Integrating NTD programme monitoring into routine health systems data: evaluating a DHIS2 platform for real-time mass administration of medicines reporting

Main Objectives

• To assess how a DHIS2-based real-time reporting tool for mass drug administration (MDA) strengthens quality, accessibility and use of data for programmatic action at all levels
• To assess whether the tool enhances government ownership of the data and the MDA programme in general
• To assess whether the tool provides a reliable estimate of treatment coverage
• To understand how the tool can be scaled up regardless of funder and location
• To understand what improvements or adaptations are required to the tool or processes around use of the tool

Summary

An electronic MDA reporting platform was developed and rolled out in Nigeria in collaboration with the Nigeria Federal Ministry of Health (FMoH) using the District Health Information Software 2 (DHIS2). With the aim of setting up the platform for future use in more states, roll out and scaling up of the DHIS2 tool and rigorous evaluation were required to ensure maximum scalability, utility, integration with the health system and access and use of data.

The pilot study was carried out in three LGAs (Babura, Sule Tankarkar and Taura) in Jigawa State during MDA using qualitative and quantitative approaches. The DHIS2 tool was then revised and optimised based on findings before scaling up in Enugu, Jigawa and Kwara states. MDA activities and data entries on the DHIS2 were monitored with toll free lines, after which treatment coverage and process evaluation was conducted. This included quantitative analysis of programme data and DHIS2 metadata, and qualitative analysis of focus group discussions, key informant interviews, joint analysis of ownership data and review meetings with relevant stakeholders.

Key findings

• Using DHIS2 for MDA increases data access and use, and would likely increase data quality over time. Ability to address errors and improve decision-making during campaigns are significant benefits
• The reporting platform improved all three components of government ownership (data access, data control, data use) at all levels of the health system, though somewhat less so at the LGA level where the burden of data entry is high
• Successful scale-up will require action on the key recommendations included in the study report

Policy and practice implications

Following this study, the Nigeria FMoH has developed national level scale-up plans, which are currently being rolled out in different states in Nigeria.

Implications for future research

Future research could focus on time and resources saved when this system fully replaces the current spreadsheet-based system. Other research could focus on a deeper dive into data quality improvements, focusing on the aspects of availability, timeliness, and completeness.