominator issues, reducing the complexity of indicators, and aligning indicators to international definitions.

摘要

埃塞俄比亚正在投资常规卫生管理信息系统。卫生部门需要改进常规数据以做出决策。

为了分析常规卫生管理信息系统数据的质量,并与其他来源(如人口与健康调查)进行三角测量,我们分析了 2012-2018 年期间有关孕产妇保健、新生儿存活率、免疫接种、儿童营养、疟疾和结核病的 19 项指标的国家卫生管理信息系统数据。分析工作由来自埃塞俄比亚卫生部和两个政府机构的 38 名分析师进行,他们参加了 2018 年 6 月至 2020 年 6 月期间的运营研究和分析师辅导(ORCA)项目。我们使用世界卫生组织数据质量审查工具包评估了指标定义、完整性、随时间和相关指标之间的内部一致性,以及与其他数据源的外部一致性。

有几项服务报告的覆盖率超过 100%。对于许多指标,分母是基于质量较差的人口数据估计。关于个人接种的数据内部一致性相对较好。相比之下,完全接种疫苗儿童的数据外部一致性较低,常规卫生管理信息系统显示覆盖率为 89%,而人口与健康调查的估计为 39%。孕产妇保健指标的覆盖率随时间增加。儿童营养、疟疾和结核病的指标不太一致。新生儿死亡率数据不完整,按 0-6 天死亡率进行操作。我们与调查和人口预测的比较表明,常规卫生管理信息系统报告的每 8 例早期新生儿死亡中有 1 例。各区域的数据质量存在差异。

卫生系统收集的常规数据质量需要进一步关注。我们建议定期与其他来源的数据进行三角测量。我们建议解决分母问题、简化指标复杂性,并使指标与国际定义保持一致。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/39d6/7833046/ecb2cc2e2b1f/ZGHA_A_1868961_F0001_OC.jpg

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