Developing an intervention model for data quality management and health information use at community and district levels in Rwanda

Abstract

The purpose of this study was to develop an intervention model for health data quality management (DQM) and health information use at community and district levels in Rwanda and similar settings, based on a situation analysis of current practices and performance in Rwanda and existing evidence found in similar settings. This thesis is by publication and comprises three research papers based on the findings of three evaluation studies conducted, and reports on the study four which describes the model developed. Methods The study was initiated based on a systematic review of health DQM and best practices at community and district levels in low-and middle-income countries (LMIC). A retrospective design was used to evaluate the quality of clinical and community health data, and a survey of health information users was conducted. The mixed methods approach was adopted to collect quantitative and qualitative data, and the teamwork in “Group Model Building” (GMB) process through a workshop was used to develop the model.Findings Poor health DQM and health information use at community and District levels in Rwanda and other LMIC was found, particularly at the sources of data. Best practices were also found, but several issues hindering the quality of health data and utilization namely poor management of District Health Information System, lack of institutional support to all stakeholders involved in DQM, and lack of information culture. Variables that influenced the quality of health data and use included the training of the staff and community health workers (CHWs), regular formative supervision and monitoring and evaluation, involvement of all stakeholders, Data Quality Audit (DQA), feedback initiatives, understanding and perception of data usefulness, use of electronic and computerized systems, and proper leadership and coordination. Those variables were included in the model developed. Conclusion Based on the identified barriers to high quality data systems, an intervention model for health DQM and health information use at community and District levels in Rwanda was developed as the main achievement of this study.