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STRENGTHENING DATA MANAGEMENT AND USE AT HOIMA REGIONAL REFERRAL HOSPITAL BY SIMON NDIZEYE – (MASTER OF SCIENCE IN POPULATION AND REPRODUCTIVE HEALTH) MEDIUM TERM FELLOW AND LUCY ASABA (REGISTERED NURSE / MIDWIFE; BACHELOR OF ARTS IN COMMUNITY BASED DEVELOPMENT) MEDIUM TERM FELLOW MAKERERE UNIVERSITY SCHOOL OF PUBLIC HEALTH-CDC MEDIUM TERM FELLOWSHIP PROGRAM REPORT NOVEMBER 2013 TABLE OF CONTENTS DECLARATION ........................................................................................................................... iii LIST OF ACRONYMS ................................................................................................................. vi OPERATIONAL DEFINITIONS ................................................................................................. vii EXECUTIVE SUMMARY ........................................................................................................... ix 1.0 INTRODUCTION AND BACKGROUND ............................................................................. 1 2.0 LITERATURE REVIEW ......................................................................................................... 2 2.1 Utilization of Health Data for Decision Making................................................................... 3 2.2 Improving Data Quality and Availability ............................................................................. 4 2.3 Capacity Building in Data Management and Use ................................................................. 5 3.0 STATEMENT OF THE PROBLEM & PROJECT JUSTIFICATION .................................... 6 3.1 Statement of the Problem ...................................................................................................... 6 3.2 Justification for the project ................................................................................................... 7 4.0 GENERAL & SPECIFIC OBJECTIVES ................................................................................. 7 4.1 General objective .................................................................................................................. 7 4.2 Specific Objectives ............................................................................................................... 7 5.0 METHODOLOGY ................................................................................................................... 8 6.0 PROJECT OUTCOMES ......................................................................................................... 11 7.0 LESSONS LEARNT .............................................................................................................. 15 8.0 CHALLENGES FACED ........................................................................................................ 16 9.0 SUMMARY AND CONCLUSIONS ..................................................................................... 16 10. RECOMMENDATIONS ........................................................................................................ 17 11. SCALE-UP/SUSTAINABILITY AND DISSEMINATION PLAN ...................................... 17 REFERENCES ............................................................................................................................. 19 LIST OF TABLES Table 1: DHIS2 Timeliness of Reporting Summary for January to September 2013…………...14 APPENDICES Appendix 1: Terms of Reference for the Data Review Committee .............................................. 21 Appendix 2: Sample of the Agenda for a Data Review Meeting ................................................. 23 Appendix 3: Members of the Data Review Committee ................................................................ 24 ii DECLARATION I, Simon Ndizeye and Lucy Asaba do hereby declare that this end of project report entitled “Strengthening data management and use at Hoima Regional Referral Hospital” was prepared and submitted in fulfillment of the requirements of the Medium-term Fellowship Program at Makerere University School of Public Health and has not been submitted for any academic or non-academic qualifications. Signed ………………………………… Date………………………………….. Simon Ndizeye, Medium-term Fellow Signed ………………………………… Date……………………………………. Lucy Asaba, Medium-term Fellow Signed ………………………………… Date………………………………….. Dr. Rose Mukisa Bisoborwa - Institutional Mentor Signed ………………………………… Date………………………………….. Assoc Prof. Rhoda Wanyenze - Academic Mentor iii ACKNOWLEDGEMENTS We would like to acknowledge the concerted efforts and invaluable contributions of various individuals towards the successful implementation of the Fellowship Project. We extend our gratitude to EngenderHealth management especially Ms Karen Beattie, the Fistula Care Program Director and Dr. Rose Mukisa Bisoborwa, the Country Program Manager for accepting us to participate in the MakSPH Fellowship program and providing funds to cover our travels, accommodation, meals and other incidentals during project implementation in Hoima district. Dr. Rose also acted as our institutional mentor and was able to provide ongoing technical guidance in the course of implementing the project. EngenderHealth Uganda staff especially the Finance and Administration team played a key role in coordinating procurement, transport and other logistics needed in the field as well as ensuring our compliance with the organization’s financial SOPs and systems. Special thanks go to our academic mentor Associate Professor Rhoda Wanyenze for reviewing our initial concept paper that we later used to develop a project proposal. She was also very instrumental in ensuring that the project proposal detailed how the identified problem of poor data management and use was going to be addressed at Hoima Hospital using the limited resources at hand. Furthermore we would like to acknowledge with much appreciation the crucial role played by Hoima Hospital top management especially the Hospital Director, Dr. Francis Mulwanyi and the Senior Principal Nursing Officer Sr. Florence Acheng in providing overall onsite leadership and creating an enabling environment for project implementation. We also thank the data review committee, medical records personnel and all staff of Hoima Hospital for spearheading the setting up of systems to strengthen data management and use. We cannot forget to commend the excellent work done by MakSPH-CDC Fellowship Staff especially Mr. Joseph Matovu, Ms. Stella Ongorok, Ms. Susan Mawemuko and Ms. Faridah Mbambu. They provided us with ongoing administrative, financial and technical/academic guidance from day one thereby enabling us to successfully complete the Fellowship Program. iv Last but not least we are grateful to the Hoima District Biostatician, Mr. David Kabagambe for providing technical support in conducting data review meetings and training health workers on how to use health facility data for decision making. v LIST OF ACRONYMS ANC - Antenatal Care DHIS2 - District Health Information System DHO - District Health Officer FC - Fistula Care HC - Health Centre HIV/AIDS - Human Immuno Virus/Acquired Immune Deficiency Syndrome HMIS - Health Management Information System M&E - Monitoring and Evaluation MCH - Maternal and Child Health MOH - Ministry of Health NGO - Non-government organization OPD - Outpatients Department PMTCT - Prevention of Mother to Child Transmission of HIV RRH - Regional Referral Hospital RVF - Rectal-Vaginal Fistula SUSTAIN - Strengthening Uganda's Systems for Treating AIDS Nationally SOPs - Standard Operation Procedures TOR - Terms of Reference VHTs - Village Health Teams VVF - Vesico-Vaginal Fistula vi OPERATIONAL DEFINITIONS • A project: An intervention that consists of a set of planned, interrelated activities designed to achieve defined objectives within a given budget and a specified period of time. • Obstetric Fistula: This is a medical complication normally caused by prolonged and/or obstructed labor where the presenting part, usually the head presses against the vagina or bladder causing death of tissues. This results in an opening/hole commonly between the bladder and the vagina (vesico vaginal fistula-VVF) or between the rectum and the vagina (recto-vaginal fistula -RVF). A woman with VVF passes urine uncontrollably through the vagina while one with RVF passes feaces through the vagina or both in extreme cases. • Mentoring: Mentoring is the long term passing on of support, guidance and advice. In the workplace it is intended to describe a relationship in which a more experienced colleague uses their greater knowledge and understanding of the work or workplace to support the development of a more junior or inexperienced member of staff in a bid to strengthen competences. • Coaching: This is defined as ‘developing a person’s skills and knowledge so that their job performance improves, hopefully leading to the achievement of organizational objectives. It targets high performance and improvement at work, although it may also have an impact on an individual’s private life. It usually lasts for a short period and focuses on specific skills and goals. • Sustainability : This is the likelihood that the positive effects of a project (such as assets, skills, facilities or improved services) will persist for an extended period after the external assistance ends. • Data management: This is the process of putting in place mechanisms and actions to track data flow, storage and reduce the probability of errors being introduced into the data at any stage. vii • Data quality refers to accurate, timely, complete, precise

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