Routine Data Quality Assessment/

RDQA

2 nd
Quarter 2016E.C
 Health Information System (HIS)

• It refers to a system that captures, stores, manages or

transmits information related to the health of individuals or

the activities of organizations, which improves health care
management decisions at all levels of the health system

• Information is crucial to inform on the performance of the

health system and about health challenges

• Heath Information system is required for timely intelligence on

the other building blocks of the health system
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 Components of HIS

Legislative, regulatory, & planning

Making readily framework, personnel, financing,
accessible to decision logistics support, ICT, coordinating
makers, ensure mechanisms
information use
Measures, usually core
set of indicators
(determinants, inputs,
Data translated to outputs, outcomes &
information health status)

1. Population-based sources
(censuses, civil registration,
Covers all aspects of data surveys)
handling, collection, storage, 2. Institution based data (individual,
quality-assurance, flow, service & resource records)
processing, compilation & 3. Others: Occasional surveys,
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analysis, research, & information, CBOs,
Health Management Information System

• Health Management Information System (HMIS) is the routine

collection, aggregation, analysis, presentation and utilization
of health and health related data for evidence based decisions
for health workers, managers, policy makers and others
• Purposes of HMIS
• Availing accurate, timely and complete data to support
decision making at each level of the health system
• Strengthening the use of locally generated data for
evidence based decision making 5
 HMIS …

Components of HMIS
1. Information management

• Data collection: Recording of health data using individual and

family folder, registers, tally and reporting formats

• Data processing: is a process of cleaning, entering and

aggregation of data.

• Data analysis and presentation: is a process of interpretation

and comparison of generated information in the form of
sentence, tables and graphs. 6
 HMIS …
2. Using information for management purposes
• Problem identification: identifying problems using key
indicators
• Prioritizing problems and decision making: Problems
identified should be prioritized and decide what types
of actions need to be taken.
• Action taking: Implementing the agreed action.
• Result monitoring: Assessing the desired result has
been achieved.

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 HMIS Indicator (2021)

▪ Indicator revision has been happening about every 3-4 years so far
▪ The most recent revision was conducted in 2017 following start of HSTP I
▪ HSTP II launched recently and will span 2020-2025 (Now HSDIP)
▪ HSTP II comes with additional new programs and initiatives
▪ Some activities of HSTP-I are matured, others are evolved that need to
amend the existing indicators
▪ Need for integration program indicators (eg. KPIs, and other quality
indicators)

▪ Therefore, the monitoring and evaluation of HSTP II demands

the revision of HMIS indicators
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Trends of Indicator Revision

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 Final revised HMIS indicators

2017_HMIS 2021_HMIS
Total Total
Indicator:131 indicators:177

Continued: 103 Modified: 3 Dropped: 25 New:71

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 Number of indicators by category (2017 versus 2021)

SN Indicator Category 2017 2021 SN Indicator Category 2017 2021

Reproductive and Neglected Tropical Diseases
1 14 15 11 2 8
Maternal health (NTD)

2 PMTCT 7 6 Non-communicable diseases

12 3 10
(NCD) & mental Health
3 EPI 13 12
13 HEP and Primary Health care 3 4
4 Child health 8 10
14 Leadership and governance 4 4
5 Nutrition 8 8 15 Health Financing 3 4

Pharmaceutical supply and

Hygiene & 16 4 7
6 2 10 services
environmental Health
17 Evidence based decision making 3 6
7 Medical service 12 21
18 Health Infrastructure 4 2
HIV/AIDS/Hepatitis
8 10 15 Human Resource Development
viruses 19 4 3
& mgt
Tuberculosis/TB/ &
9 22 22 20 Regulatory system 1 2
Leprosy

10 Malaria 5 8 Total 131 11 177

 REVISED REGISTERS AND TALLY SHEETS

S. No Type of Tools Maintained Modified New Total

1 Registers 13 26 18 57

2 Tally Sheets 5 9 7 21

• There are changes in data elements (some

3 Report forms modified and others added) and NTD, TB &
Leprosy quarterly changed to monthly

Registers: for HCs/Hosp= 42 For Hosp only =13 For HC only= 1

Geographic Areas specific= 2 Special center=1

NB: Health Post level tools are not included

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 Individual patient Medical Records
1• Common components:
3 1. Individual Folder 6. Patient Card/form
2. Individual Summary
Sheet 7. RH/ANC card
3. Tracer card
4. Service ID Card 8. Woman’s Card
5. Master Patient Index
9. Appointment card

NB: No. 1-5 are

components which are 10. Others
provided for all clients
 What Is Data Quality Assurance?
• An explicit combination of methods and activities that are carried
out for the purpose of reaching and maintaining high levels of
data quality
• A critical factor for generating and sustaining high-quality data
(accurate, complete, and timely)
• A system to ensure that data are collected, maintained, monitored,
transformed into useful information, and interpreted in ways that
maintain high quality and accuracy for all users

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 Importance of Data Quality for Data Use and Decision
Data quality assurance is critical for health information systems to:
Making
• Ensure accountability and reporting
• Strengthen programs and improve results
• Enhance quality of services
• Plan strategically
• Support requests for resources
• Contribute to lessons learned
• Identify trends and needs
• Support changes in delivery of programs and services
• Justify changes in technical and administrative policies
• Provide evidence-informed clinical decision making

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 Roles and Responsibilities for Maintaining Data Quality by
RHIS Levels

Central Level
Health Facilities Intermediate Level
(Service Delivery Sites) Provide guidelines on data
collection, reporting, and
management procedures

Review reports received; submit

aggregated reports Ensure timeliness and
completeness of reporting
Collect and enter initial data
Ensure timeliness and
completeness of reporting Monitor quality of data
throughout all levels
Summarize patient data and check
quality of registers Monitor quality of data captured
Monitor quality of data captured
and reported
and reported

Submit and complete summary

reports on time Conduct routine Conduct routine
supervisory visits supervisory visits

Routinely analyze and use data Routinely analyze and use data Routinely analyze and use data
 WHO Data Quality Review (DQR) Framework

Multipronged approach to assessing data quality from health

facilities

Routine & regular

Annual independent In-depth reviews of
reviews (e.g.,
assessment examining data quality that focus
monthly) of data
quality of health on single
quality that are built
facility data for annual disease/program area
into a system of
health sector planning that are conducted
checks & part of
& program periodically (3-5
supportive supervision
monitoring years)
and feedback
 Data Quality Assurances Processes

• Functioning information systems

• Clearly defined indicators, used consistently
• Description of specific roles and responsibilities
• Reporting timelines
• Standardized data collection and reporting forms
• Documented data review procedures
• Steps to address data quality challenges
• Storage policy and filing practices for easy retrieval
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 Examples of Data Quality Tools

Designed to verify the quality of reported data and assess

data management and reporting systems

RDQA: Routine Data Quality • Assessment/monitoring

Assessment (MEASURE • Simplified version of DQA formerly used by
Evaluation) programs

Performance of Routine Information

System Management • Assessment
PRISM: RHIS Performance Diagnostic
Tool • Part of PRISM tool package
(MEASURE Evaluation):

• Assessment
DQR: Data Quality Review
• National desk review and site visits
(WHO/MEASURE
Evaluation) • Updated version of WHO’s Data Quality Report
Card (DQRC)
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 Data Quality Assurance Methods
• Supportive supervision/self-assessments

• Independent assessments/audits

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