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. 2021 Jan 1;14(1):1868961.
doi: 10.1080/16549716.2020.1868961.

Routine health management information system data in Ethiopia: consistency, trends, and challenges

Abyot Adane  1 , Tewabe M Adege  2 , Mesoud M Ahmed  2 , Habtamu A Anteneh  2 , Emiamrew S Ayalew  2 , Della Berhanu  3 , Netsanet Berhanu  2 , Misrak G Beyene  4 , Antoinette Bhattacharya  3 , Tesfahun Bishaw  2 , Eshetu Cherinet  2 , Mamo Dereje  2 , Tsega H Desta  2 , Abera Dibabe  2 , Heven S Firew  4 , Freweini Gebrehiwot  4 , Etenesh Gebreyohannes  2 , Zenebech Gella  2 , Addis Girma  2 , Zuriash Halefom  2 , Sorsa F Jama  2 , Binyam Kemal  2 , Abyi Kiflom  1 , Carina Källestål  3   5 , Seblewengel Lemma  3 , Yidnekachew D Mazengiya  2 , Kalkidan Mekete  4 , Magdelawit Mengesha  2 , Meresha W Nega  2 , Israel A Otoro  2 , Joanna Schellenberg  3 , Tefera Taddele  4 , Gulilat Tefera  1 , Admasu Teketel  1 , Miraf Tesfaye  2 , Tsion Tsegaye  1 , Kidist Woldesenbet  2 , Yakob Wondarad  2 , Zemzem M Yosuf  2 , Kidist Zealiyas  4 , Mebratom H Zeweli  2 , Lars Åke Persson  3   5 , Annika Janson  3   6
Affiliations

Routine health management information system data in Ethiopia: consistency, trends, and challenges

Abyot Adane et al. Glob Health Action. .

Abstract

Background: Ethiopia is investing in the routine Health Management Information System. Improved routine data are needed for decision-making in the health sector. Objective: To analyse the quality of the routine Health Management Information System data and triangulate with other sources, such as the Demographic and Health Surveys. Methods: We analysed national Health Management Information System data on 19 indicators of maternal health, neonatal survival, immunization, child nutrition, malaria, and tuberculosis over the 2012-2018 time period. The analyses were conducted by 38 analysts from the Ministry of Health, Ethiopia, and two government agencies who participated in the Operational Research and Coaching for Analysts (ORCA) project between June 2018 and June 2020. Using a World Health Organization Data Quality Review toolkit, we assessed indicator definitions, completeness, internal consistency over time and between related indicators, and external consistency compared with other data sources. Results: Several services reported coverage of above 100%. For many indicators, denominators were based on poor-quality population data estimates. Data on individual vaccinations had relatively good internal consistency. In contrast, there was low external consistency for data on fully vaccinated children, with the routine Health Management Information System showing 89% coverage but the Demographic and Health Survey estimate at 39%. Maternal health indicators displayed increasing coverage over time. Indicators on child nutrition, malaria, and tuberculosis were less consistent. Data on neonatal mortality were incomplete and operationalised as mortality on day 0-6. Our comparisons with survey and population projections indicated that one in eight early neonatal deaths were reported in the routine Health Management Information System. Data quality varied between regions. Conclusions: The quality of routine data gathered in the health system needs further attention. We suggest regular triangulation with data from other sources. We recommend addressing the denominator issues, reducing the complexity of indicators, and aligning indicators to international definitions.

Keywords: Data Quality; HMIS; RHIS; Routine Health Information System; WHO data quality review toolkit.

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Conflict of interest statement

No potential conflict of interest was reported by the authors.

Figures

Figure 1.
Figure 1.
Number of regions and city administrations (n = 11) with internal consistency over time per routine Health Management Information System indicator or data element (n = 19)
Figure 2.
Figure 2.
Number of routine Health Management Information System indicators (n = 19) that showed internal consistency over time per region or city administration (n = 11)
Figure 3.
Figure 3.
External consistency comparing the routine Health Management Information System (HMIS) data 2014/15 or 2015/16 (Ethiopian fiscal year 2007 or 2008) with the Ethiopian Demographic and Health Survey (EDHS) 2016 for (a) coverage of four antenatal care visits, (b) coverage of vaccinations against measles, (c) fully vaccinated 1-year old children and, (d) coverage of deworming of children
See this image and copyright information in PMC

References

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