Table 3.
Action plans developed by facilities and progress achieved.
(N=number of facilities out of 100 who identified the issue as important)
| Issue identified | Action taken | Progress |
|---|---|---|
| Late submission of data reports to the district; insufficient number of staff compiling reports (N=51) | Staff from each department trained to summarize data | More than 90% of health facilities submitted reports on time |
| Data collection tools incomplete; registers not updated on a monthly basis and staff not familiar with how to complete them (N=88) | Training provided in how to complete registers. Supervisors required to check tools and registers on a regular basis. | Based on mentorship team’s evaluation of data quality, registers were completed and accurate; quality of reports to district improved as a result |
| Lack of QI committee to evaluate data and interpret it for use in programming (N=79) | Mentorship teams worked to set up QI committee; training in how to review specific indicators to evaluate service provision | Projects developed to improve programming weaknesses, such as ART adherence assessments, TB screening of HIV patients, and ongoing review of TB and HIV records to improve TB case-finding |
| Limited data analysis and use (N=84) | Hold facility data review meetings quarterly; performance graphs developed after data analysis | Graphs of MOH performance indicators compared to MOH targets displayed in areas where the staff and the public could see them* |
| Poor record keeping and use of outdated data tools (N=65) | Organize space for record keeping and discard outdated registers; provision of updated tools by META and MOH | Improved filling of clients’ files in the HIV clinics so they could be retrieved; data collected on updated forms |
| Lack of knowledge about data management by some health care workers (N=92) | Oriented health facility staff in data management and reporting with support from META staff | Data requests from different departments increased; different departments became involved in compiling reports |
| Limited or no health facility Supervision of records assistants; high levels of absenteeism (N=95) | Staff in charge of facilities began regular supervision; data committees with representatives from departments were created, and performed monthly reviews of data quality | Reduced absenteeism of records assistants and increased involvement by individual departments in data management |
| Inaccurate data reported to the district and thus also to the MOH (N=74) | Conduct data quality assessments routinely to check accuracy and completeness of data | Improvement in accuracy of reporting for key HIV indicators. |
*
MOH-specified indicators that were required to be monitored included immunization coverage, numbers and proportions of HIV infected clients enrolled in care, ante-natal clinic attendance of pregnant women, among others.