O'Neil So, Taylor Sydney, Sivasankaran Anitha
Health Foundations, Mathematica, Cambridge, MA 02139, United States.
Mathematica, Seattle, WA 98121, United States.
Digit Health. 2021 Dec 22;7:20552076211061922. doi: 10.1177/20552076211061922. eCollection 2021 Jan-Dec.
To assess a common hypothesis that data serve as a mechanism to improve health and health equity in low-and middle-income countries (LMICs), we conducted a synthesis of the evidence about the linkage between data capabilities in LMICs and health outcomes.
We searched and reviewed peer-reviewed and grey literature published in the past decade that focused on at least one aspect of health data or health equity or provided insights on the relationship between data use and improved health outcomes, decision-making, or both. We supplemented this with expert interviews and convenience-sampled literature.
Of the 50 included articles, 33 discussed data collection, with 23 stating that poor accuracy, reliability, and completeness hindered data-informed decision-making. Of 27 articles discussing data access, 18 described how lack of interoperability between data systems hampered governments' and other organizations' ability to leverage the full value of data available. Of 19 articles discussing data use, 13 discussed how data were not getting to those doing work on the ground. Although key informants postulated a virtuous cycle between data and improved health outcomes, evidence did not support this connection.
Findings indicate better data might improve health service delivery. However, more work is needed to examine whether improvements in data yield improvements in health outcomes in LMICs. Our conceptual framework of data equity for health and health equity developed through this scoping review helps identify the key components along which to assess improvements in LMICs' data capabilities.
为了评估一个常见假设，即数据是改善低收入和中等收入国家（LMICs）健康及健康公平性的一种机制，我们对有关LMICs数据能力与健康结果之间联系的证据进行了综合分析。
我们检索并回顾了过去十年发表的同行评审文献和灰色文献，这些文献至少关注健康数据或健康公平性的一个方面，或者提供了关于数据使用与改善健康结果、决策制定或两者之间关系的见解。我们通过专家访谈和便利抽样文献对其进行补充。
在纳入的50篇文章中，33篇讨论了数据收集，其中23篇指出准确性、可靠性和完整性差阻碍了基于数据的决策制定。在27篇讨论数据获取的文章中，18篇描述了数据系统之间缺乏互操作性如何阻碍政府和其他组织充分利用现有数据的价值。在19篇讨论数据使用的文章中，13篇讨论了数据如何无法传达给实际工作的人员。尽管关键信息提供者假设数据与改善健康结果之间存在良性循环，但证据并不支持这种联系。
研究结果表明，更好的数据可能会改善卫生服务的提供。然而，需要更多的工作来研究数据的改善是否会在LMICs中带来健康结果的改善。我们通过本次范围审查制定的健康数据公平和健康公平概念框架有助于确定评估LMICs数据能力改善的关键组成部分。
