Extend of RI data falsification in Nigeria_ Bauchi state

[Dr. Khalid Abubakar]

Quality immunization data in one of the major challenge of immunization in Nigeria. Data as a tool used to monitor performance for action  become difficult to analysed, difficult to make decisions, difficult to planning and difficult for utilization of scarce available resources. Bauchi state benefiting from the tripartite MOU has achieved alot in immunization however data quality is major issue. How quality is our data? How can we used the data for planing? how could the data generated translate into financial support derived from donors?.  Majors were taken to explore quality of data through bi- annual data quality survey (DQS) which revealed real issues with regard to data over-reporting, under-reporting and other issues of quality of monitoring system like recording, archiving and use of data for action. Recent the state conducted REW microplan exercised using GIS to estimated target population for each HF catchment area with involvement of community members to validate the information, as denominator posed challenge leading outrageous coverage and high administrative data. 

Attitude of health personnel toward generating false data become persistent with recent experience of falsification on immunization register. I decide to utilized the Community survey during supportive supervision which became eye opener to uncovered the falsification on the register by comparing the child health card records and immunization recorded on the register in HF. Decision was taken through effective accountability framework, to grant amnesty (warning letter dispatched to all providers) and ensure zero tolerance to data falsification subsequently. Robust supervisory plan was designed to tracked and monitor sessions and capacity building of the supervisors, data quality check on monthly bases and feedback during monthly meeting with the providers. Need your inputs thanks

attached evidence pictures 

[Puta, Chilunga]

Hello Doc

This indeed is very interesting work, although I am sure that your challenges are not unique to Nigeria. What has gotten my attention is the deliberate falsification of data. Genuine errors, incompleteness of data might be attributed to work overload or some other legitimate reason – but deliberate falsification would suggest to me that the concerned health workers do not have an appreciation of the value of health data particularly for efficient and effective programming (and by extension better health services and healthier populations, a key factor in national development!). I wonder if you could enhance change management activities so that health workers really do buy into the vision for high quality data for better health care service delivery? My view is that unless the health workers at that level buy into the value of quality data this battle may not be won.

Chilunga

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[Dr. Khalid Abubakar]

Thanks for the feedback. I really appreciate your response. Health workers attitude is indeed major cause of data falsification. As u rightly mention they don't value health data which we are now trying to institute postive behavioural change and effective accountability framework. 

Work load also due contribute to some extend but our nature of falsification in Nigeria is worrisome. As we uncovered so many issues but discrepancies between register, tally, summery occasionally, NHMIS form, vaccine utilization and even data on monitoring chart so also child health card. This quite deliberate.... But transaction error may not follow such trend.

Hope y will assist us with more inputs

Best regards

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[Puta, Chilunga]

As a matter of interest, what constitutes your behavioral change strategy and accountability framework?

Anybody from the network able to make suggestions to Dr Khalid?

Thanks

Chilunga

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[Dr. Khalid Abubakar]

No specific strategy on behavioral change as its very difficult to decide which work best, unless we try different approach and apply the one which suit our system.

i have few innovations in mind, while inputs from other members of this network will enrich my points toward minimizing data falsification in our various locations. some of the innovations include,  Need for health workers to understand the value of quality data for health and plan to Grand pardon "Amnesty" for the health workers about the past ( data falsification issues). Also invite service providers were we will discussion on data quality especially those with evidence of falsification(In phase). While for accountability framework was developed by the NPHCDA/ Partners in national emergency operation center (national level) recently which will be share to all level, with emphasis on data quality.

Thanks once again

Dr khalid A Isah

Cluster consultant,

World Health Organisation (WHO)

No. 20 Ahmed Abdulkadir Bank Road,

WHO/Unicef Shared Premises Bauchi Nigeria.
Contact:- +2348038675855

E-mail; shaml...@gmail.com                              

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[Atikah Adyas]

Hello Doc,

Sometimes we found the different target coverage between  centre and local  (national, province and district), so that confusing for the health workers to refer.

Another challenge is generally data is not interested job, but giving an incentive for a certain work performance , may motivate the personnel to do better job.

 

Atikah

Ministry of health of Indonesia

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[Dr. Khalid Abubakar]

Dear Atika,

Thanks for sharing for your input... Despite difference in Target at Central and peripheral level, data should be consistent when check between data tools especially at the source (HFs). While for incentive, accountability framework has reward and punishment which will support the providers. 

It's all about quality data, and how to improve on it. Data is very difficult issue but we need commitment to ensure consistency.

On Sep 5, 2017 1:28 AM, "'Atikah Adyas' via BID Initiative Discussions" <bidini...@googlegroups.com> wrote:

Hello Doc,

Sometimes we found the different target coverage between  centre and local  (national, province and district), so that confusing for the health workers to refer.

Another challenge is generally data is not interested job, but giving an incentive for a certain work performance , may motivate the personnel to do better job.

 

Atikah

Ministry of health of Indonesia

On Saturday, September 2, 2017 12:37 PM, Dr. Khalid Abubakar <shaml...@gmail.com> wrote:

Quality immunization data in one of the major challenge of immunization in Nigeria. Data as a tool used to monitor performance for action  become difficult to analysed, difficult to make decisions, difficult to planning and difficult for utilization of scarce available resources. Bauchi state benefiting from the tripartite MOU has achieved alot in immunization however data quality is major issue. How quality is our data? How can we used the data for planing? how could the data generated translate into financial support derived from donors?.  Majors were taken to explore quality of data through bi- annual data quality survey (DQS) which revealed real issues with regard to data over-reporting, under-reporting and other issues of quality of monitoring system like recording, archiving and use of data for action. Recent the state conducted REW microplan exercised using GIS to estimated target population for each HF catchment area with involvement of community members to validate the information, as denominator posed challenge leading outrageous coverage and high administrative data. 

Attitude of health personnel toward generating false data become persistent with recent experience of falsification on immunization register. I decide to utilized the Community survey during supportive supervision which became eye opener to uncovered the falsification on the register by comparing the child health card records and immunization recorded on the register in HF. Decision was taken through effective accountability framework, to grant amnesty (warning letter dispatched to all providers) and ensure zero tolerance to data falsification subsequently. Robust supervisory plan was designed to tracked and monitor sessions and capacity building of the supervisors, data quality check on monthly bases and feedback during monthly meeting with the providers. Need your inputs thanks

attached evidence pictures 

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