Quality of reporting and trends of emergency obstetric and neonatal care indicators: an analysis from Tanzania district health information system data between 2016 and 2020.

Autor: Shabani J; Ifakara Health Institute, Dar es Salaam, Tanzania. jshabani@ihi.or.tz., Masanja H; Ifakara Health Institute, Dar es Salaam, Tanzania., Kagoye S; National Institute for Medical Research, Mwanza, Tanzania., Minja J; Ifakara Health Institute, Dar es Salaam, Tanzania., Bajaria S; Ifakara Health Institute, Dar es Salaam, Tanzania., Mlacha Y; Ifakara Health Institute, Dar es Salaam, Tanzania., Msuya S; Kilimanjaro Christian Medical University College, Kilimanjaro, Tanzania., Masoud M; University of Dar es Salaam, Dar-es-Salaam, Tanzania., Simba D; Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania., Pembe AB; Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania., Makuwani AM; Ministry of Health, Dodoma, Tanzania., Ismail H; Ministry of Health, Dodoma, Tanzania., Chacha M; Ministry of Health, Dodoma, Tanzania., Kumalija C; Ministry of Health, Dodoma, Tanzania., Boerma T; University of Manitoba, Manitoba, Canada., Hanson C; London School of Hygiene & Tropical Medicine, London, UK.
Jazyk: angličtina
Zdroj: BMC pregnancy and childbirth [BMC Pregnancy Childbirth] 2023 Oct 07; Vol. 23 (1), pp. 716. Date of Electronic Publication: 2023 Oct 07.
DOI: 10.1186/s12884-023-06028-z
Abstrakt: Background: Routine health facility data provides the opportunity to monitor progress in quality and uptake of health care continuously. Our study aimed to assess the reliability and usefulness of emergency obstetric care data including temporal and regional variations over the past five years in Tanzania Mainland.
Methods: Data were compiled from the routine monthly district reports compiled as part of the health management information systems for 2016-2020. Key indicators for maternal and neonatal care coverage, emergency obstetric and neonatal complications, and interventions indicators were computed. Assessment on reliability and consistency of reports was conducted and compared with annual rates and proportions over time, across the 26 regions in of Tanzania Mainland and by institutional delivery coverage.
Results: Facility reporting was near complete with 98% in 2018-2020. Estimated population coverage of institutional births increased by 10% points from 71.2% to 2016 to 81.7% in 2020 in Tanzania Mainland, driven by increased use of dispensaries and health centres compared to hospitals. This trend was more pronounced in regions with lower institutional birth rates. The Caesarean section rate remained stable at around 10% of institutional births. Trends in the occurrence of complications such as antepartum haemorrhage, premature rupture of membranes, pre-eclampsia, eclampsia or post-partum bleeding were consistent over time but at low levels (1% of institutional births). Prophylactic uterotonics were provided to nearly all births while curative uterotonics were reported to be used in less than 10% of post-partum bleeding and retained placenta cases.
Conclusion: Our results show a mixed picture in terms of usefulness of the District Health Information System(DHIS2) data. Key indicators of institutional delivery and Caesarean section rates were plausible and provide useful information on regional disparities and trends. However, obstetric complications and several interventions were underreported thus diminishing the usefulness of these data for monitoring. Further research is needed on why complications and interventions to address them are not documented reliably.
(© 2023. BioMed Central Ltd., part of Springer Nature.)
Databáze: MEDLINE
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