Assessing and improving data quality from community health workers: a successful intervention in Neno, Malawi

Abstract

Setting A community health worker (CHW) program was established in Neno District, Malawi, in 2007 by Partners In Health in support of Ministry of Health activities. Routinely generated CHW data provide critical information for program monitoring and evaluation. Informal assessments of the CHW reports indicated poor quality, limiting the usefulness of the data. Objectives 1) To establish the quality of aggregated measures contained in CHW reports; 2) to develop interventions to address poor data quality; and 3) to evaluate changes in data quality following the intervention. Design We developed a lot quality assurance sampling-based data quality assessment tool to identify sites with high or low reporting quality. Following the first assessment, we identified challenges and best practices and followed the interventions with two subsequent assessments. Results At baseline, four of five areas were classified as low data quality. After 8 months, all five areas had achieved high data quality, and the reports generated from our electronic database became consistent and plausible. Conclusion Program changes included improving the usability of the reporting forms, shifting aggregation responsibility to designated assistants and providing aggregation support tools. Local quality assessments and targeted interventions resulted in immediate improvements in data quality.

Toward utilization of data for program management and evaluation: quality assessment of five years of health management information system data in Rwanda

“…Our results contrast with the other published assessment of HMIS using the WHO report card framework in sub-Saharan Africa, where they found poor data quality ( 24 ). They also differ with most results of different assesments of facility data quality, which also found gaps in data quality pointing to a need for improvement ( 7 – 15 ) . Another study from Mozambique, using a Global Fund methodology, also found high quality for assessed indicators ( 3 ).…”

“…In most countries, health management information systems (HMISs) serve as the primary data source for national health planning and evaluation ( 2 , 4 ). However, existing evidence suggests variable and often poor quality of this data ( 7 – 15 ) . In 2009, the World Health Organization (WHO) shared a framework for assessing data quality of HMIS through checks of completeness, internal consistency and external consistency ( 16 ), offering countries a way to measure data quality and identify gaps.…”

Increasing utilisation of perinatal services: estimating the impact of community health worker program in Neno, Malawi

“…In 2015, Neno had 11 health centers and two hospitals offering primary and secondary medical services, respectively. CHWs started working in Neno in 2007 and were primarily assigned to HIV and tuberculosis patients to provide education, accompaniment to medical appointments, psychosocial support, and linkage to formal health services [18]. In 2015, approximately 800 CHWs worked in Neno.…”

Cervical cancer data and data systems in limited‐resource settings: Challenges and opportunities

“…Leveraging the valuable position of community health workers, many countries have provided training on data collection and use; this both fosters appreciation for data collection tasks and enables active improvement of data quality (e.g. obtaining missing data, following up with patients after referral to determine outcomes, and validating vital registration system data) . A common lesson across interventions is the need to supplement training with supportive supervision, feedback mechanisms, and reliable, timely access to data.…”

“…obtaining missing data, following up with patients after referral to determine outcomes, andvalidatingvital registration systemdata). 41,52,[56][57][58][59][60] Acommonlessonacrossinterventionsistheneed tosupplementtrainingwithsupportivesupervision,feedbackmechanisms,andreliable,timelyaccesstodata.…”