Current guidance and tools for DDU

1. Comprehensive Training to support the National Integrated TB/HIV Information System Implementation Current guidance and tools for DDU

2. Context (1) • The whole concept of DDU is not entirely new, clearly addressed in the current DOH policies and SOP • Guidance is provided on • what is meant by data quality • how information should be retrieved and used • how frequently the information should be used • timelines and data flow of data from facility to national

3. Context (2) • Guidance is not always adhered to • During facility engagements, couple of issues identified: e.g. • Non-standard data collection tools in some facilities • Non-usage of TIER.Net line lists • Data not flowing from one level to the other timeously • Outliers and missing data identified at higher levels instead of previous levels • Etc.

4. Governance documents • Key SOPs and Policies • Integrated TB/HIV Data Management SOP • Key role players • Data sources • THIS line lists • Data flow • DHMIS Policy • Data quality dimensions • Facility-level DHMIS SOP • Principles for implementing the SOP • Key HIS maintenance practices at sub-national levels

5. Governance documents

6. Integrated TB/HIV DM SOP – key role players • Sub(district) and higher SOP: • Sub(district) managers (SDM/DM) • Information Management (IM) • HAST managers (HM) • DITs, TKIs, • Provincial managers (PM) • Information Management • PIT leads • HAST managers • National Managers • Facility SOP: • Admin Clerk (AC) • Facility and/or Operational Manager (FM/OM) • Facility/Health Information Officer (F/HIO) • Clinician • Club Manager • Mobile Clinic Nurse

7. Integrated TB/HIV DM SOP – data sources • Data sources for capture in the TB/HIV information system • It is imperative that the prescribed standard data sources are used for digitisingof information • Multiple non-standard data sources would affect quality of clinical governance • E.g. HIV clinical stationery, TB clinical stationery, HTS register, TB case ID register etc. • In line with Ideal Clinic prescript - ‘one patient, one folder, one folder number’ • Where available, Health Patient Record Number (HPRN) must be used as the main folder number

8. Integrated TB/HIV DM SOP - lists and reports • Line lists and reports • Important for line lists and reports to be generated at stipulated timeframes • Admin clerk is responsible for generating the line lists and reports • Facility Manager is responsible for ensuring appropriate action is taken

9. Integrated TB/HIV DM SOP - lists and reports • TIER.Net: available line lists - HIV Daily Weekly Monthly

10. Integrated TB/HIV DM SOP - lists and reports • TIER.Net: available line lists - TB Weekly Monthly

11. Integrated TB/HIV DM SOP - lists and reports • TIER.Net: available reports

12. Integrated TB/HIV DM SOP - lists and reports • TIER.Net: available reports

13. Integrated TB/HIV DM SOP - lists and reports • TIER.Net: available reports e.g. Facility management report Report and line lists Explanation of the alert Alert

14. Integrated TB/HIV DM SOP - lists and reports • TIER.Net: available reports e.g. Facility management report

15. Integrated TB/HIV DM SOP - lists and reports • TIER.Net: available reports e.g. Facility management report

16. Integrated TB/HIV DM SOP - lists and reports • TIER.Net: available reports e.g. (Sub)District management report

17. Integrated TB/HIV DM SOP - lists and reports • TIER.Net: available reports e.g. (Sub)District management report

18. Integrated TB/HIV DM SOP - lists and reports • TIER.Net: available reports e.g. (Sub)District management report

19. Integrated TB/HIV DM SOP – data flow

20. DHMIS Policy – data quality • Data quality improvement initiatives: • Data is generally considered to be of high quality if it is "fit for [its] intended uses in operations, decision making and planning“ • Who routinely interrogates data quality, and how do they do this? • What are the typical feedback mechanisms in place to address issues identified in those reviews? • External stakeholder’s role in this process (i.e. DSPs)? • WHO data quality tool?

21. DHMIS Policy – 8 data quality dimensions

22. DHMIS Policy – 8 data quality dimensions • Relevance • To ensure relevance of all indicators and data elements, NDoH engages a broad range of stakeholders at all levels of health system • Integrity • values and related practices that maintain the confidence users have in the information itself • Timeliness • delays in data collection, conversion into information or data submission compromise the value of the data

23. DHMIS Policy – 8 data quality dimensions 4. Accessibility • ease with which users can obtain the information • Reliability • data should be analysed at all levels with purpose of identifying establishments with unstable data, and thus unstable service delivery • Completeness • All levels of health system should implement mechanisms for verifying the completeness and consistency of data

24. DHMIS Policy – 8 data quality dimensions • Accuracy • All facility managers shall be responsible for ensuring that data accuracy assessments are conducted in each facility, comparing tally sheets, registers and/or patient folders with the summary data and applying data validation rules before data is submitted for capturing • Coherence and comparability • Coherence = degree to which data can be successfully brought together with other similar informationfrom different sources within a broad analytical framework overtime • Comparability = ability to compare data on the same characteristics between different points in time and geographical areas

25. DHMIS facility level SOP - Introduction • The DHMIS facility level SOP (2016) is an updated version of the 2013 SOPs • Clarifies responsibilities and procedures for effective management of aggregated routine health service data • The SOP is mandatory for all health information related activities for NDoH • Facility Manager must ensure team members understand the SOPs objectives • Team members sign that they have read and understand the SOPs

26. DHMIS facility level SOP - Principles • Principles for implementing SOP: • Standardised set of rationalised registers • Service points allocated appropriate organisational units • Admin clerks enter data into various systems • Each patient should have a facility retained clinical record in which all services are recorded • All clinical records and data collection tools must be stored safely and access to them controlled

27. DHMIS facility-level SOP • Key HIS sub-national level maintenance practices: • All policies and SOPs must be available and implemented • Staff must be trained on all policies and SOPs • Each patient must have one patient folder/clinical record and file is always available in facility • Information recorded on data collection tool are consistent with patient folder and supporting documentation • All applicable patient records are captured on electronic databases, e.g. ETR.Net, TIER.Net etc. • Information captured in DHIS is consistent with data input forms

28. DHMIS facility-level SOP • All data collection tools used for collection of must be reviewed for quality and have been signed off • All registersreviewed for quality and have been signed-off by facility manager • All validation errors corrected or explained • All outliersexplained • Processing of data updates has been completed correctly • Sign off forms are properly completed and signed by the facility manager

29. Thank you