Bulletin of the World Health Organization

Improving quality and use of data through data-use workshops: Zanzibar, United Republic of Tanzania

Jørn Braa, Arthur Heywood & Sundeep Sahay

Volume 90, Number 5, May 2012, 379-384

Table 1. Examples of improved information use resulting from project for strengthening the Health Management Information System (HMIS) in Zanzibar, the United Republic of Tanzania, 2005–2008

Health entity      Examples of improved information use
RCH Unit – Development of indicators to monitor emergency obstetric and neonatal care availability
– Monitoring of quality of antenatal care and skilled birth attendance coverage
– Introduction of maternal death audits
– Introduction of the “couple year protection rate” indicatora
– Improved anaemia diagnosis in pregnancy
Malaria Programme – Increased emphasis on bed net coverage
– Monitoring of malaria in pregnancy
– Treatment of confirmed rather than clinical cases, which in some instances resulted in data showing lower malaria incidence
Expanded Programme on Immunization – Investigation of high dropout rates and coverage over 100%
– Identification of double counting, resulting in improved quality control mechanisms
– Introduction of diagnostic criteria to reduce misdiagnosis of pneumonia and malaria
HIV/AIDS and STIs – Reduction of excessive data categories and age groupings
Hospitals – Routine collection of basic inpatient indicators such as average length of stay and bed occupancy rate
– Focus on signal functions of emergency obstetric careb and referrals, not just reporting of complications
– Inclusion of laboratory data to check quality of diagnosis, particularly of malaria, tuberculosis, anaemia and syphilis
– Improvement of OPD reporting to gain a more comprehensive idea of district-wide disease burden by: (i) using data elements identical to PHC units, enabling meaningful comparisons with peripheral health centres and encouraging back-referrals; and (ii) streamlining specialist OPD clinic data and adding it to the national database
– Development of workload indicators to rationalize staffing needs and advocate for redistribution of staff away from central hospitals

AIDS, acquired immunodeficiency syndrome; HIV, human immunodeficiency virus; OPD, outpatient department; PHC, primary health care; RCH, reproductive and child health; STI, sexually transmitted infection.

a The rate at which couples (specifically women) are protected against pregnancy using modern contraceptive methods.12

b Key medical interventions that are used to treat the direct obstetric complications that cause most of maternal deaths around the globe. The signal functions are indicators of the level of care being provided.13