Can routine health facility data be used to monitor subnational coverage of maternal, newborn and child health services in Uganda?
Can routine health facility data be used to monitor subnational coverage of maternal, newborn and child health services in Uganda?
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常规的医疗机构数据可用于监测乌干达的孕产妇，新生儿和儿童健康服务的次国覆盖范围吗？
DOI：
10.1186/s12913-021-06554-6
复制
发表时间：
2021-09-13
影响因子：
2.8
通讯作者：
Waiswa P
中科院分区：
文献类型：
--
作者：
Agiraembabazi G;Ogwal J;Tashobya C;Kananura RM;Boerma T;Waiswa P
卫生设施的常规数据是地方监测国家以下一级进展和绩效的重要来源。乌干达多年来一直使用来自设施数据的地区卫生统计数据。我们的目的是系统地评估数据质量，并研究不同的方法，以获得对孕产妇、新生儿和儿童健康干预措施覆盖率的合理的次国家估计。使用了乌干达常规卫生设施信息系统2015-2019年所有135个县的年度数据，以及用于外部比较和确定接近全民覆盖的干预措施的国家调查。通过设施报告的完整性、极端异常值的存在和内部数据的一致性来评估关于产前和分娩护理和儿童免疫接种的报告数据的质量。必要时进行了调整。覆盖率指标的分母来自人口预测和保健设施关于几乎全民覆盖干预措施的数据。将不同分母的覆盖率结果与住户调查结果进行比较。乌干达设施报告的完整性接近100%，极端异常值很少。以年度波动和干预措施之间的一致性衡量，报告事件的不一致是常见的，135个区比15个分区域更不一致。与预计的出生人口或首次产前检查相比，报告的疫苗接种数量高得令人难以置信，尤其是在2015-2016年。人口预测与根据报告的产前检查或免疫接种人数所作的预期目标人口之间也存在不一致之处。从设施数据得出分母的另一种办法比根据人口预测得出的结果更似是而非更符合调查结果，尽管大量分区域和地区的结果仍然不一致。我们对关键事件和分母例行报告的质量进行了系统评估，结果表明，通过透明的调整和方法可以计算地区卫生统计数据，从而大致了解大多数地区和分区域的水平和趋势，但提高数据质量对于获得更准确的监测至关重要。在线版本包含补充材料，可在10.1186/s12913-021-06554-6获得。
Routine health facility data are a critical source of local monitoring of progress and performance at the subnational level. Uganda has been using district health statistics from facility data for many years. We aimed to systematically assess data quality and examine different methods to obtain plausible subnational estimates of coverage for maternal, newborn and child health interventions. Annual data from the Uganda routine health facility information system 2015–2019 for all 135 districts were used, as well as national surveys for external comparison and the identification of near-universal coverage interventions. The quality of reported data on antenatal and delivery care and child immunization was assessed through completeness of facility reporting, presence of extreme outliers and internal data consistencies. Adjustments were made when necessary. The denominators for the coverage indicators were derived from population projections and health facility data on near-universal coverage interventions. The coverage results with different denominators were compared with the results from household surveys. Uganda’s completeness of reporting by facilities was near 100% and extreme outliers were rare. Inconsistencies in reported events, measured by annual fluctuations and between intervention consistency, were common and more among the 135 districts than the 15 subregions. The reported numbers of vaccinations were improbably high compared to the projected population of births or first antenatal visits – and especially so in 2015–2016. There were also inconsistencies between the population projections and the expected target population based on reported numbers of antenatal visits or immunizations. An alternative approach with denominators derived from facility data gave results that were more plausible and more consistent with survey results than based on population projections, although inconsistent results remained for substantive number of subregions and districts. Our systematic assessment of the quality of routine reports of key events and denominators shows that computation of district health statistics is possible with transparent adjustments and methods, providing a general idea of levels and trends for most districts and subregions, but that improvements in data quality are essential to obtain more accurate monitoring. The online version contains supplementary material available at 10.1186/s12913-021-06554-6.
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DOI：
10.2471/blt.11.99580
发表时间：
2012-05-01
期刊：
Bulletin of the World Health Organization: International Journal of Public Health
影响因子：
--
作者：
Braa, Jørn;Heywood, Arthur;Sahay, Sundeep
通讯作者：
Sahay, Sundeep
影响因子：
3.3
作者：
Wagenaar BH;Gimbel S;Hoek R;Pfeiffer J;Michel C;Manuel JL;Cuembelo F;Quembo T;Afonso P;Porthé V;Gloyd S;Sherr K
通讯作者：
Sherr K
影响因子：
9.3
作者：
Gething, Peter W.;Noor, Abdisalan M.;Snow, Robert W.
通讯作者：
Snow, Robert W.
影响因子：
3.3
作者：
Bosch-Capblanch, Xavier;Ronveaux, Olivier;Bchir, Abdallah
通讯作者：
Bchir, Abdallah
影响因子：
2.8
作者：
KirungaTashobya, Christine;Ssengooba, Freddie;Criel, Bart
通讯作者：
Criel, Bart