Quality data, key to improving health service delivery in Sierra Leone

By Harriet Mason, Communications Officer with UNICEF Sierra Leone

KORTUHUN, Sierra Leone – Zainab Conteh and her team are on a mission to improve the quality of data received from health facilities in Bombali district, northern Sierra Leone.

At the end of every month, the 112 health centres in the district are supposed to send data on more than 13 different areas of work, from the numbers of births and deaths, the types of illnesses being treated, and the numbers of women coming for antenatal and post-partum clinics. Until recently, most were not filling on time, and many were sending data that couldn’t be used.

“When you don’t get complete or reliable data, it means that decisions you make will be misinformed,” said Zainab Conteh, Monitoring and Evaluation Officer at the Bombali District Health Management Team (DHMT).

Staff of the Bombali District Health Management Team inspect data registers at the Kortuhun Community Health Centre in Bombali district. ©UNICEF Sierra Leone/2018/Mason

With funding from USAID, UNICEF is supporting the Ministry of Health and Sanitation (MoHS) in the districts of Bombali, Tonkolili and Port Loko improve their data flows through supportive supervision, including health centre visits by the district monitoring and evaluation staff.

When I joined them, their first stop was the health centre in Kortuhun village. “We are here to give them on-the-spot training and coaching,” said Zainab. “This will help guide them to capture the right data and collate them correctly, to improve the quality of data they provide to the DHMT and at national level,” she added.

Strong health systems require effective information management systems. That means that the data are accessible and of a high quality – complete, timely, accurate and consistent. Over the years, MoHS in Sierra Leone has faced challenges in collecting, reporting and using quality data, and the Ebola outbreak 2014-2016, in particular, revealed weaknesses in the health management information system.

To help address this, the Ministry set an objective to improve capacity for data management – and with funding from donors including the European Union, USAID and DFID, UNICEF supported the Ministry to establish the Directorate of Policy, Planning and Information.

The Kortuhun health centre lies 65 minutes’ drive from the district town Makeni, serving a rural community where most people are subsidence farmers. The small centre sits on the edge of the village, surrounded by a green scenery. According to Margaret John, who works as a community health officer at the centre, supportive supervision is very useful as it helps them identify their weaknesses and offers them the opportunity to improve. “We have learnt a lot from this,” said Margaret. “Now we really know how to fill out our registers and tally our data in the correct way,” she added. She believes that these sorts of exercises allow health workers to have one-on-one mentoring.

L-R: Margaret John, Kadiatu Sesay, Manso Kanu and Safiatu Kamara, health workers attached to the Kortuhun Community Health Centre in Bombali district. ©UNICEF Sierra Leone/2018/Mason

The work is already contributing to strengthening the district and national level health information systems with 99 per cent of all required reports being sent to national level – up from 60 per cent when the project began in September 2016; and 97 per cent of expected reports from all district sent to national level on time – up from 34 per cent.

Although it has been a busy day, Margaret and her staff feel their time and energy wasn’t wasted: “It was worth it because our data management skills have improved,” she said. “I believe the data we will be sending from now on will be of high quality,” she added with a smile.

Staff of the Bombali District Health Management Team check data received from health facilities across the district. ©UNICEF Sierra Leone/2018/Mason

As Zainab and her team review the updated data sheets of the Kortuhun health centre, they feel pleased that they visited. “Getting accurate data like this first time around from every health facility in the country will be a dream come true,” said Zainab. “The health system will not only be informed correctly, it will also be in a better position to make critical decisions that will ultimately help improve the health service delivery in the country, especially for women and children.”