Centre for Global Child Health, The Hospital for Sick Children, 686 Bay Street, Toronto, ON, M5G 0A4, Canada.
Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON, M5T 3M7, Canada.
BMC Health Serv Res. 2022 Mar 5;22(1):305. doi: 10.1186/s12913-022-07680-5.
The health management information system (HMIS) is an integral component of a strong health care system. Despite its importance for decision-making, the quality of HMIS data remains of concern in low- and middle-income countries. To address challenges with the quality of maternal and child health (MCH) data gathered within Malawi's HMIS, we conducted a pilot study evaluating different support modalities to district-level HMIS offices. We hypothesized that providing regular, direct financial assistance to HMIS offices would enable staff to establish strategies and priorities based on local context, resulting in more accurate, timely, and complete MCH data.
The pilot intervention was implemented in Mwanza district, while Chikwawa, Neno, and Ntchisi districts served as control sites given support received from other institutions. The intervention consisted of providing direct financial assistance to Mwanza's HMIS office following the submission of detailed budgets and lists of planned activities. In the control districts, we performed interviews with the HMIS officers to track the HMIS-related activities. We evaluated the intervention by comparing data quality between the post- and pre-intervention periods in the intervention and control districts. Additionally, we conducted interviews with Mwanza's HMIS office staff to determine the acceptability and appropriateness of the intervention.
Following the 10-month intervention period, we observed improvements in MCH data quality in Mwanza. The availability and completeness of MCH data collected in the registers increased by 22 and 18 percentage points, respectively. The consistency of MCH data between summary reports and electronic HMIS also improved. In contrast, 2/3 control districts noted minimal changes or reductions in data quality after 10 months. The qualitative interviews confirmed that, despite some challenges, the intervention was well received by the participating HMIS office. HMIS staff preferred our strategy to other conventional strategies that fail to give them the independence to make decisions.
This pilot intervention demonstrated an alternative approach to support HMIS offices in their daily efforts to improve data quality. Given the Ministry of Health's (MoH) interest in strengthening its HMIS, our intervention provides a strategy that the MoH and local and international partners could consider to rapidly improve HMIS data with minimal oversight.
健康管理信息系统（HMIS）是一个强大的医疗保健系统的组成部分。尽管它对决策很重要，但在低收入和中等收入国家，HMIS 数据的质量仍然令人担忧。为了解决马拉维 HMIS 收集的母婴健康（MCH）数据质量方面的挑战，我们进行了一项试点研究，评估了向地区级 HMIS 办公室提供不同支持模式。我们假设向 HMIS 办公室定期提供直接财政援助将使工作人员能够根据当地情况制定战略和优先事项，从而产生更准确、及时和完整的 MCH 数据。
试点干预措施在姆万扎区实施，而奇克瓦瓦、恩诺和恩奇西则作为控制区，因为它们得到了其他机构的支持。该干预措施包括在详细预算和计划活动清单提交后，向姆万扎的 HMIS 办公室提供直接财政援助。在控制区，我们对 HMIS 官员进行了访谈，以跟踪与 HMIS 相关的活动。我们通过比较干预前后和控制区的数据质量来评估干预措施。此外，我们还对姆万扎的 HMIS 办公室工作人员进行了访谈，以确定干预措施的可接受性和适当性。
在 10 个月的干预期后，我们观察到姆万扎的 MCH 数据质量有所改善。登记册中收集的 MCH 数据的可用性和完整性分别增加了 22%和 18%。摘要报告和电子 HMIS 之间的 MCH 数据一致性也有所提高。相比之下，在 10 个月后，2/3 的控制区注意到数据质量几乎没有变化或减少。定性访谈证实，尽管存在一些挑战，但参与的 HMIS 办公室对该干预措施反应良好。HMIS 工作人员更喜欢我们的策略，而不是其他无法给予他们决策独立性的传统策略。
这项试点干预措施展示了一种支持 HMIS 办公室努力提高数据质量的替代方法。鉴于卫生部（MoH）有兴趣加强其 HMIS，我们的干预措施提供了一种策略，MoH 和当地及国际合作伙伴可以考虑采用这种策略，在最小监督的情况下快速改善 HMIS 数据。
