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Muhoza P, Saleem H, Faye A, Gaye I, Tine R, Diaw A, Gueye A, Kante AM, Ruff A, Marx MA. Key informant perspectives on the challenges and opportunities for using routine health data for decision-making in Senegal. BMC Health Serv Res 2021; 21:594. [PMID: 34154578 PMCID: PMC8218491 DOI: 10.1186/s12913-021-06610-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 06/04/2021] [Indexed: 12/03/2022] Open
Abstract
Background Increasing the performance of routine health information systems (RHIS) is an important policy priority both globally and in Senegal. As RHIS data become increasingly important in driving decision-making in Senegal, it is imperative to understand the factors that determine their use. Methods Semi-structured interviews were conducted with 18 high- and mid-level key informants active in the malaria, tuberculosis and HIV programmatic areas in Senegal. Key informants were employed in the relevant divisions of the Senegal Ministry of Health or nongovernmental / civil society organizations. We asked respondents questions related to the flow, quality and use of RHIS data in their organizations. A framework approach was used to analyze the qualitative data. Results Although the respondents worked at the strategic levels of their respective organizations, they consistently indicated that data quality and data use issues began at the operational level of the health system before the data made its way to the central level. We classify the main identified barriers and facilitators to the use of routine data into six categories and attempt to describe their interrelated nature. We find that data quality is a central and direct determinant of RHIS data use. We report that a number of upstream factors in the Senegal context interact to influence the quality of routine data produced. We identify the sociopolitical, financial and system design determinants of RHIS data collection, dissemination and use. We also discuss the organizational and infrastructural factors that influence the use of RHIS data. Conclusions We recommend specific prescriptive actions with potential to improve RHIS performance in Senegal, the quality of the data produced and their use. These actions include addressing sociopolitical factors that often interrupt RHIS functioning in Senegal, supporting and motivating staff that maintain RHIS data systems as well as ensuring RHIS data completeness and representativeness. We argue for improved coordination between the various stakeholders in order to streamline RHIS data processes and improve transparency. Finally, we recommend the promotion of a sustained culture of data quality assessment and use.
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Affiliation(s)
- Pierre Muhoza
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Haneefa Saleem
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Adama Faye
- Institut de Santé et Développement, Université Cheikh Anta Diop de Dakar, Dakar, Senegal
| | - Ibrahima Gaye
- Institut de Santé et Développement, Université Cheikh Anta Diop de Dakar, Dakar, Senegal
| | - Roger Tine
- Faculté de Médecine, de Pharmacie et d'Odontologie, Université Cheikh Anta Diop de Dakar, Dakar, Senegal
| | - Abdoulaye Diaw
- Direction de la Planification, de la Recherche et des Statistiques/ Division du Système d'Information Sanitaire et Social, Ministère de la Santé et de l'Action Sociale (MSAS), Dakar, Senegal
| | - Alioune Gueye
- Programme National de Lutte Contre le Paludisme, Ministère de la Santé et de l'Action Sociale (MSAS), Dakar, Senegal
| | - Almamy Malick Kante
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Andrea Ruff
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Melissa A Marx
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Kolasa K, Goettsch W, Petrova G, Berler A. ‘Without data, you’re just another person with an opinion’. Expert Rev Pharmacoecon Outcomes Res 2020; 20:147-154. [DOI: 10.1080/14737167.2020.1751612] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Affiliation(s)
- Katarzyna Kolasa
- Head of Department of Health Economics and Healthcare Management, Akademia Leona Kozminskiego - Health Economics and Healthcare Management, Warszawa, Poland
| | - Wim Goettsch
- WHO Collaborating Centre for Pharmaceutical Policy, Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, Utrecht, Netherlands
| | - Guenka Petrova
- Department of Social Pharmacy and Pharmacoeconomic, Faculty of Pharmacy, Medical University of Sofia, Sofia, Bulgaria
| | - Alexander Berler
- Head of Department of Health Economics and Healthcare Management, Gnomon, Athens, Greece
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Koon AD, Windmeyer L, Bigdeli M, Charles J, El Jardali F, Uneke J, Bennett S. A scoping review of the uses and institutionalisation of knowledge for health policy in low- and middle-income countries. Health Res Policy Syst 2020; 18:7. [PMID: 31959208 PMCID: PMC6971874 DOI: 10.1186/s12961-019-0522-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 12/20/2019] [Indexed: 12/21/2022] Open
Abstract
There is growing interest in how different forms of knowledge can strengthen policy-making in low- and middle-income country (LMIC) health systems. Additionally, health policy and systems researchers are increasingly aware of the need to design effective institutions for supporting knowledge utilisation in LMICs. To address these interwoven agendas, this scoping review uses the Arskey and O’Malley framework to review the literature on knowledge utilisation in LMIC health systems, using eight public health and social science databases. Articles that described the process for how knowledge was used in policy-making, specified the type of knowledge used, identified actors involved (individual, organisation or professional), and were set in specific LMICs were included. A total of 53 articles, from 1999 to 2016 and representing 56 countries, were identified. The majority of articles in this review presented knowledge utilisation as utilisation of research findings, and to a lesser extent routine health system data, survey data and technical advice. Most of the articles centered on domestic public sector employees and their interactions with civil society representatives, international stakeholders or academics in utilising epistemic knowledge for policy-making in LMICs. Furthermore, nearly all of the articles identified normative dimensions of institutionalisation. While there is some evidence of how different uses and institutionalisation of knowledge can strengthen health systems, the evidence on how these processes can ultimately improve health outcomes remains unclear. Further research on the ways in which knowledge can be effectively utilised and institutionalised is needed to advance the collective understanding of health systems strengthening and enhance evidence-informed policy formulation.
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Affiliation(s)
- Adam D Koon
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, 615 N Wolfe St, Baltimore, MD, 21205, United States of America. .,International Development Division, Abt Associates Inc, Rockville, MD, United States of America.
| | - Lauren Windmeyer
- Upstream USA, Oakland, CA, United States of America.,John F Kennedy School of Government, Harvard University, Cambridge, MA, United States of America
| | | | - Jodi Charles
- Office of Health Systems, United States Agency for International Development, Washington, D.C, United States of America
| | | | | | - Sara Bennett
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, 615 N Wolfe St, Baltimore, MD, 21205, United States of America
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Nabyonga-Orem J, Nabukalu BJ, Andemichael G, Khosi-Mthetwa R, Shaame A, Myeni S, Quinto E, Dovlo D. Moving towards universal health coverage: The need for a strengthened planning process. Int J Health Plann Manage 2018; 33:1093-1109. [PMID: 30074277 DOI: 10.1002/hpm.2585] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 06/29/2018] [Indexed: 11/08/2022] Open
Abstract
As countries embrace the ambitious universal health coverage (UHC) agenda whose major tenents include reaching everyone with the needed good quality services, strengthening the planning process to work towards a common objective is paramount. Drawing from country experiences-Swaziland and Zanzibar, we reviewed strategic planning processes to assess the extent to which they impact on realising alignment towards a collective health sector objective. Employing qualitative approaches, we reviewed strategic plans under implementation in the health sector and using an interview guide consisting of open-ended questions, interviewed key informants at the national and district level. Results showed that strategic plans are too many with majority of program strategies not well aligned to the health sector strategic plan, are not costed, and there overlaps in objectives among the several strategies addressing the same program. Weaknesses in the development process, perceived poor quality of the strategies, limited capacity, high staff turnover, and inadequate funding were the identified challenges that abate the utility of the strategic plans. Moving towards UHC starts with a robust planning process that rallies all actors and all available resources around a common objective. The planning process should be strengthened through ensuring participatory processes, evidence informed prioritisation, MoH institutional capacity to lead the process, and consideration for implementation feasibility. Flexibility to take into consideration emerging evidence and new developments in global health needs consideration.
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Affiliation(s)
- Juliet Nabyonga-Orem
- Health Systems and Services Cluster, Inter-Country Support Team for Eastern and Southern Africa; World Health Organization, Harare, Zimbabwe
| | | | | | | | - Attiye Shaame
- Ministry of Health, Directorate of Policy, Planning, and Research, Ministry of Health, Zanzibar, United Republic of Tanzania
| | - Sebentile Myeni
- Ministry of Health, Swaziland, Monitoring and Evaluation Unit, Mbabane, Swaziland
| | - Ebony Quinto
- Ministry of Health Headquarters, Kampala, Uganda
| | - Delanyo Dovlo
- World Health Organization Regional Office for Africa, Health Systems and Services Cluster, Brazzaville, Republic of Congo
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Nabyonga-Orem J. Monitoring Sustainable Development Goal 3: how ready are the health information systems in low-income and middle-income countries? BMJ Glob Health 2017; 2:e000433. [PMID: 29104767 PMCID: PMC5663251 DOI: 10.1136/bmjgh-2017-000433] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 10/08/2017] [Accepted: 10/11/2017] [Indexed: 11/05/2022] Open
Abstract
Sustainable Development Goals (SDGs) present a broader scope and take a holistic multisectoral approach to development as opposed to the Millennium Development Goals (MDGs). While keeping the health MDG agenda, SDG3 embraces the growing challenge of non-communicable diseases and their risk factors. The broader scope of the SDG agenda, the need for a multisectoral approach and the emphasis on equity present monitoring challenges to health information systems of low-income and middle-income countries. The narrow scope and weaknesses in existing information systems, a multiplicity of data collection systems designed along disease programme and the lack of capacity for data analysis are among the limitations to be addressed. On the other hand, strong leadership and a comprehensive and longer-term approach to strengthening a unified health information system are beneficial. Strengthening country capacity to monitor SDGs will involve several actions: domestication of the SDG agenda through country-level planning and monitoring frameworks, prioritisation of interventions, indicators and setting country-specific targets. Equity stratifiers should be country specific in addressing policy concerns. The scope of existing information systems should be broadened in line with the SDG agenda monitoring requirements and strengthened to produce reliable data in a timely manner and capacity for data analysis and use of data built. Harnessing all available opportunities, emphasis should be on strengthening health sector as opposed to SDG3 monitoring. In this regard, information systems in related sectors and the private sector should be strengthened and data sharing institutionalised. Data are primarily needed to inform planning and decision-making beyond SGD3 reporting requirements.
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Affiliation(s)
- Juliet Nabyonga-Orem
- Inter-Country Support Team for Eastern &Southern Africa; Health systems and services cluster, World Health Organisation, Harare, Zimbabwe
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