Dean's Office, Medical College, Aga Khan University, Karachi, Pakistan.
Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan.
BMJ Open. 2023 Sep 21;13(9):e071616. doi: 10.1136/bmjopen-2023-071616.
Data are essential for tracking and monitoring of progress on health-related sustainable development goals (SDGs). But the capacity to analyse subnational and granular data is limited in low and middle-income countries. Although Pakistan lags behind on achieving several health-related SDGs, its health information capacity is nascent. Through an exploratory qualitative approach, we aimed to understand the current landscape and perceptions on data in decision-making among stakeholders of the health data ecosystem in Pakistan.
We used an exploratory qualitative study design.
This study was conducted at the Aga Khan University, Karachi, Pakistan.
We conducted semistructured, in-depth interviews with multidisciplinary and multisectoral stakeholders from academia, hospital management, government, Non-governmental organisations and other relevant private entities till thematic saturation was achieved. Interviews were recorded and transcribed, followed by thematic analysis using NVivo.
Thematic analysis of 15 in-depth interviews revealed three major themes: (1) institutions are collecting data but face barriers to its effective utilisation for decision-making. These include lack of collection of needs-responsive data, lack of a gender/equity in data collection efforts, inadequate digitisation, data reliability and limited analytical ability; (2) there is openness and enthusiasm for sharing data for advancing health; however, multiple barriers hinder this including appropriate regulatory frameworks, platforms for sharing data, interoperability and defined win-win scenarios; (3) there is limited capacity in the area of both human capital and infrastructure, for being able to use data to advance health, but there is appetite to improve and invest in capacity in this area.
Our study identified key areas of focus that can contribute to orient a national health data roadmap and ecosystem in Pakistan.
数据对于跟踪和监测与健康相关的可持续发展目标(SDG)的进展至关重要。但是,在中低收入国家,分析国家以下和颗粒度数据的能力有限。尽管巴基斯坦在实现几个与健康相关的 SDG 方面落后,但它的健康信息能力尚处于起步阶段。通过探索性的定性方法,我们旨在了解巴基斯坦卫生数据生态系统利益相关者在决策中对数据的现状和看法。
我们采用了探索性的定性研究设计。
本研究在巴基斯坦卡拉奇的阿迦汗大学进行。
我们对来自学术界、医院管理、政府、非政府组织和其他相关私营实体的多学科和多部门利益相关者进行了半结构化的深入访谈,直到达到主题饱和。对访谈进行了录音和转录,然后使用 NVivo 进行主题分析。
对 15 次深入访谈的主题分析揭示了三个主要主题:(1)各机构正在收集数据,但在将其有效用于决策方面面临障碍。这些障碍包括缺乏针对需求的数据收集、缺乏性别/数据收集工作中的公平性、数字化程度不足、数据可靠性和有限的分析能力;(2)有开放和热情为促进健康而共享数据;然而,有多个障碍阻碍了这一点,包括适当的监管框架、数据共享平台、互操作性和定义双赢的方案;(3)在人力资本和基础设施方面的能力有限,无法利用数据来促进健康,但有意愿改善和投资于这一领域的能力。
我们的研究确定了可以为巴基斯坦制定国家卫生数据路线图和生态系统提供重点关注的关键领域。