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Review
. 2020 Mar 31;5(3):e002108.
doi: 10.1136/bmjgh-2019-002108. eCollection 2020.

Data for tracking SDGs: challenges in capturing neonatal data from hospitals in Kenya

Christiane Hagel  1 , Chris Paton  1 , George Mbevi  2 , Mike English  1   2 ; Clinical Information Network (CIN) information systems interest group
Affiliations
Review

Data for tracking SDGs: challenges in capturing neonatal data from hospitals in Kenya

Christiane Hagel et al. BMJ Glob Health. .

Abstract

Background: Target 3.2 of the United Nations Sustainable Development Goals (SDGs) is to reduce neonatal mortality. In low-income and middle-income countries (LMICs), the District Health Information Software, V.2 (DHIS2) is widely used to help improve indicator data reporting. There are few reports on its use for collecting neonatal hospital data that are of increasing importance as births within facilities increase. To address this gap, we investigated implementation experiences of DHIS2 in LMICs and mapped the information flow relevant for neonatal data reporting in Kenyan hospitals.

Methods: A narrative review of published literature and policy documents from LMICs was conducted. Information gathered was used to identify the challenges around DHIS2 and to map information flows from healthcare facilities to the national level. Two use cases explore how newborn data collection and reporting happens in hospitals. The results were validated, adjusted and system challenges identified.

Results: Literature and policy documents report that DHIS2 is a useful tool with strong technical capabilities, but significant challenges can emerge with the implementation. Visualisations of information flows highlight how a complex, people-based and paper-based subsystem for inpatient information capture precedes digitisation. Use cases point to major challenges in these subsystems in accurately identifying newborn deaths and appropriate data for the calculation of mortality even in hospitals.

Conclusions: DHIS2 is a tool with potential to improve availability of health information that is key to health systems, but it critically depends on people-based and paper-based subsystems. In hospitals, the subsystems are subject to multiple micro level challenges. Work is needed to design and implement better standardised information processes, recording and reporting tools, and to strengthen the information system workforce. If the challenges are addressed and data quality improved, DHIS2 can support countries to track progress towards the SDG target of improving neonatal mortality.

Keywords: health policy; health systems; paediatrics.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Healthcare levels in Kenya.
Figure 2
Figure 2
Health information flow to DHIS2 in Kenya.
Figure 3
Figure 3
Use case 1 for healthy inpatient neonates.
Figure 4
Figure 4
Use case 2 for sick inpatient neonates admitted to a Newborn Unit (NBU).
See this image and copyright information in PMC

References

    1. United Nations “Sustainable Development Goal 3: Ensure healthy lives and promote well-being for all at all ages,” Sustainable Development Goals Knowledge Platform, 2017. Available: https://sustainabledevelopment.un.org/sdg3 [Accessed 9 Jan 2019].
    1. United Nations Children’s Fund (UNICEF) “Under-five mortality,” UNICEF Data: Monitoring the situation of children and women, 2018. Available: https://data.unicef.org/topic/child-survival/under-five-mortality/ [Accessed 10 Jan 2019].
    1. World Health Organization (WHO) & United Nations Children’s Fund (UNICEF) “EVERY NEWBORN ACTION PLAN,” Country Progress Tracking Report, 2015. Available: https://www.healthynewbornnetwork.org/hnn-content/uploads/ENAP-country-s... [Accessed 12 Jan 2019].
    1. U.S. National Library of Medicine (NIH) “Medline Plus,” Medical Encyclopedia—Neonate, 2019. Available: https://medlineplus.gov/ency/article/002271.htm
    1. World Health Organization (WHO) “Global Health Observatory (GHO) data,” Neonatal data. Situation and trends, 2019. Available: https://www.who.int/gho/child_health/mortality/neonatal_text/en/ [Accessed 5 Dec 2019].

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