Abstract

BackgroundRoutine health information is an essential health system building block. In low and low-middle income countries however, concerns about the quality of routine administrative data have often undermined their use. The purpose of the present study was to verify the data availability, and consistency of six key maternal and child health indicators (first antenatal care, fourth antenatal care, skilled birth attendants, postnatal care, ‘Bacillus Calmette Guerin and diphtheria-pertussis-tetanus third dose).MethodsThe study collected data for the identified indicators in 2011 from Xiengkhouang and Houaphanh provinces in the Lao People’s Democratic Republic (PDR). The data came from health centres (N = 109), sub-districts (N = 26) and district health offices (N = 16). Core indicators were calculated using numerators and denominators from the different data sources at the district and health centre level and standardized statistical tests performed.ResultsThe study revealed that data for the six indicators were either not available or not complete in the service logbooks or registers in most of the health centres. Furthermore, few health centres kept the data for up to five years, often destroying it once the report had been sent to the district health office. In addition, there was limited numerator consistency between the different data sources.ConclusionData on the six indicators collected and reported in the public health system across the two provinces lacked completeness, accuracy and consistency. To improve the quality of data, there is a need to train health centre staff in data collection and recording as well as ensuring there is adequate monitoring and supervision. A uniform national standardized form is also necessary with findings shared with district health offices and centres. Additionally, staff should be encouraged to own and value local data.

Highlights

  • Routine health information is an essential health system building block

  • Data availability Availability of indicators refers to the extent to which health centre monthly reports included all reportable events from each health centre during 2011 for the six selected maternal and child health (MCH) indicators (ANC1, ANC4, SBA, PNC1, BCG, and DPT3-Hep)

  • Missing values at the health center level were observed. This was especially observed for PNC1 which had a higher number of missing values than the other MCH indicators

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Summary

Introduction

Routine health information is an essential health system building block. In low and low-middle income countries concerns about the quality of routine administrative data have often undermined their use. Improvements in maternal and child health are universally accepted health system goals. Reliable data on key maternal and child health (MCH) indicators at national and sub-national levels are essential in tracking progress of interventions designed to improve MCH. A key health system building block is the Health Information System (HIS). Maternal and under five child mortality is improving but remains unacceptably high (357/100 000 and 79/1000, respectively) [7]. The health system is predominantly public and has four administrative strata: central, provincial, district and health centre level with a strong vertical structure. At the local level if health staff see that their coverage rates are below the target set by the central government, they have the authority to take steps to improve coverage rates

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