Improving Health Care in Low- and Middle-Income Countries by Unknown

Author:Unknown
Language: eng
Format: epub
ISBN: 9783030431129
Publisher: Springer International Publishing

Data Collection and Analysis

Although installation of the offline database described above was quite simple using a self-extracting file, it had to be done in each facility by the QI coordinators from the professional associations. In addition, there were occasional problems with exporting audit report data to save in document or spreadsheet format, depending on the end user’s software. A more significant problem was maintaining a “master” database at the national level and getting results to the facilities in a timely manner. Theoretically, database files updated at the facility level could be e-mailed to the QI coordinator to import into the master database. However, this rarely happened, either because end users had difficulty locating the database file or were not skilled enough at sending e-mail with file attachments. In reality, the QI coordinators gathered audit data in the field using paper forms and then returned to their central offices where they would update the master database file. They would then provide facilities with the updated database files during their next planned visit. As a result, the QI discussions that occurred during visits by the QI coordinators were always focused on results from the prior audit cycle rather than “real-time” data. This was not universally true at the hospital level, where the QI coordinators occasionally had time to help the facility QI curators enter data and generate reports that were discussed during the same visit.

These problems prompted the project to move to an online database in year two. The transition to using an online database was fairly seamless and resolved all of these issues, while creating a few unexpected challenges. Computer and Internet access was often limited to one office within each facility, but this did not pose a significant barrier to utilization. Most users were trained in person on how to find and log on to the database and were able to use it well afterward. Although not an issue in the Kyrgyz Republic, other countries where the project implemented identical initiatives were hesitant to have their QI data stored on a server outside the country (the project rented server space from a company based in the United States for the online database). In the Kyrgyz Republic, there remain challenges with transferring the database to an MOH-based server, as they have limited capacity to provide 24-hour server support and maintenance.

The online database was designed to assign various roles to users, each with a customizable set of privileges. For example, a national-level QI coordinator from a professional association or the Ministry of Health might have full privileges to enter, edit, and view data from any district, while a facility-level QI curator would be allowed to enter and edit data only for their facility, but could view data from any facility or district. Facility- and provider-level data were always displayed by code to maintain confidentiality.

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