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Strengthening data management and use in decision making to improve health care services: Lessons learnt
Malaria continues to be a major killer of under-fives, and Tanzania has set strategies to reduce malaria in the country. To complement efforts of the Ministry of Health and Social Welfare, in 2011 the United States Agency for International Development (USAID) created the Tibu Homa Project to improve diagnosis and treatment of febrile illnesses among children under five years of age in the Lake Zone of Tanzania. THP is led by University Research Co., LLC (URC) working in partnership with Amref Health Africa and Management Sciences for Health (MSH). The project is operational in 28 districts of six regions in the Lake Zone (Kagera, Mwanza, Geita, Mara, Shinyanga, and Simiyu).
Over the past three years, the Tibu Homa Project (THP) has been supporting health facility system strengthening to improve case management of children under five with fever in the Lake Zone of Tanzania. This intervention has applied a quality improvement approach that emphasizes proper documentation and data use for decision making.
THP facilitated the establishment of pediatric quality improvement teams (PQITs) in each of the supported health facilities and trained two members of each team in data management. THP assisted the teams in developing an improvement aim, identifying performance indicators, setting targets, documenting changes, testing the effectiveness of specific changes, plotting data on time series charts to track performance, and using the results to make decisions.
Quarterly results showed significant improvement in proper data collection and use. The proportion of health facilities using data to make improvement decisions has improved. The improvements were largely brought about by the strong collaboration between Council Health Management Teams (CHMTs), PQITs, and the project staff.
The key lessons learnt here are that the improvement in health facilities’ data management has a direct link in improving case management of under-fives with fever. The availability of accurate facility-generated data contributes to strengthening the capacity of health systems to make good decisions in improving care for under-fives. Data use and decision making is an important component of quality improvement at all levels.
It is recommended that data management initiatives continue to be an integral part of supportive supervision and mentorship to health facilities.