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Data Informed Platform for Health Data Informed Platform for Health Feasibility Study Report Gombe State, Nigeria 2012 FEASIBILITY STUDY REPORT Multi-country feasibility study for the ‘Data Informed Platform for Health’ (DIPH): India, Ethiopia and Nigeria. This report is one of three country- specific reports and is based on research findings from North East Nigeria (Gombe state). The concept note describing the overall premise of the DIPH is on page 4. Acknowledgements Dr Joanna Schellenberg, Principal Investigator, IDEAS project, London School of Hygiene & Tropical Medicine Funded by the Bill & Melinda Gates foundation Research supervised by Dr Bilal Iqbal Avan Report prepared by Health Hub Limited (Dr Ritgak Dimka Tilley-Gyado, Dr Obinna Onyekwena, Dr Chioma Ejeagba and Dr Iboro Nta) and Dr Nasir Umar Proof read by Agnes Becker, Tania Ghosh and Shirine Voller Coordination of publication by Agnes Becker Copyright London School of Hygiene & Tropical Medicine w: ideas.lshtm.ac.uk Cover image © Fotolia ISBN – 978 0 902657 87 9 FEASIBILITY STUDY REPORT Table of Contents DATA-INFORMED PLATFORM FOR HEALTH: CONCEPT NOTE 4 EXECUTIVE SUMMARY 6 CONTEXT 8 Data Informed Platform for Health 8 • Brief background: Focus geographical areas and relationship with the 9 10 • Rationale for selection of Shongom LGA for feasibility study S• TRU Maps CTURES AND GOVERNANCE 12 Public Health System 12 12 14 • Brief structure of the Ministry of Health and departments relevant to the DIPH 15 • Existing contact opportunities between state and LGA 15 • Supervisory structure and activities 16 • Supply system and record keeping on commodities from national to facility level Non-governmental• Portfolio of Local Stakeholders organisations 18 and their programmes in Gombe State 18 • Brief structure of non-governmental organisations relevant to the DIPH 19 19 • Existing contact opportunities between the NGOs and the LGA System 19 • Supervisory structures and activities DATA• Supply REV systemIEW and record keeping of commodities from national to facility level 20 20 20 • Data sources relevant to the implementation of the DIPH in Gombe State 21 • Categories of data available F• ORWAR Use of InformationD PLANNING by LGAs 22 22 22 • General receptiveness of local stakeholders to the DIPH approach 24 • Engagement strategy 24 • Recommendation: Outline of plan for the pilot study of the DIPH APP• PotentialENDICES challenges in the implementation of the DIPH 26 26 33 • Appendix I: Nationally agreed HMIS framework and indicators Ac• AppendixRONYMS II: Brief outline of visits, meetings and contacts made 34 ideas.lshtm.ac.uk Feasibility study report for the Data Informed Platform for Health – Nigeria 3 CONCEPT NOTE Data-Informed Platform for Health: Concept note Plans based on local data Data-Informed Platform for Health In low-resource settings, the use of We propose the “Data-Informed Platform local health data for planning is usually for Health” (DIPH), a framework to guide coordination, bringing together key data from public and private health tolimited. ascertain In the the context causes of of maternal changes inand sectors on inputs and processes that MNHnewborn outcomes. health Sharing(MNH) it information is difficult across governmental and other service providers would reduce duplication 1.could to promote influence the maternal use of local and datanewborn for of effort and ensure resources are not health.decision-making The aims of andthe DIPHpriority-setting are: wasted. In India, Nigeria and Ethiopia, at local health administration level; level of the district, LGA or woreda. Themultiple Health sources Management of data exist Information at the and performance; local programme staff The key data will be reportSystem on reflects human health and physical facility utilisation resources; and non-governmental organisations synthesised to create report on community-based activities. a measure of programme Programme managers could work implementation strength together to share this information, with technical support acting as a for each local area, which catalyst. The shared data could empower in turn can be used in the local decision making and reposition evaluation of the effects health service delivery in line with the available resources and community of large-scale programmes maternal and newborn health needs. on health outcomes.” Figure 1 – Data-Informed Platform for Health Framework Level 2 Level 2 primary goal Data-Informed Secondary administrative Appraisal and comparison of Platform for Health unit of the health system initiatives based on local data Data-Informed Data-Informed Data-Informed Level 1 Area for Area for Area for Level 1 primary goal Primary administrative unit Health A Health B Health C Health decision-making based if the health system (inputs and (inputs and (inputs and on local data processes) processes) processes) 4 Feasibility study report for the Data Informed Platform for Health – Nigeria ideas.lshtm.ac.uk CONCEPT NOTE 2. to promote the use of local data on processes for initiatives and inputs and processes for programme programmes affecting maternal appraisal and comparison at the and newborn health. These can be regional or zonal level. synthesised to create a measure of programme implementation strength The DIPH concept has its roots in the for each local area, which in turn “District Evaluation Platform” approach can be used in the evaluation of the (Victora, Lancet 2010)¹. The framework effects of large-scale programmes should be embedded, owned and on health outcomes. sustained by local health departments. The DIPH operates at local area and regional level, and includes both the “data-informed area for health” and Management Information System the “data-informed region for health”. Data sources: links to the Health Networks for coordination and feedback The DIPH is complementary to the are shown in Figure 1. Area health Health Management Information administration will periodically assess Photo above: A mother and child the available resources and activities 1. The DIPH focus is on inputs and recieving treatment. © Teun Bousema (inputs and processes) by all key health System.processes It differs in health as follows: service provision providers and will share this information – as compared to service uptake for mutual decision making on health and health outcome recorded service provision and research. through routine HMIS. A local health area is considered 2. The DIPH will bring together key TheNext IDEAS steps project team (ideas.lshtm. as the operating unit for the DIPH, data from both governmental and assuming that this is the lowest non-governmental service providers. and potential of the DIPH to assess effective level of decision making The focus is on effective use of theac.uk) scale is interestedup of maternal to explore and newborn interest in a health system – in Ethiopia, this health initiatives in India, Ethiopia would be the woreda; in Nigeria, the planning and decision making. and Nigeria. The feasibility phase Local Government Area; and in India, 3. Theexisting DIPH data will sources focus on for a local few level for DIPH has been successfully it would be the district. key indicators rather than the comprehensive range of data detailed pilot work will be carried out encompassed within the HMIS. incompleted 2013. and, based on the findings, Features of the DIPH The DIPH will use some HMIS At the local area level, the DIPH data, but also include data on ¹ Victora CG, Black RE, Boerma JT, approach provides a mechanism commodities, training, monitoring, Bryce J. Measuring impact in the to bring governmental and non- and supervision, from government Millennium Development Goal era governmental service providers to and non-governmental sources. a common forum on a regular basis, A limited amount of primary data large-scale effectiveness evaluations. to share data in a systematic manner, collection may be carried out. and beyond: a new approach to and to use the resulting information as a tool in priority setting for resource Lancet. 2011 Jan 1;377(9759):85-95. allocation and needs assessment for further acquisition of funds. At regional, zonal or national level, the DIPH provides information The DIPH is an innovative approach could be equally for the appraisal of effectiveness of meaningful for Governments, funding agencies and programmes or initiatives across local areas and regions. Data from other health stakeholders in terms assessment of their implementation efforts and necessary course correction.” local areas will reflect inputs and ideas.lshtm.ac.uk Feasibility study report for the Data Informed Platform for Health – Nigeria 5 EXECUTIVE SUMMARY Executive summary Gombe is one of 36 states in the federal republic of Photos above: Above left: A group of Nigerian children playing in their village. Located in the northeastern part of the country, it is © ThinkStock Nigeria, and has an estimated population of 2,755387. Above: A happy mother holding her twin boys outside her surgery maternal and newborn death rates in the world. in Nigeria. one of the six states in a region with some of the highest Gombe is one of the states IDEAS – a Important enablers to successful Bill & Melinda Gates foundation funded implementation of the DIPH include project – is working in to improve the a well established data collection health and survival of mothers and and sharing system from the districts newborns through the generation and synthesis of evidence to inform policy the administrative structure in the and practice. countryto the federal is divided
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