Published on May 28, 2014
Data Demand and Use Facilitating the Use of Data to Inform Programs and Planning in Health
Why We Collect Data The ultimate goal is not to gain information, but to improve action. Credits: Pierre Holtz for UNICEF
“… without information, things are done arbitrarily and one becomes unsure of whether a policy or program will fail or succeed. If we allow our policies to be guided by empirical facts and data, there will be a noticeable change in the impact of what we do.” Director of Policy, National Action Committee on AIDS, Nigeria
Data are often underutilized because of… Lack of a “data culture” Unclear staff roles or low staff motivation Lack of technical skills Lack of information technology Poor data quality Lack of appreciation of existing data
Organizational and data quality issues topped the list of issues identified as constraints in a DDU study in India. Source: Data Use in the Indian Health Sector, MEASURE Evaluation
What Do We Mean By Data Use? Availability use Data are reviewed to: monitor a program create or revise a program or strategic plan develop or revise a policy advocate for a policy or program allocate resources Review is linked to a decision making process
There is no single “right way” to use data to support decisions. Multiple stakeholders Multiple and/or conflicting goals Different ways to measure success Ambiguous interpretation of what the data mean How much data is sufficient to make an informed decision
Decisions are influenced by factors other than information and data. Political, cultural or religious ideology Power and influence of sectional interests Corruption Arbitrariness Anecdote
DDU is part of the data-information-use cycle. Data Demand Information Availability Information Use (Decisions made) Data Collection and Analysis Decision-Making Process
Data Demand And Use 1. Is a systematic and deliberate approach 2. Ideally starts at the beginning of the data cycle 3. Includes users of the data and other stakeholders in all stages 4. Is facilitated through the use of various tools and approaches 5. Principles apply at all levels from the facility and community, to national and international programs
Decisions The Three DDU Elements
Element 1: Stakeholders and Decision-Makers Government USG SI officers Other Donors Implementing Partners Beneficiaries Program Managers Policy Makers Journalists/Media Private Sector Engage stakeholders to identify issues and data required
Element 2: Data and Information Service statistics Surveillance data Household surveys Vital events data Research Census Mapping of health facilities and services Financial and management information Modeling, estimates and projections Assemble or collect and analyze data
Element 3: Decisions Problem identification, awareness raising & advocacy Policy & planning Program design & improvement Program management & operations Facilitate use of data by stakeholders
Project’s Vision for DDU Data Demand and Use Strategy, MEASURE Evaluation Dec 2009 “By the end of the project period it is anticipated that data use will be fully integrated into and part of the regular M&E process. Moreover, it is envisioned that select country collaborators will have institutionalized data use approaches and tools and will regularly consider issues relating to data informed decision making at the outset of all M&E activities.”
Phase 2: Changing the paradigm Developed the theory, concepts, tools and case study examples Conceptual framework Toolkit Case studies Arusha meeting Training by experts
Phase 3: Scale Up and Institutionalization Refined & standardized DDU approach Revised toolkit – 2 additional tools, one in draft Publications (10) Data Use Net (954 members) Expanded Conceptual Framework & Logic Model
Phase 3: Scale Up And Institutionalization Capacity building and technical assistance in DDU Capacity building packages; eLearning Webinars DDU advisors in Nigeria, Kenya, Tanzania, South Africa Case studies with service providers
Remember…. The ultimate goal is not to gain information, but to improve action.
DDU in Action The new DDU framework and intervention strategy DDU in Cote d’Ivoire
Data Demand and Use As a Health Systems Strengthening Intervention Tara Nutley End of Project Meeting May 22, 2014
Expanded audience Expanded reach Institutionalization Increased demand Outcomes Phase 2 Phase 3
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Data Use Intervention: 8 Activities 1. Assess & improve data use context 2. Engage data users & producers 3. Identify information needs 4. Improve data quality 5. Improve data availability (access, synthesis, communication) 6. Build capacity in data use core competencies 7. Strengthen organization’s data use infrastructure 8. Evaluate & communicate data use successes
Partnership with Pact Worldwide Institutionalize DDU tools and strategies within organizations with a global reach Apply DDU intervention in one country for proof of concept Pact Lesotho – OVC & HIV prevention project Rely on diffusion of innovation to reach an expanded audience
DDU Intervention 1) Assess data use context Pact HQ & Lesotho, 6 of 12 NGOs Rapid assessment 8 month work plan January notice of program closure in 2 & 5 months
DDU Intervention 2) Engage data users & producers In depth data review & use meetings Utilized existing data Generated demand for additional data
DDU Intervention 3) Identify information needs Applied Framework for Linking Data with Action Question – What difference did the program create at partner & beneficiary levels?
DDU Intervention 4) Improve data quality 5) Improve data availability 6) Build capacity On-line course Qualitative methods course
DDU Intervention 7) Strengthen DDU infrastructure Data use policy 8) Monitor & evaluate Increased review of & demand for data
Intervention Results – The ‘So What’ Service delivery Increased # of guardians of OVC receiving services & improved dialogue Global diffusion Pact Global M&E standards mandate datause plan
Data Demand and Use in Cote d’Ivoire Leontine Gnassou, Resident Advisor MEASURE Evaluation End-of-Phase-III Event, May 22, 2014
MEval-II in Cote d’Ivoire Beginning of Phase II – 2004 Absence of harmonized HIV indicators and data collection tools Data not available for decision making Implementation of Health Information System Strengthening Plan
MEval-III in Cote d’Ivoire Beginning of Phase III – 2008 PRISM found weaknesses in data quality and use of information Focus on data quality and use at central and decentralized level of the health system First example of data use intervention integrated in RHIS strengthening plan from the beginning
Data Use Interventions 1. Assess and improve data use context 2. Engage data users and producers 3. Identify information needs 4. Improve data quality 5. Improve data availability (access, synthesis, communication) 6. Build capacity in data use core competencies 7. Strengthen organization’s data use infrastructure 8. Evaluate and communicate data use successes
1. Assess and Improve Data Use Context PRISM 2008 PRISM 2012
2. Engage Data Users and Producers DDU workshop in 2010 Regional data review meetings every 6 months Questions identified Additional analysis Recommendations for improved programs Tool application
3. Identify Information Needs Regional strategic information coordination meetings supported in six out of the 19 regions in the country Data users and producers identified information by prioritizing their programmatic questions
4. Improve Data Quality Data management procedure manual developed Indicators revised Trained to use the Routine Data Quality Assessment (RDQA) RDQA supervision by DIPE & regional level
5. Improve Data Availability Created a DDU module for the OVC database Program Plus database for HIV care and treatment data (Access, Synthesis, Communication)
6. Build Capacity in Data Use Core Competencies Data use concepts & tools incorporated into 4 in- service & pre- service training institutions Schools of: health professionals, public health, statistics & economics, social training Individual capacity building Trained a total of 479 students, PEPFAR IPs & MOH staff
7. Strengthen Organization’s Data Use Infrastructure M&E staffing MOH mandated new regional positions Six regions hired regional M&E specialists 1region hired 6 district M&E officers Regular regional meetings for data review,DQA use tools, and DQA procedures
8. Evaluate Intervention Data use – Data quality – Data availability – 44% to70% at district level 38% – nochange at facility level 43% to 60%at district level 40% to81% at facility level 7% to29% at facility level PRISM results 2008 & 2012
8. Evaluate Intervention Engagement & ID information needs – New quarterly strategic data use meetings Capacity building – data use curriculum in national universities Institutionalization – National guidelines & protocols, regular data use fora, new positions to oversee data use activities Observed results:
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