Step 1. Select a country for this assignment.

Selected Country – Ethiopia

Step 2. Join the WhatsApp group for this country.

Joined Ethiopia WhatsApp group

Step 3. Identify the questions you want to answer about data flow, data tools, and the performance of your country’s monitoring system.

I have identified questions related with Ethiopian health information system

1. How does data flow?
2. What are the different reporting layers (that is, who reports to whom) and what are the requirements for timeliness and reporting frequencies?
3. Who first collects the data, prepares paper reports, enters data into electronic systems, receives and reviews reports?

Step 4. Identify and collect relevant background documents and other sources of information for your selected country.

Resources collected

Ethiopian Health Sector Transformation Plan 2016-2020

Ethiopian Health Data Recording and Reporting Procedure manual

Ethiopian Mini Demographic and Health Survey 2019

HMIS Indicator Reference Guide

EPI data collection tools 2015

Step 5. Share the most useful resources you find in our Scholar community SHARES.

I have shared 3 documents on HMIS manuals and other material in the scholar community.

Step 6. Perform a rapid review of these sources and evidence for data flow, tools, and performance of your country’s monitoring system.

Limit your review to find:

I have got most of important resources to assess recording & reporting immunization data, data flow and mini DHS 2019 survey document has evidence of real coverage & used to triangulate with administrative coverage.

Step 7. Summarize the quality of the available evidence.

Most Resources has good quality however I can not get recent DQA documents

Step 8. Describe the data flow of your country.

How does data flow?

Health Data Flow in Ethiopia

Type Health facilities in Ethiopia:- Health Post, Clinics (primary, medium, speciality), Health center, Hospitals (primary, General, specialized) & Speciality center.

Administrative Health Unit:- Federal Ministry of Health /FMOH/, Regional Health Bureau /RHB/, Zone Health department /ZHD/ & Woreda/district Health Office.

Data flow starts first at health facility level from service provision room to HMIS focal person & ones the facility report compiled/prepared, reported to the next level.

Immunization Data Flow in Ethiopia

• Health posts reporting the data to Health centers
• Health centers, primary clinics, medium clinics, speciality clinics and primary hospitals reporting the data to Woreda/district Health Office
• General hospitals, Speciality centers & Woreda/district Health Office reporting the data to Zone Health department /ZHD/
• Zone Health department /ZHD/ reporting the data to Regional Health Bureau /RHB/
• Regional Health Bureau /RHB/ & specialized hospitals reporting the data to Federal Ministry of Health /FMOH/

DHIS 2 data flow

• Depending on the availability of the Internet, zones, woredas, and health facilities will directly connect to the national server or will have their own offline instances. The offline version will remain a viable option for woredas and health facilities with intermittent or no Internet connection. After data entry, offline sites will export and send their data to the upper level in the reporting hierarchy via USB sticks (flash disks) or CD /DVD for the data to be uploaded (imported) to the national server. Nevertheless, health centers with no computer or electricity will keep sending hard copy reports to their respective woredas for the woreda HMIS focal person to enter their data on DHIS 2.

What are the different reporting layers (that is, who reports to whom) and what are the requirements for timeliness and reporting frequencies?

Reporting hierarchy of health facilities

3. Who first collects the data, prepares paper reports, enters data into electronic systems, receives and reviews reports?

• Data are collected first by dedicated service provider & they compile their report & submit to HMIS in charge.
• HMIS focal person prepare paper-based report of the facility & also make data entry to computer.
• Performance review team /PRT/ of the facility receives and reviews the reports at facility level.

3.1 What measures and procedures are in place for data verification, cleaning and feedback? What process is followed if data seems to be wrong?

• Data validation rules are in place in DHIS2
• PRT manual & tool(pad) is available at all level which is helps to check the coverage, quality of data (LQAS), & use of data and also to provide feedback
• When the level of data quality/accuracy (LQAS) is in unacceptable level, the report will be discarded & the facility re-collecting new report

3.2 Who are relevant players/stakeholders at each level? What do they do with the data (for example, collect, enter into electronic system, analyze, use to make decisions, etc.)?

• Relevant players for primary data collection are service providers at facility level
• For Paper based report & data enter into electronic system relevant players are HMIS focal persons assigned in each health facility, most of them are HIT (Health Information & Technology) professionals
• For Data analysis & use players are PRT at all level, program managers & officers, HMIS focal persons & partners. The main responsibility of these groups/persons at all level is checking data quality, analizing the data, calculate coverage & comparing with target/eligible, making trend analysis, identifying problems, feedback provision, deciding action points.

 

Step 9. Make a SWOT analysis.

Make a SWOT analysis for the monitoring system in your country. Analyze the Strengths, Weaknesses, Opportunities, and Threats.

Step 10. Summarize what you learned from all of the other steps.

I learned, using different building blocks independently to identify gaps & strengths, review of different sources to assess program performance, how SWOT analysis clarify the performance status