Objective:
UNICEF Somalia commissioned Khulisa, with partner Daytam Research and Consulting, to conduct a targeted Data Quality Review (DQR) to assess the quality of reported data at public health facilities in Somalia. The DQR was conducted using standardized World Health Organization (WHO) DQR tools and processes on three indicators (HIV, TB, and Malaria) as well as two cohorts of the multidrug-resistant tuberculosis (MDR-TB) indicator (long and short regimen) reported in 2018.
The DQR aimed to determine the quality of HIV/AIDS, Malaria, and TB data reported in Somalia’s three regional areas: Puntland, Somaliland, and South & Central. Specifically, the DQR:
- Established a sample of 60 public health facilities and 24 national and regional area offices in the three regions;
- Assessed the quality of data for the selected indicators at the sampled facilities and higher reporting levels, including identifying gaps related to data availability, data flow, and data management systems structures and processes;
- Recommended improvements in data management; and
- Disseminated the DQR results for strategic planning and quality improvement.
Approach:
The DQR’s design was based on, and guided by, WHO DQR guidelines, which clearly outline assessment procedures at health facility and higher levels. The DQR was carried out in two parts:
- A desk review, which Khulisa conducted hand-in-hand with UNICEF and World Vision staff. Khulisa trained UNICEF’s antiretrovial treatment (ART) program managers and World Vision’s TB & MDR-TB program managers on how to use the desk review tools and supported these staff remotely until the tools were completed.
- A survey component, which Khulisa conducted in-person at the sampled sites. The survey component consisted of an assessment of the data management system and a physical verification of reported data against established data quality criteria.
Impact:
The evaluation’s conclusions, lessons learned, and recommendations informed UNICEF/Somalia and World Vision/Somalia, highlighting the need for the following improvements:
- Increase the coverage of facility visits and provide written feedback during each visit, including data quality issues;
- Document standard operating procedures (SOPs) and job descriptions for all staff with data management system responsibilities, including those doing data entry and report compilation;
- Clearly assign the responsibility of data entry and compilation of report to specific team members;
- Establish standardized data analysis and data use protocols, including data visualization, at facilities to enhance understanding of trends and to support planning at facilities;
- Promote and support a culture of data analysis and use from facility, to regional, to national levels, including the use of data for performance reviews and planning at all levels;
- Promote data reviews before reporting to the next level;
- Establish a data quality control procedure protocol;
- Promote a data quality control culture by training staff on data quality control at all levels; and
- Create an SOP around providing regular feedback, particularly on the data quality.