Collecting Reliable Health Data in Democratic Republic of the Congo
In the vast, logistically challenging Democratic Republic of the Congo (DRC), health data are often incomplete, unreliable, or submitted too late to be of use to public health authorities.
Health data for the Nseke health area (Kanzenze health zone) seemed at odds with what the health zone management team actually saw on monitoring and supervisory visits. On paper, it looked like the local health facilities were performing well. But community feedback and verification told a different story.
In late 2013, the USAID-funded Integrated Health Project (DRC-IHP) launched a pilot results-based financing (RBF) program in Kanzenze and six other health zones to see if financial incentives and systematic goal-setting could improve access to care, quality of services, and community engagement. At the end of 2013, In the first quarter after RBF was implemented, health facility staff reported that 9 percent of pregnant women attended their fourth prenatal visit—but counter-verification showed only 1 percent. As a result of inaccurate data, the Nseke health facilities received only $480 compared to the $910 stipend that they would have received if they had performed better.
Xénon Ngoy Kabamba, head nurse from the Nseke health area, was determined to find out where the inaccuracies arose. He soon realized that nurses from the secondary, local health facilities—who collected most of the raw data—never met to discuss indicators or data with the head nurses working in health area offices, to whom they submitted their records.
Supported by DRC-IHP, Xénon and the Kanzenze health zone management team began to facilitate monthly meetings on data analysis with all health-area nurses, starting in January 2014. Immediately the data discrepancies began to decrease. By mid-2015, the area reported 100 percent data accuracy. In addition, the health facilities' performance drastically improved during RBF implementation as the number of patients visits increased from 39 in February 2014 to 243 in September 2015. The percentage of pregnant woman attending their fourth prenatal visit also increased from 1 percent to 10 percent in the last quarter of 2015.
"When all the nurses from the health area worked together to compile and analyze data to report to the National Health Information System," Xénon said, "100 percent of the data we reported was accurate and validated by the auditors. We are very proud of that."