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    Tracking health system performance in times of crisis using routine health data: lessons learned from a multicountry consortium

    Turcotte-Tremblay, Anne-Marie
    Leerapan, Borwornsom
    Akweongo, Patricia
    Amponsah, Freddie
    Aryal, Amit
    Asai, Daisuke
    Awoonor-Williams, John Koku
    Ayele, Wondimu
    Bauhoff, Sebastian
    Doubova, Svetlana V.
    Gadeka, Dominic Dormenyo
    Dulal, Mahesh
    Gage, Anna
    Gordon-Strachan, Georgiana
    Haile-Mariam, Damen
    Joseph, Jean Paul
    Kaewkamjornchai, Phanuwich
    Kapoor, Neena R.
    Gelaw, Solomon Kassahun
    Kim, Min Kyung
    Kruk, Margaret E.
    Kubota, Shogo
    Margozzini, Paula
    Mehata, Suresh
    Mthethwa, Londiwe
    Nega, Adiam
    Oh, Juhwan
    Park, Soo Kyung
    Passi-Solar, Alvaro
    Cuevas, Ricardo Enrique Perez
    Reddy, Tarylee
    Rittiphairoj, Thanitsara
    Sapag, Jaime C.
    Thermidor, Roody
    Tlou, Boikhutso
    Arsenault, Catherine
    2023-01-31

    COVID-19 has prompted the use of readily available administrative data to track health system performance in times of crisis and to monitor disruptions in essential healthcare services. In this commentary we describe our experience working with these data and lessons learned across countries. Since April 2020, the Quality Evidence for Health System Transformation (QuEST) network has used administrative data and routine health information systems (RHIS) to assess health system performance during COVID-19 in Chile, Ethiopia, Ghana, Haiti, Lao People’s Democratic Republic, Mexico, Nepal, South Africa, Republic of Korea and Thailand. We compiled a large set of indicators related to common health conditions for the purpose of multicountry comparisons. The study compiled 73 indicators. A total of 43% of the indicators compiled pertained to reproductive, maternal, newborn and child health (RMNCH). Only 12% of the indicators were related to hypertension, diabetes or cancer care. We also found few indicators related to mental health services and outcomes within these data systems. Moreover, 72% of the indicators compiled were related to volume of services delivered, 18% to health outcomes and only 10% to the quality of processes of care. While several datasets were complete or near-complete censuses of all health facilities in the country, others excluded some facility types or population groups. In some countries, RHIS did not capture services delivered through non-visit or nonconventional care during COVID-19, such as telemedicine. We propose the following recommendations to improve the analysis of administrative and RHIS data to track health system performance in times of crisis: ensure the scope of health conditions covered is aligned with the burden of disease, increase the number of indicators related to quality of care and health outcomes; incorporate data on nonconventional care such as telehealth; continue improving data quality and expand reporting from private sector facilities; move towards collecting patient-level data through electronic health records to facilitate quality-of-care assessment and equity analyses; implement more resilient and standardized health information technologies; reduce delays and loosen restrictions for researchers to access the data; complement routine data with patient-reported data; and employ mixed methods to better understand the underlying causes of service disruptions.

    Routine health information systems
    Health systems
    Quality of care
    COVID-19
    Journal
    Text
    application/pdf
    This work is licensed under a Creative Commons Attribution 4.0 International license (CC BY 4.0).
    Open access
    Copyright (c) 2023 The Author(s)
    https://resources.equityinitiative.org/handle/ei/645
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    Tracking health system performance in times of crisis using routine health data lessons learned from a multicountry consortium.pdf

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