Routine data in a primary care performance dashboard, Ethiopia

Area of Science:

• Health Management Information Systems
• Primary Care Performance Measurement
• Public Health Data Analytics

Background:

• The Ethiopian Health Management Information System (HMIS) utilizes the District Health Information Software 2 (DHIS2) platform.
• Assessing primary care performance is crucial for improving health outcomes in diverse regions.
• Data quality and completeness are key challenges in utilizing DHIS2 for performance dashboards.

Purpose of the Study:

• To evaluate the feasibility of creating a primary care performance dashboard using DHIS2 data in Ethiopia.
• To develop and assess primary care performance indicators across urban, agrarian, and pastoral regions.
• To examine data completeness, outliers, and external validity of DHIS2 data for performance measurement.

Main Methods:

• Extracted 26 data elements from 12,062 health facilities in Ethiopia (July 2022-June 2023).
• Developed 14 primary care performance indicators focusing on effectiveness, safety, and user experience.
• Assessed data completeness, outliers, and external validity of the extracted data.

Main Results:

• Average data completeness varied by region: Addis Ababa (82.9%), Oromia (66.2%), and Somali (52.6%).
• Private clinics showed lower data completeness across all regions.
• External validity was high for 11 of 14 indicators, but key indicators like ART retention and NCD control showed poor validity.

Conclusions:

• Ethiopian DHIS2 data can be used to measure primary care performance at national and regional levels.
• Despite data quality issues, DHIS2 is a valuable resource for national health system performance assessment.
• Further improvements in data quality are necessary for robust primary care performance monitoring.