Abstract
ABSTRACTBackground: Following the launch of District Health Information System 2 across facilities in Kenya, more health facilities are now capable of carrying out malaria parasitological testing and reporting data as part of routine health information systems, improving the potential value of routine data for accurate and timely tracking of rapidly changing disease epidemiology at fine spatial resolutions. Objectives: This study evaluates the current coverage and completeness of reported malaria parasitological testing data in DHIS2 specifically looking at patterns in geographic coverage of public health facilities in Kenya. Methods: Monthly facility level data on malaria parasitological testing were extracted from Kenya DHIS2 between November 2015 and October 2016. DHIS2 public facilities were matched to a geo-coded master facility list to obtain coordinates. Coverage was defined as the geographic distribution of facilities reporting any data by region. Completeness of reporting was defined as the percentage of facilities reporting any data for the whole 12-month period or for 3, 6 and 9 months. Results: Public health facilities were 5,933 (59%) of 10,090 extracted. Fifty-nine per Cent of the public facilities did not report any data while 36, 29 and 22% facilities had data reported at least 3, 6 and 9 months, respectively. Only 8% of public facilities had data reported for every month. There were proportionately more hospitals (86%) than health centres (76%) and dispensaries/clinics (30%) reporting. There were significant geographic variations in reporting rates. Counties along the malaria endemic coast had the lowest reporting rate with only 1% of facilities reporting consistently for 12 months.Conclusion: Current coverage and completeness of reporting of malaria parasitological diagnosis across Kenya’s public health system remains poor. The usefulness of routine data to improve our understanding of sub-national heterogeneity across Kenya would require significant improvements to the consistency and coverage of data captured by DHIS2.
Highlights
Following the launch of District Health Information System 2 across facilities in Kenya, more health facilities are capable of carrying out malaria parasitological testing and reporting data as part of routine health information systems, improving the potential value of routine data for accurate and timely tracking of rapidly changing disease epidemiology at fine spatial resolutions
Decades of interest in approaches to improving routine health information data collection has culminated in the latest popular framework, referred to as the District Health Information System version 2 (DHIS2) [6]
For the purposes of the present study we have focused on all fixed facilities managed by the Ministry of Health, Local Authorities, Faith Based Organizations (FBO) and Non-Governmental Organizations (NGO) capable of offering general health services to the public
Summary
Following the launch of District Health Information System 2 across facilities in Kenya, more health facilities are capable of carrying out malaria parasitological testing and reporting data as part of routine health information systems, improving the potential value of routine data for accurate and timely tracking of rapidly changing disease epidemiology at fine spatial resolutions. Objectives: This study evaluates the current coverage and completeness of reported malaria parasitological testing data in DHIS2 looking at patterns in geographic coverage of public health facilities in Kenya. Must be captured in a meaningful way, across all national health service providers every month to provide the granularity required to use this information to track changes in malaria risk with time. DHIS2 provides a platform for all health data, including malaria testing and positivity, to be captured, viewed and analyzed at all levels of the health system from the reporting facility to district and national aggregates. DHIS2 data are increasingly being used to provide national quarterly bulletins of sub-national malaria risk, for example in Uganda, Kenya and Ghana [7,8,9] and are used by the WHO regional office to compile sub-regional maps of malaria risk [10]
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