Using routine information system data to assess maternal and perinatal care services in Mali and Senegal (QUARITE trial)

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Study Justification:
– The study aimed to assess the quality of data collected in referral hospitals in Mali and Senegal after strengthening the routine information system (RIS).
– Problems of access to relevant and high-quality facility-based statistics in sub-Saharan Africa hinder the assessment of safe motherhood programs.
– Strengthening the RIS would provide an economically and technologically appropriate system for monitoring maternal and perinatal health in these countries.
Highlights:
– The study found that after strengthening the RIS, the completeness rate of data collected ranged from 94% to 97%.
– The completion and accuracy rates of data also increased significantly during the study period.
– The average investment per hospital to strengthen the RIS was less than 1% of state subsidies for public hospitals.
Recommendations for Lay Reader:
– Strengthening the routine information system (RIS) in referral hospitals can greatly improve the monitoring of maternal and perinatal health.
– Investing in RIS is a cost-effective way to improve the performance of health systems.
– Policy makers and researchers in countries with limited resources should consider investing in RIS to enhance data collection and monitoring.
Recommendations for Policy Maker:
– Allocate resources to strengthen the routine information system (RIS) in referral hospitals.
– Provide support for technical, organizational, and behavioral factors to ensure the effectiveness of the RIS.
– Promote the use of RIS to monitor and improve maternal and perinatal health outcomes.
Key Role Players:
– Ministry of Health: Responsible for allocating resources and providing support for strengthening the RIS.
– Hospital Administrators: Involved in implementing and managing the RIS in referral hospitals.
– Health Information Management Staff: Responsible for data collection, monitoring, and analysis using the RIS.
– Researchers: Conduct studies to evaluate the effectiveness of the RIS and provide evidence-based recommendations.
Cost Items for Planning Recommendations:
– Technical Support: Budget for hiring or training staff to provide technical assistance for RIS implementation and maintenance.
– Infrastructure: Funds for upgrading or purchasing necessary hardware and software for the RIS.
– Training and Capacity Building: Budget for training healthcare staff on data collection, management, and analysis using the RIS.
– Monitoring and Evaluation: Resources for regular monitoring and evaluation of the RIS to ensure its effectiveness and identify areas for improvement.
– Communication and Awareness: Funds for promoting the use of RIS among healthcare providers and raising awareness among the public and policymakers.

The strength of evidence for this abstract is 7 out of 10.
The evidence in the abstract is moderately strong. The study conducted a multicenter observational study and monitored completeness, completion, and accuracy rates in referral hospitals in Mali and Senegal. The study found significant improvements in these rates after strengthening the routine information system (RIS). The average investment per hospital was also determined. However, the abstract does not provide specific details about the methodology used or the sample size. To improve the strength of the evidence, the abstract could include more information about the study design, sample size, and statistical analysis methods used.

Background: In sub-Saharan Africa, problems of access to relevant and high-quality facility-based statistics hinder the assessment of safe motherhood programs. The objective of this study was to assess the quality of data collected in referral hospitals in Mali and Senegal after the routine information system (RIS) was strengthened. Methods: This was a multicenter observational study conducted during the pre-intervention period of a randomized controlled trial (trial QUARITE). The RIS was strengthened based on technical, organizational and behavioral factors. We included all women who gave birth in the 46 referral hospitals from October 1, 2007 to October 30, 2008. The completeness, completion and accuracy rates were monitored every 3. months in each hospital. The cost of investment needed to strengthen the existing RIS was also determined. Results: The mean completeness rate ranged from 94 to 97% depending on the study period. The completion and accuracy rates increased during the study period from 72% and 79% to 87% and 93%, respectively (significant differences). The average investment per hospital was less than 1% of state subsidies for public hospitals. Conclusion: Strengthening the existing information system has set up an economically and technologically appropriate system for monitoring maternal and perinatal health in Senegal and Mali. We encourage policy makers and researchers from countries with limited resources to invest in RIS to improve and monitor the performance of health systems. © 2012 Elsevier Masson SAS.

The innovation described in the study is the use of routine information system (RIS) data to assess maternal and perinatal care services in Mali and Senegal. The RIS was strengthened based on technical, organizational, and behavioral factors. This allowed for the monitoring of completeness, completion, and accuracy rates of data collected in referral hospitals. The study found that the strengthening of the RIS led to improvements in data quality and recommended that policymakers and researchers in resource-limited countries invest in RIS to improve and monitor the performance of health systems.
AI Innovations Description
The recommendation from the study is to strengthen the routine information system (RIS) in referral hospitals in Mali and Senegal. By improving the technical, organizational, and behavioral factors of the RIS, the quality of data collected on maternal and perinatal care services can be enhanced. This will enable better assessment of safe motherhood programs and improve access to relevant and high-quality facility-based statistics.

The study found that after strengthening the RIS, there was an increase in the completeness, completion, and accuracy rates of the data collected. The completeness rate ranged from 94% to 97%, while the completion and accuracy rates increased from 72% and 79% to 87% and 93% respectively. These improvements were statistically significant.

Furthermore, the study found that the investment required to strengthen the RIS was relatively low, with the average investment per hospital being less than 1% of state subsidies for public hospitals. This suggests that strengthening the RIS is an economically feasible solution.

The conclusion of the study encourages policy makers and researchers in countries with limited resources to invest in strengthening their RIS. This will not only improve the monitoring of maternal and perinatal health but also enhance the overall performance of the health systems.
AI Innovations Methodology
Based on the provided description, here are some potential recommendations for improving access to maternal health:

1. Strengthen Routine Information Systems (RIS): Investing in the improvement of RIS can provide accurate and timely data on maternal and perinatal health. This can help identify gaps and areas for improvement in healthcare services.

2. Enhance Technical Capacity: Providing training and resources to healthcare providers on data collection, management, and analysis can improve the quality and completeness of data collected.

3. Improve Organizational Processes: Streamlining data collection processes and ensuring clear guidelines and protocols are in place can help healthcare facilities collect and report data more effectively.

4. Promote Behavioral Change: Encouraging healthcare providers to prioritize data collection and reporting can lead to increased accuracy and completeness of data.

To simulate the impact of these recommendations on improving access to maternal health, a methodology could include the following steps:

1. Define Key Indicators: Identify the specific indicators that will be used to measure access to maternal health, such as the number of antenatal care visits, skilled birth attendance, or postnatal care utilization.

2. Baseline Data Collection: Gather data on the selected indicators before implementing the recommendations. This will serve as a baseline for comparison.

3. Implement Recommendations: Introduce the recommended interventions, such as strengthening RIS, enhancing technical capacity, improving organizational processes, and promoting behavioral change.

4. Ongoing Data Monitoring: Continuously collect data on the selected indicators after implementing the recommendations. This can be done through routine data collection systems or surveys.

5. Data Analysis: Analyze the collected data to assess the impact of the recommendations on access to maternal health. Compare the post-intervention data with the baseline data to identify any improvements or changes.

6. Evaluation and Interpretation: Evaluate the results and interpret the findings to determine the effectiveness of the recommendations in improving access to maternal health. Consider factors such as completeness, accuracy, and timeliness of data, as well as changes in healthcare utilization.

By following this methodology, policymakers and researchers can assess the impact of the recommendations on improving access to maternal health and make informed decisions on further interventions or improvements needed.

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