Data management update in the AFR; ARCI, Dar-es-Salaam, Tanzania, 10-12 December 2012 2 | Presentation outline Background Gaps in data management.

Data management update in the AFR; ARCI, Dar-es-Salaam, Tanzania, 10-12 December 2012 2 |

Presentation outlinePresentation outline

Background

Gaps in data management in the health system

Strategies to tackle data quality issues

Data management system in AFRO

Currents efforts

2013 Priorities

Data management update in the AFR; ARCI, Dar-es-Salaam, Tanzania, 10-12 December 2012 3 |

Data quality is one of the 4 IVD priority in AFRO

Existence of robust DM system at different level

There is more interest on data quality than ever (Opportunity)

Good data = good decision, wrong data = wrong decision

Need data to monitor goals at all levels (Country, Region, Global)

Data management has not enjoyed deserved recognition from EPI Manager on staff allocation (skills)

Recommendations from TFI as well as EPI managers’ meetings

BackgroundBackground

Data management update in the AFR; ARCI, Dar-es-Salaam, Tanzania, 10-12 December 2012 4 | 4

DQS: discrepencies between reported and verified data

Surveys: results challenging reported coverage

Denominator issues (4%, 3.49% enumeration quality, use of 2 populations …)

Focus on indicators versus sources of indicators

One person taking a country responsibility for data sharing

Existing Gaps

Data management update in the AFR; ARCI, Dar-es-Salaam, Tanzania, 10-12 December 2012 5 |

Data in EPIData in EPI

Capacity building

1. Vaccine supply & quality2. Logistics

3. Services delivery4. Surveillance

5. Communication

Operations

Capacity building

1. Vaccine supply & quality2. Logistics

3. Services delivery4. Surveillance

5. Communication

Operations

Capacity building

1. Vaccine supply & quality2. Logistics

3. Services delivery4. Surveillance

5. Communication

Operations

1. Vaccine supply & quality2. Logistics

3. Services delivery4. Surveillance

5. Communication

Operations

Health system building blocksImmunization sub-system components

1. Financing2. Capacity building3. Management4. Information/Data management

Data management update in the AFR; ARCI, Dar-es-Salaam, Tanzania, 10-12 December 2012 6 |

Strategies to tackle data quality Strategies to tackle data quality issuesissues

Data management update in the AFR; ARCI, Dar-es-Salaam, Tanzania, 10-12 December 2012 7 |

Main strategies to tackle DQ issueMain strategies to tackle DQ issue

a. Technical aspect

Improving the denominator and basic information

Conduct high quality enumeration at the lowest levelPromote link between EPI and statistic officesConsider updated information of live birth and surviving Standardize the district spelling in utility, DB and shape filesPromote regular census and availability of EPI needed data

a

Data management update in the AFR; ARCI, Dar-es-Salaam, Tanzania, 10-12 December 2012 8 |

Main strategies to tackle data quality issuesMain strategies to tackle data quality issues

a. Technical aspect (Cnt.)

Improving the Numerator

Conduct regular DQS at all districtPromote monthly monitoring meeting at district level between District

team and health facilities including the communitiesConduct monthly data harmonization and validation meeting with

required participants and contentConduct monthly technical ICC meetings at national and provincial

level

Data management update in the AFR; ARCI, Dar-es-Salaam, Tanzania, 10-12 December 2012 9 |

Main strategies to tackle data quality issuesMain strategies to tackle data quality issues

b. Management aspect

Ensure data management is supported by appropriate staff in EPI

Create a group for in-country estimates of national best estimates for JRF Estimates

Raise the interest of EPI managers beyond the calculated indicators and start looking at the sources of the indicators

Incorporate information system as one of the key immunization sub-system components

Data management update in the AFR; ARCI, Dar-es-Salaam, Tanzania, 10-12 December 2012 10 |

Data management system in AFROData management system in AFRO

Data management update in the AFR; ARCI, Dar-es-Salaam, Tanzania, 10-12 December 2012 11 |

IVD Data management system in AFROIVD Data management system in AFROIVD Data management system in AFROIVD Data management system in AFRO

Data management update in the AFR; ARCI, Dar-es-Salaam, Tanzania, 10-12 December 2012 12 |

Surveillance data management system in the AFRSurveillance data management system in the AFR

FS/ CS /AS

Form Ech

Ref Lab

Cas Positifs

Lab Reg BD

Form

Ech

Resu

lats

DB

/Fee

db

ack

Surv BD

IST

Lab Nat BD

Lab Nan BD

DB/Feedback

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

DRC Tchad Congo Gabon CentralAfrican

Republic

EquatorialGuinea

Cameroon Angola Burundi S.T. &Principe

IST

Compl Timel.

Surv BD

Form

EP

ID #

Form, Ech

FB, supervisionNat Surv / PEV

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

DRC Tchad Congo Gabon CentralAfrican

Republic

EquatorialGuinea

Cameroon Angola Burundi S.T. &Principe

IST

Compl Timel.

Results/Form/Ech

National Lab

Nat Lab DB

Form

Ech

Copie Form, Ech

FB, supervision

Province

Form EchFB

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

DRC Tchad Congo Gabon CentralAfrican

Republic

EquatorialGuinea

Cameroon Angola Burundi S.T. &Principe

IST

Compl Timel.

FB

District

Form Ech

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

DRC Tchad Congo Gabon CentralAfrican

Republic

EquatorialGuinea

Cameroon Angola Burundi S.T. &Principe

IST

Compl Timel.

OMS Pays/Autres

Surv BD

Lab Nat BDBD/Feedback DB/Feedback

HarmonisationValidation

DB/Feedback

Surv DB

AFRO

Lab Nat

Lab Nat BD

Glo

bal

lev

el

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

DRC Tchad Congo Gabon CentralAfrican

Republic

EquatorialGuinea

Cameroon Angola Burundi S.T. &Principe

IST

Compl Timel.

BD, Feedback

Data management update in the AFR; ARCI, Dar-es-Salaam, Tanzania, 10-12 December 2012 13 |

IVD databaseIVD databasein AFROin AFRO

Domaine   Database/reports Software Period

PEV de Routine 1 DB routine Epiinfo/Ms Access 7th of M+22

Utility/Population Epiinfo/Ms Access 25 Feb3

JRF Ms Excell15 Mach IST/AFRO, 15 Apr HQ

4 GAVI situation report Ms Excel 15 AprPolio 5 AFP surveillance Epiinfo/Ms Access Tuesday

6 AFP lab Epiinfo/Ms Access Tuesday7 Reference Lab Epiinfo/Ms Access Tuesday

8Polio Risk assessment Ms Excel 20 Aprl, July, Oct, jan

9 Polio Expert comity reports Ms Word  March10 Certification reports Ms Word  March

Rougeole 11 Measles casebased Epiinfo/Ms Access Tuesday12 National lab Measles/YF lab Epiinfo/Ms Access Tuesday13 Regional Lab Epiinfo/Ms Access Tuesday

YF 14 YF surveillance Epiinfo/Ms Access 7th of M+115 Labo Regional FJ Epiinfo/Ms Access 7th of M+1

Tetanus 16 Surveillance Tetanos Epiinfo/Ms Access 7th of M+1New vaccine surveillance

17 Hib PBM Epiinfo/Ms Access 7th of M+118 Roravirus Epiinfo/Ms Access 7th of M+1

Meningitis 19 Surveillance Meningite Ms Excel 7th of M+1Logistic 20 SMT Ms Excel 7th of M+1

21 DVDMT Ms Excel 7th of M+1SIAs 22 Polio

Ms Excel, 10 days after the end of SIAs

23 Measles24 YF25 Tetanus26 Meningitis27

IM Ms Excel7 days after the end of SIAs

28Corrective actions following IM Ms Excel

15 days after the end of SIAs

Data management update in the AFR; ARCI, Dar-es-Salaam, Tanzania, 10-12 December 2012 14 |

Workload related to Data management in IVD/AFROWorkload related to Data management in IVD/AFRO

Database # database Frequency Annual numberPopulation 46 1 46 Routine Immunization 46 12 552 JRF 46 1 46 Polio lab 20 52 1,040 AFP 46 52 2,392 Measles 46 52 2,392 Mesales YF lab 46 12 552 YF 20 12 240 TMN 10 12 120 YF reg Lab 1 12 12 Risk Assessment 46 4 184 New vaccine surveillance 19 12 228 SAIs Ad hoc Ad hoc - Independent Monitoring Ad hoc Ad hoc - LQAS Ad hoc Ad hoc -

Total 7,804

Data management update in the AFR; ARCI, Dar-es-Salaam, Tanzania, 10-12 December 2012 15 |

Current effortsCurrent efforts

Improvement in data completeness and timeliness Drastic reduction in number of countries with differences between JRF and Estimates 40% of countries currently conduct data harmonization meetings Establishment of a Regional Data Management System that allows the tracking of District level

specific performances every month for the Region (pick data issues at District level and provide immediate feedback)

Standardization of SIAs data management tools (Admin, IM, post IM Action taken) with automatized reports

Create an group for in country estimates of national best estimates for JRF Estimates

Raise the national Authority interest beyond the calculated indicators and start looking at the sources of the indicators

Data management update in the AFR; ARCI, Dar-es-Salaam, Tanzania, 10-12 December 2012 16 |

Current efforts (Cont.)Current efforts (Cont.)

Development of integrated Data Management modules for countries Establishment of Regional IVD integrated database Regional shape file at District level Development of surveillance site visits’ monitoring system Development of a standard risk assessment tool Reinforcement of Data Management coordination in the Region

daily call with priority countries, regional teleconference on data management every 2 months

Systematic Data quality feedback to ISTs and countries

Data management update in the AFR; ARCI, Dar-es-Salaam, Tanzania, 10-12 December 2012 17 |

IllustrationsIllustrations

Data management update in the AFR; ARCI, Dar-es-Salaam, Tanzania, 10-12 December 2012 18 |

2013 Priorities2013 Priorities

a. Improvement of data quality from the source•Advocacy for more interest on data quality at country level

•Standardization of basic data and shape files

•Support countries to assess and improve their data quality (DQS, Monthly Data harmonization meeting, enumeration, link between EPI and statistic offices, Census and Surveys, ICC, etc.)

•Capacity building and on-site supports for country Data managers

Data management update in the AFR; ARCI, Dar-es-Salaam, Tanzania, 10-12 December 2012 19 |

2013 Priorities2013 Priorities

b. Enhancing data management at higher levels

•Build an interactive data visualization system on top of the available IVD integrated database in coordination with the DPC real time system and the African Health Observatory (Use of new technology)

•Reinforce coordination with partners

•Scale up the use of surveillance sites monitoring system

•Continue the development of integrated modules for easy use in countries (using the YF model)

Data management update in the AFR; ARCI, Dar-es-Salaam, Tanzania, 10-12 December 2012 20 |

AksantiAksantiThank you Thank you

Merci Merci Obrigado Obrigado