1. Module 5: Sharing data & information

2. Module 5: Learning objectives  Understand the importance of information feedback in program improvement and management  Understand the elements of good feedback  Understand the importance of information flow and how it affects data use

3. Data Demand & Information Use

4. “We are always giving patient forms and data to our M&E Unit, who then gives data to donors and the government. I am the head doctor and I never have the chance to look through the data before they go up. We just keep giving data up and up, and we never hear back about it…” Head of ART facility, Nigeria

5. 5 Lack of information feedback is a common problem  Local data not used locally  Higher-level information does not return back to local level  Local data not assessed in broad context  Little incentive to produce high-quality data

6. Why is feedback important to the provider?  Understand how daily work contributes to greater program  Provides opportunity to compare programs – resulting in expanded data use  Informs providers that data they collect are used – leads to improved data quality  Incentive/motivation to continue to collect, analyze, & use data

7. Sharing information  Information needs to be shared  At timely and regular intervals  Within, between, up, and down Effective communication helps to ensure use of information for planning and programmatic improvement

8. Higher levels: district, province, national Analysts, Evaluators Service Delivery Point Feedback Managers, Government, Donors Program Compiled Data Clinical Histories, Service Statistics Reports Information Flow

9. Purpose of understanding information flow  Helps us better understand our role in health information system and importance of collecting data  Identify opportunities for improving data collection & analysis, increasing availability, and ensuring data use

10. Information Use Map

11. Information Use Mapping  Purpose  Describes existing flow of health information to identify opportunities for improving its use  Description  Identifies gaps and opportunities for using information  Identifies opportunities for additional feedback mechanisms  Identifies points at which analysis & data could support programmatic decision making

14. Improving Information flow  FEEDBACK!  Sharing information and commentary within a facility, organization, district, province  Sharing information between facilities, districts, provinces  Discussing and using information  Demanding information

15. Working toward a culture of information use  Information becomes an integral part of decision- making processes, including planning, problem solving, choosing alternatives, feedback, etc.  Empowers people to ask questions, seek improvement, learn, and improve quality

16. Variety of Formats  Narratives  Summaries, bulleted items, graphs, charts  In-person discussion  One-on-one  Staff meetings, district meetings  Speeches to staff  Supervision visits

18. Quarterly Performance Indicators #IndicatorNumeratorDenominatorPercentage ART 1% of eligible clients placed on ART # of new clients on ARTSum of # of new clients on ART and clients on ART waiting list 100% 39 2% of current ART clients # of active clients on ART# of cumulative clients on ART 92% 16201765 3% of ART clients in 6 month cohort undergoing repeat CD4 testing # of clients for whom repeat CD4 testing was done at 6 months Total # of active ART clients in 6 month cohort 94% 147156 Pediatric ART 1% of children current on ART # of active children on ART# of cumulative children on ART 78% 4558 ART Care Follow-up 1% of non active ART patients who have stopped ART. # of patients who stopped ART. # of non active ART patients. 0% 0145 2% of non active ART patients who transferred out. # of patients who transferred out. # of non active ART patients. 6% 8145 3% of non active ART patients who died. # of patients who died.# of non active ART patients. 73% 106145 4% of non active ART patients who have been lost to follow- up. # of patients who have been lost to follow-up. # of non active ART patients. 16% 23145

19. 19 When developing feedback mechanism, consider…  The information being shared  Who will benefit from feedback  The format of the feedback mechanism  The forum at which feedback will be shared  How often the feedback will be provided  How the feedback will move to the next level

20. 20 Potential barriers to providing feedback  Hierarchy  Role clarification – data clerk & M&E officer  Approval requirements to distribute data  Lack of knowledge as to what information stakeholders need

21. Key Messages  Effective data feedback helps to ensure use of information for planning and programmatic improvement  It is important to identify and address barriers to information flow  Information Use Map can highlight intervention points to improve information use