Use Of Data For Decision Research Articles

Our Calendar Stopped! The Organizational Change at UFPB due to COVID-19

ABSTRACT This teaching case aims to analyze the context of the Federal University of Paraíba, which experiences the impacts of social isolation due to COVID-19, especially in conducting undergraduate classes, considering that the activities face-to-face were suspended. The case presents the facts related to the possibility of implementing a supplementary calendar, based on the concept of remote emergency teaching. Because of this scenario, the Pro-Rectory of Graduation managers needed to plan carefully to manage the uncertainties and resistance to changes that such a proposal would represent, mainly because there were no models to be based on since practically all public HEIs have suspended graduation classes. The case raises a significant dilemma: in the face of the challenges of implementing a supplementary remote calendar, is it better to follow or step back? The pedagogical objectives of this teaching case involve: analyzing the impact of COVID-19 on organizational behavior; discuss aspects related to the implementation of organizational changes; identify the use of data for decision-making and support for organizational change; and making decisions in the face of managerial dilemmas. Its analysis can be done by undergraduate students, in Administration and Public Management courses.

Our Calendar Stopped! The Organizational Change at UFPB due to COVID-19

ABSTRACT This teaching case aims to analyze the context of the Federal University of Paraíba, which experiences the impacts of social isolation due to COVID-19, especially in conducting undergraduate classes, considering that the activities face-to-face were suspended. The case presents the facts related to the possibility of implementing a supplementary calendar, based on the concept of remote emergency teaching. Because of this scenario, the Pro-Rectory of Graduation managers needed to plan carefully to manage the uncertainties and resistance to changes that such a proposal would represent, mainly because there were no models to be based on since practically all public HEIs have suspended graduation classes. The case raises a significant dilemma: in the face of the challenges of implementing a supplementary remote calendar, is it better to follow or step back? The pedagogical objectives of this teaching case involve: analyzing the impact of COVID-19 on organizational behavior; discuss aspects related to the implementation of organizational changes; identify the use of data for decision-making and support for organizational change; and making decisions in the face of managerial dilemmas. Its analysis can be done by undergraduate students, in Administration and Public Management courses.

The Application of the ADDIE Model and the Training Cycle in the Development, Implementation and Evaluation of Training Program on Data Use for Decision-making among End-users of Electronic Health Information System

Objective. This paper describes the process utilized in developing a training program on data use for decision making tailored for real-time monitoring of maternal and child health indicators through Community Health Information Tracking System (rCHITS) end-users in selected areas in the Philippines.
 Methods. Guided by the ADDIE (Analysis, Design, Development, Implementation and Evaluation) model and the training cycle, existing records and reports lodged with the National Telehealth Center (NTHC) pertaining to rCHITS were reviewed, supplemented by interviews with the technical staff of the NTHC and discussion with healthcare workers. Training design was developed, training modules and materials were prepared, critiqued, revised and finalized. The training was implemented and evaluated using an evaluation tool designed for this specific capability-building endeavor.
 Results. A tailored training program on data use for decision-making was designed for rCHITS end-users in select areas in the Philippines. The process of developing the training program was guided by the ADDIE Model and the Training Cycle. Training was delivered to a total of 128 public health workers. Majority of the participants gave high evaluation on the clarity and relevance of objectives, discussion of topics, methods of delivery, and time devoted in addressing issues (range 3.5-3.8 out of highest possible score of 4).
 Conclusion. This paper demonstrates the utility of the ADDIE Model and the Training Cycle in developing a training program aimed at enhancing the capability of the field personnel in utilizing the data generated from rCHITS in decision-making. Training participants must also be monitored and evaluated in their workplace setting in order to determine if the concepts and principles covered during the training program are put into practice.

The Marriage of Policy, Practices, and Data to Achieve Educational Reform.

The policy decisions of state, district and school educators affect the extent to which students have access to high-quality practices. This is especially relevant for students with disabilities and their families. This article summarizes a presentation made at the 2019 AAIDD conference and proposes an operational role for policy makers. Two frequently cited advances in education are (a) the commitment to adopt "evidence-based practices," and (b) the impact of information technology and data systems on the active "use of data for decision making" in schools. This article reviews the integrative role that policy decisions make in transforming effective practices and good data systems into practical outcomes for children and families.

Using Implementation Science to Understand Rwanda's Success in Dropping Under‐5 Mortality

Research ObjectiveTo understand how and why Rwanda implemented Evidence‐Based interventions (EBIs) faster than similar countries to reduce amenable U5 mortality (U5M) and contextual factors which facilitated or hindered success.Study DesignExplanatory mixed methods study using an implementation research (IR) framework adapted from existing frameworks (Exploration, Preparation, Implementation, Sustainment expanded include Adaptation (EPAIS), and Consolidated Framework for Implementation Research) to guide literature and document review, and key informant interviews with health care managers and leaders, implementers and policy makers.Population StudiedNot applicable.Principal FindingsRwanda effectively used a 5‐step process to determine the need for and strategies to implement EBIs to address leading causes of death (Table). Critical strategies included rapid uptake of emerging EBIs, stakeholder engagement, donor, and partner coordination based on national plan, data use for decision making, including research when needed, and integrating into and building on existing systems and primary care. Facilitating contextual factors included leadership commitment to health and primary care, existing community health worker program, culture of data use and accountability, donor and partner resources, and national equity agenda. Rwanda was able to implement (feasibility) with high coverage (reach) key EBis including vaccinations, facility delivery, and PMTCT with high acceptability. U5M dropped by 74 percent, from 196 deaths per 1000 live births in 2000 to 50 deaths per 1000 live births in 2015.ConclusionsThrough strategic and stepwise process, Rwanda was able to achieve rapid and broad implementation of life‐saving interventions to reduce U5M. The lesson learned offer transferable knowledge to help other countries accelerate U5M reduction.Implications for Policy or PracticeUsing IR adapted to the study aims is effective in emerging generalizable lessons and knowledge needed for other countries to more effectively implement EBIs and reduce U5M.Primary Funding SourceBMGF and Gates Ventures.

Considering the Evolution of the STEM Mathematical Pathway at the University of Oklahoma Using Organizational Development and Change Theory

In this case study, we use organizational development and change theory to look at how the University of Oklahoma (OU) has attended to the mathematical pathway leading to STEM fields. Using multiple sources of data, we are able to create an informative narrative that provides the particular context of the situation and in-depth picture of the campus response, including key changes and ongoing challenges that were noted over a five-year period. Through the use of both internal and external funding, OU has been able to improve its teaching and learning in the STEM mathematical pathway. OU has also been able to develop a First-Year Mathematics program based on national recommendations. We report how efforts have directly impacted hiring, placement, pedagogical methods, course coordination, TA training, as well as the collection and use of data in decision making.

Is the malaria short course for program managers, a priority for malaria control effort in Nigeria? Evidence from a qualitative study.

A Malaria Short Course (MSC) was conceptualized to build the capacity of program managers for malaria control due to the lack of a single comprehensive broad-based programmatic training in Nigeria. Prior to its implementation, a needs assessment was conducted based on the perspectives of stakeholders to plan and develop the curriculum. This was an exploratory qualitative study. Fifty-six purposively selected stakeholders at local, state and national levels were interviewed. Opinions on the need for training, its perceived impact, priority focus, likelihood of participation, sustainability of and planned support for the MSC were explored using a pretested researcher-designed interview guide. Interviews were audiotape recorded, and the transcripts were subjected to thematic content analysis. Participants included Directors of Primary Health Care (50%), State Malaria Program Officers (8.9%), State Directors of Public Health Services (7.1%) and Roll Back Malaria Officers (5.4%). Participants' mean number of years of experience in their current positions was 6.2 (SD 4.7) years. The dominant view was "malaria remains a problem in Nigeria, exacerbated by poor funding, knowledge deficit, lack of training opportunities for program managers and prioritized training budget". A common viewpoint was "to achieve the malaria policy goals, MSC should focus on improving program managers' knowledge of the disease, novel interventions, data audit and use of data for decision making, supportive supervision as well as leadership and management skills. The prioritized thematic areas were malaria epidemiology, case management and data management. The consensus opinion was the MSC would have a positive impact on the performance of program managers. All managerial participants were willing to release their staff for the MSC and encouraged step-down training. However, most participants opined they could not guarantee that their institutions would provide financial support to the MSC attendees. Implementing the MSC for program managers was considered essential towards achieving malaria control. Moreover, there is need for prioritized funding and sustainability mechanisms to actualize the implementation of the course.

The use of data in decision making for school-based social work

The use of data in decision making for school-based social work

'Do you trust those data?'-a mixed-methods study assessing the quality of data reported by community health workers in Kenya and Malawi.

High-quality data are essential to monitor and evaluate community health worker (CHW) programmes in low- and middle-income countries striving towards universal health coverage. This mixed-methods study was conducted in two purposively selected districts in Kenya (where volunteers collect data) and two in Malawi (where health surveillance assistants are a paid cadre). We calculated data verification ratios to quantify reporting consistency for selected health indicators over 3 months across 339 registers and 72 summary reports. These indicators are related to antenatal care, skilled delivery, immunization, growth monitoring and nutrition in Kenya; new cases, danger signs, drug stock-outs and under-five mortality in Malawi. We used qualitative methods to explore perceptions of data quality with 52 CHWs in Kenya, 83 CHWs in Malawi and 36 key informants. We analysed these data using a framework approach assisted by NVivo11. We found that only 15% of data were reported consistently between CHWs and their supervisors in both contexts. We found remarkable similarities in our qualitative data in Kenya and Malawi. Barriers to data quality mirrored those previously reported elsewhere including unavailability of data collection and reporting tools; inadequate training and supervision; lack of quality control mechanisms; and inadequate register completion. In addition, we found that CHWs experienced tensions at the interface between the formal health system and the communities they served, mediated by the social and cultural expectations of their role. These issues affected data quality in both contexts with reports of difficulties in negotiating gender norms leading to skipping sensitive questions when completing registers; fabrication of data; lack of trust in the data; and limited use of data for decision-making. While routine systems need strengthening, these more nuanced issues also need addressing. This is backed up by our finding of the high value placed on supportive supervision as an enabler of data quality.

Digital maturity – the new competitive goal

Purpose The authors of “The Digital Fallacy” are interviewed by veteran strategist David Rader. They envision digital implementation as a learning journey rather than a time-boxed program. They name the journey “Digital Maturity.” Design/methodology/approach Explains how Digital Maturity is a way of applying digital technology – at first to promote efficiency and ultimately in creative ways to innovate new business models – an operation that continues to grow and evolve. Findings Digitally mature companies are more likely to be agile, experimental, risk tolerant, collaborative and learning organizations. Practical implications Getting started can begin with identifying leaders within the organization with characteristics exhibited by digitally mature organizations and tasking them and a team with an effort that allows them to test fast, learn fast and scale fast. Originality/value Companies often start by focusing on efficiency gains, then move to better use of data for decision making and then lastly to employ technology to transform their offerings and business models. The final stage is where the greatest value from digital maturity is achieved.

Pengembangan Instrumen RDQA Untuk Surveilans Epidemiologi DBD Di Dinas Kesehatan Kota Tarakan

In 2016 from 7 Puskesmas in Tarakan City, 4 (four) Puskesmas (58%) sent their reports above the 5th of each month. There is still a mismatch of the number of source data with the results of recapitulation such as the number of DHF cases in Tarakan DHO with the number of DHF cases in the Ministry of Health Republic of Indonesia SKDR as well as the incompatibility of the reporting format by recording surveillance staff. The purpose of this study was to develop a Routine Data Quality Assessment (RDQA) instrument for DHF Epidemiological Surveillance in Tarakan City Health Office. The type of research used is Research and Development. The total subjects of the study were 9 people with details of 7 data management officers in the Puskesmas in the Tarakan DKK working area and 1 person in charge of the DHF Program in Tarakan DKK. The steps in this study, namely: (1) Potential and problems, (2) Data Collection (3) Product Design (4) Design Validation (5) Design Revision (6) Product Trial (7) Product Revision (8) Trial Use. The results of this study are that data quality assessment instruments have been developed according to RDQA and routine data quality assessments by the Ministry of Health with R & D research methods modified with eight indicators namely timeliness, data availability, data completeness, monitoring and evaluation unit capabilities, reporting indicators and guidelines, data collection and reporting format, data management process, linkages with the national reporting system and the use of data for decision making. The results of the assessment of the instruments developed, namely the aspect of content feasibility has an average value of 81%, the feasibility aspect of presentation is 78% and language assessment aspects 81%. Based on the results of the assessment of the three aspects assessed in the development of the RDQA instrument, a good conclusion is reached, but there are general recommendations given both by the Chair of the DHF Program in the DHO and the Epidemiological Surveillance Data Management Officer in DHO and Puskesmas, namely the use of modules and manuals RDQA instrument.

Country ownership and sustainability of Nigeria\u2019s HIV/AIDS Supply Chain System: qualitative perceptions of progress, challenges and prospects

BackgroundThe emergency response phase to HIV epidemic in Nigeria and other countries saw to the deployment of donors’ resources with little consideration for country ownership (CO) and sustainability. The progress that has been made in the fight against the pandemic has however precipitated a paradigm shift towards CO and sustainability. With the decline in donors’ funding, countries must continually evaluate their readiness to own and sustain their HIV response especially the supply chain system (SCS) and bridge any observed gaps. This study assessed the current understanding of CO and sustainability of Nigeria’s HIV/AIDS SCS, established progress that has been made, identified challenges that may be hampering CO and possible recommendations to address these challenges. It also explored opportunities that the country can leverage on.MethodsWe conducted a cross sectional descriptive study through semi-structured interview of twelve purposefully selected key informants involved in HIV/AIDS supply chain management. Transcribed qualitative data were analyzed using a thematic approach.ResultsAmong other submissions, respondents acknowledged that CO involves non-government stakeholders. Key CO and sustainability achievements were: development of national strategic plans and policy documents, establishment of coordinating structures, allocation of funds for some logistics activities at the state level and payment of salaries of government staff, institution of pre-service training, use of logistics data for decision making and the unification of the hitherto parallel HIV/AIDS supply chains. Challenges included: inadequate domestic funding, bureaucratic bottlenecks and inadequate manpower at the health facility level. Respondents recommended more political commitment and increased government funding, exploration of alternative sources of funding, improved accountability, effective healthcare workforce planning and local manufacture of HIV commodities. Existing structures and programmes that the country can leverage on included: Nigeria Supply Chain Integration Project, National Health Insurance Scheme and the private sector.ConclusionsNigeria has made some progress towards achieving CO and sustainability. The country however needs to address financial and human resource gaps through innovative resource mobilization and effective workforce planning. As other countries plan for CO and sustainability, it is important to secure political buy-in and adopt a working definition for CO and sustainability while resource mobilization and workforce planning should be prioritized.

Factors Predicting Sustained Implementation of a Universal Behavior Support Framework

In this 3-year prospective study, we tested the extent to which school-, practice-, and district-level variables predicted sustained implementation for schools in various stages of implementation of school-wide positive behavioral interventions and supports (SWPBIS) Tier 1 (universal) systems. Staff from 860 schools in 14 U.S. states completed a research-validated measure of factors associated with sustained implementation of school interventions during Year 1 of this study. Analyses included multigroup structural equation modeling of school and district implementation fidelity data. Results indicated that adequate implementation fidelity and better Team Use of Data for decision making in Study Year 1 were the strongest predictors of sustained implementation in Year 3. In addition, the number of other schools in the district adopting SWPBIS was a similarly strong predictor. A critical mass of schools implementing was also predictive, especially for schools earlier in implementation. School characteristics were not predictive, except for grade levels served, which was an inconsistent predictor by stage.

Scaling-up strategic purchasing: analysis of health system governance imperatives for strategic purchasing in a free maternal and child healthcare programme in Enugu State, Nigeria

BackgroundSignificant knowledge gaps exist in the functioning of institutional designs and organisational practices in purchasing within free healthcare schemes in low resource countries. The study provides evidence of the governance requirements to scale up strategic purchasing in free healthcare policies in Nigeria and other low-resource settings facing similar approaches.MethodsThe study was conducted at the Ministry of Health and in two health districts in Enugu State, Nigeria, using a qualitative case study design. Semi-structured interviews were conducted with 44 key health system actors (16 policymakers, 16 providers and 12 health facility committee leaders) purposively selected from the Ministry of Health and the two health districts. Data collection and analysis were guided by Siddiqi and colleagues’ health system governance framework. Data were analysed using a framework approach.ResultsThe key findings show that supportive governance practices in purchasing included systems to verify questionable provider claims, pay providers directly for services, compel providers to procure drugs centrally and track transfer of funds to providers. However, strategic vision was undermined by institutional conflicts, absence of purchaser-provider split and lack of selective contracting of providers. Benefit design was not based on stakeholder involvement. Rule of law was limited by delays in provider payment. Benefits and obligations to users were not transparent. The criteria and procedure for resource allocation were unclear. Some target beneficiaries seemed excluded from the scheme. Effectiveness and efficiency was constrained by poor adherence to purchasing rules. Accountability of purchasers and providers to users was weak. Intelligence and information is constrained by paper-based system. Rationing of free services by providers and users’ non-adherence to primary gate-keeping role hindered ethics.ConclusionWeak governance of purchasing function limits potential of FMCHP to contribute towards universal health coverage. Appropriate governance model for strengthening strategic purchasing in the FMCHP and possibly free healthcare interventions in other low-resource countries must pay attention to the creation of an autonomous purchasing agency, clear framework for selective contracting, stakeholder involvement, transparent benefit design, need-based resource allocation, efficient provider payment methods, stronger roles for citizens, enforcement of gatekeeping rules and use of data for decision-making.

Rural versus urban perspectives on behavioral health issues and priorities

Local incidence of behavioral health issues such as substance abuse or poor mental health are a topic of increasing concern, but the specific needs, issues, and priorities of cities can differ from those in rural areas. We illustrate how rural and urban perceptions and knowledge may differ with a survey about community behavioral health priorities in Clark County, Nevada. The survey had a 44% response rate and the sample was 77.3% urban. Rural leaders had different behavioral health concerns and received information from different sources than their urban counterparts. Alcohol abuse and illegal drug use were top behavioral health priorities for both groups. Rural leaders cited mental and physical abuse as priorities, while urban leaders prioritized depression and suicide. The findings demonstrate the importance of recognizing that geographic proximity does not equate to identical behavioral health concerns or priorities, which also impacts community use of data for decision-making.

Influence of Organizational Structure and Administrative Processes on the Performance of State-Level Malaria Programs in Nigeria

—Studies have found links between organizational structure and performance of public organizations. Considering the wide variation in uptake of malaria interventions and outcomes across Nigeria, this exploratory study examined how differences in administrative location (a dimension of organizational structure), the effectiveness of administrative processes (earmarking and financial control, and communication), leadership (use of data in decision making, state ownership, political will, and resourcefulness), and external influences (donor influence) might explain variations in performance of state malaria programs in Nigeria. We hypothesized that states with malaria program administrative structures closer to state governors will have greater access to resources, greater political support, and greater administrative flexibility and will therefore perform better. To assess these relationships, we conducted semistructured interviews across three states with different program administrative locations: Akwa-Ibom, Cross River, and Niger. Sixty-five participants were identified through a snowballing approach. Data were analyzed using a thematic framework. State program performance was assessed across three malaria service delivery domains (prevention, diagnosis, and treatment) using indicators from Nigeria Demographic and Health Surveys conducted in 2008 and 2013. Cross River State was best performing based on 2013 prevention data (usage of insecticide-treated bednets), and Niger State ranked highest in diagnosis and treatment and showed the greatest improvement between 2008 and 2013. We found that organizational structure (administrative location) did not appear to be determinative of performance but rather that the effectiveness of administrative processes (earmarking and financial control), strong leadership (assertion of state ownership and resourcefulness of leaders in overcoming bottlenecks), and donor influences differed across the three assessed states and may explain the observed varying outcomes.

Leveraging the power of place in citizen science for effective conservation decision making

Many citizen science projects are place-based - built on in-person participation and motivated by local conservation. When done thoughtfully, this approach to citizen science can transform humans and their environment. Despite such possibilities, many projects struggle to meet decision-maker needs, generate useful data to inform decisions, and improve social-ecological resilience. Here, we define leveraging the ‘power of place’ in citizen science, and posit that doing this improves conservation decision making, increases participation, and improves community resilience. First, we explore ‘place’ and identify five place dimensions: social-ecological, narrative and name-based, knowledge-based, emotional and affective, and performative. We then thematically analyze 134 case studies drawn from CitSci.org (n=39), The Stewardship Network New England (TSN-NE; n=39), and Earthwatch (n=56) regarding: (1) use of place dimensions in materials (as one indication of leveraging the power of place), (2) intent for use of data in decision-making, and (3) evidence of such use. We find that 89% of projects intend for data to be used, 46% demonstrate no evidence of use, and 54% provide some evidence of use. Moreover, projects used in decision making leverage more (t=−4.8, df=117; p<0.001) place dimensions (x̅=3.0; s=1.4) than those not used in decision making (x̅=1.8; s=1.2). Further, a Principal Components Analysis identifies three related components (aesthetic, narrative and name-based, and social-ecological). Given these findings, we present a framework for leveraging place in citizen science projects and platforms, and recommend approaches to better impart intended outcomes. We discuss place in citizen science related to relevance, participation, resilience, and scalability and conclude that effective decision making as a means towards more resilient and sustainable communities can be strengthened by leveraging the power of place in citizen science.

Opportunities and challenges in conducting secondary analysis of HIV programmes using data from routine health information systems and personal health information.

IntroductionHIV programme data from routine health information systems (RHIS) and personal health information (PHI) provide ample opportunities for secondary data analysis. However, these data pose unique opportunities and challenges for use in health system monitoring, along with process and impact evaluations.MethodsAnalyses focused on retrospective case reviews of four of the HIV-related studies published in this JIAS supplement. We identify specific opportunities and challenges with respect to the secondary analysis of RHIS and PHI data.ResultsChallenges working with both HIV-related RHIS and PHI included missing, inconsistent and implausible data; rapidly changing indicators; systematic differences in the utilization of services; and patient linkages over time and different data sources. Specific challenges among RHIS data included numerous registries and indicators, inconsistent data entry, gaps in data transmission, duplicate registry of information, numerator-denominator incompatibility and infrequent use of data for decision-making. Challenges specific to PHI included the time burden for busy providers, the culture of lax charting, overflowing archives for paper charts and infrequent chart review.ConclusionsMany of the challenges that undermine effective use of RHIS and PHI data for analyses are related to the processes and context of collecting the data, excessive data requirements, lack of knowledge of the purpose of data and the limited use of data among those generating the data. Recommendations include simplifying data sources, analysis and reporting; conducting systematic data quality audits; enhancing the use of data for decision-making; promoting routine chart review linked with simple patient tracking systems; and encouraging open access to RHIS and PHI data for increased use.

Implementing people-centred health systems governance in 3 provinces and 11 districts of Afghanistan: a case study.

BackgroundPrevious studies show that health systems governance influences health system performance and health outcomes. However, there are few examples of how to implement and monitor good governing practices in fragile and conflict affected environments. Good governance has the potential to make the health system people-centered. More research is needed on implementing a people-centered governance approach in these environments.Case descriptionWe piloted an intervention that placed a people-centred health systems governance approach in the hands of multi-stakeholder committees that govern provincial and district health systems. We report the results of this intervention from three provinces and eleven districts in Afghanistan over a six month period. This mixed-methods exploratory case study uses analysis of governance self-assessment scores, health management information system data on health system performance, and focus group discussions. The outcomes of interest are governance scores and health system performance indicators.We document the application of a people-centred health systems governance conceptual model based on applying four effective governing practices: cultivating accountability, engaging with stakeholders, setting a shared strategic direction, and stewarding resources responsibly. We present a participatory approach where health system leaders identify and act on opportunities for making themselves and their health systems more accountable and responsive to the needs of the communities they serve.Discussion and evaluationWe found that health systems governance can be improved in fragile and conflict affected environments, and that consistent application of the effective governing practices is key to improving governance. Intervention was associated with a 20% increase in antenatal care visit rate in pilot provinces. Focus group discussions showed improvements across the four governing practices, including: establishment of new sub-committees that oversee financial transparency and governance, collaboration with diverse stakeholders, sharper focus on community health needs, more frequent presentation of service delivery data, and increased use of data for decision making.ConclusionsOur findings have implications for policy and practice within and beyond Afghanistan. Governance is central to making health systems responsive to the needs of people who access and provide services. We provide a practical approach to improving health systems governance in fragile and conflict affected environments.Electronic supplementary materialThe online version of this article (doi:10.1186/1752-1505-9-2) contains supplementary material, which is available to authorized users.

Moving data off the shelf and into action: an intervention to improve data-informed decision making in Côte d'Ivoire

Background Improving a health system requires data, but too often they are unused or under-used by decision makers. Without interventions to improve the use of data in decision making, health systems cannot meet the needs of the populations they serve. In 2008, in Côte d'Ivoire, data were largely unused in health decision-making processes. Objective To implement and evaluate an intervention to improve the use of data in decision making in Cote d'Ivoire. Design From 2008 to 2012, Cote d'Ivoire sought to improve the use of national health data through an intervention that broadens participation in and builds links between data collection and decision-making processes; identifies information needs; improves data quality; builds capacity to analyze, synthesize, and interpret data; and develops policies to support data use. To assess the results, a Performance of Routine Information System Management Assessment was conducted before and after the intervention using a combination of purposeful and random sampling. In 2008, the sample consisted of the central level, 12 districts, and 119 facilities, and in 2012, the sample consisted of the central level, 20 districts, and 190 health facilities. To assess data use, we developed dichotomous indicators: discussions of analysis findings, decisions taken based on the analysis, and decisions referred to upper management for action. We aggregated the indicators to generate a composite, continuous index of data use. Results From 2008 to 2012, the district data-use score increased from 40 to 70%; the facility score remained the same – 38%. The central score is not reported, because of a methodological difference in the two assessments. Conclusions The intervention improved the use of data in decision making at the district level in Côte d'Ivoire. This study provides an example of, and guidance for, implementing a large-scale intervention to improve data-informed decision making.