Timely and routine access to data is necessary for all health systems to improve decision making and guide resource allocation. The ASSP project’s health systems strengthening approach identifies stakeholder needs and capacity, emphasizes data quality and security, and focuses on the end goal: using data to improve planning, management, and health outcomes. ASSP is helping the Congolese government to improve capacity and use of its national health information system (SNIS) while also addressing facility level gaps such as equipment, training, and skills at the health zone level to analyze data. Perhaps the most pressing challenges for data collection are the geographic barriers and technological limitations in the DRC. As a result, many health facilities still use paper-based systems that limit timely access to data.

Our Approach

ASSP is working with the MOH to strengthen the National Health Information System (SNIS) by building human resource capacity, infrastructure, and information sharing platforms to improve data dissemination and use for decision-making. ASSP has worked closely with the Ministry of Health (MOH) to roll out a web-based management information system (DHIS2) that allows for more timely, accurate, and transparent use of data in all 52 ASSP health zones. IMA also provides technical assistance to the MOH for the configuration and ongoing technical support of the DHIS2 software, implementation in the remaining non-ASSP 474 health zones in DRC that are not a part of the ASSP project, and coordination at the national level.

Key Achievements

ASSP’s DHIS2 initiatives continue to receive strong support and engagement from the MOH. In the last quarter of year 5, 1,824 health facilities were submitting routine monthly reports using DHIS2, achieving more than 100% of the cumulative project target and representing an increase of 74% compared to the first quarter of year 3. In 2017, on average, 92% of health facilities submitted reports through DHIS2 each month.

Using DHIS2, ASSP began analyzing and sending feedback reports to Provincial Health Information Officers, which can be used for dialogue for health service delivery improvement. The project also set up dashboards by program area (service utilization, reproductive health, vaccination) to simplify and encourage data analysis by provincial and health zone staff.

More than 500 people that work in ASSP’s 52 health zones and five provinces have been trained in DHIS2. ASSP has also played a significant role in supporting the Ministry of Health in delivering training to health care workers in the rest of the country.

In January 2017, with technical assistance from ASSP, the MOH launched a revised version of the monthly reporting forms used by health facilities. During that quarter, a marked increase in data quality scores was noted for all ASSP health zones with 46 health zones reaching a score of 80% or more, exceeding the quarterly target of 28. In addition to being more concise, these new forms incorporated indicators from vertical programs such as the national vaccination program and malaria programs in efforts to reduce the existence of parallel reporting systems.

IMA instituted a VSAT-linked system that tracks daily internet availability in each of the ASSP zones, helping monitor health facilities’ ability to submit data using DHIS2 and establish baseline internet access for any future projects.

Three VSAT installation and maintenance trainings were conducted to train provincial technicians who now serve more remote parts of ASSP-supported provinces. All health zones were switched to a new internet service provider. The new set-up offers unlimited internet connection to four pre-approved computers and laptops operating in the health zone office.

In addition to supporting the routine health information system, the ASSP team has also provided surveillance and data management support for outbreak response. In May 2018, four members of the ASSP staff were requested by the Ministry of Health to support critical Ebola data visualization work. This work included support to set up the electronic database to capture patient and contact data, and to facilitate the production of line listing and data dashboards to support on-going monitoring of the outbreak.