are we in the right path ?

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Are we in the right path ?. the data have been collected collated validated analyzed presented the indicators have been calculated. NOW. What is the meaning of the stuff we have?. Interpretation - making sense of information. MED-INF 5200. TOPIC 6. Humberto Muquingue. - PowerPoint PPT Presentation

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  • Are we in the right path ?the data have been collectedcollatedvalidatedanalyzedpresentedthe indicators have been calculated NOW. What is the meaning of the stuff we have?

  • Interpretation - making sense of informationApril 16, 2007TOPIC 6MED-INF 5200Humberto Muquingue

  • Learning outcomesAt the end of this topic, you should be able to: Define what is interpretation of informationDescribe the requirements for interpretation Understand the practical issues involved in interpretationList some problems related to interpretation

  • The walls inside are plastered with laboriously made graphs

  • Outside, people have been queuing for hours

  • Interpretation(making sense of information)Is about UNDERTANDING constructing meaning with: Old information to find known patternsNew information to place a new look at known patternsRational and logical approaches: Mix new information with old Put new information into the context Link up different pieces of new information Link up different pieces of new and old information

  • How is Information Interpreted ?

    Understanding implies:

    Appropriate interpretations make many linkages possible (correct, logical, sensible) may answer important questions may result in actionPossible interpretations are context dependent (population, health, service status) depend on data quality rely on data definitions

    Therefore: discuss, explore and consult discuss different interpretations and explore different views this allows improved understanding

  • Preparing for interpretation- The essential ingredients Accuracy checks 3 Cs and 1 T, includes: Routine validation and trends checked over time Data checked per month, per facility, per district Local / contextual knowledge on: Population data: ethnicity, lifestyle, occupation Health data: common diseases Service data: types of facilities, proficiency of staff Effective interpretation needs a minimum of 6 months worth of data

  • Garbage in ? Garbage out !!!!one cannot effectively analyse data that is of poor quality, one cannot interpret information that is of poor and suspect quality with any hope of relevance, appropriateness and usefulness !!!ASK: Is this data measuring what it is required to measure?

  • Practical questions in interpretation1. Why have you produced this information/ indicator? 2. What does the indicator measure? 3. What is the actual measurement unit? 4. Has the indicator been accurately measured? 5. What is the target value OR action trigger value?

  • Practical questions in interpretation6. What is the normal range? In your country: - urban - rural In the world: - best in the world - worst in the world 7. How does it fit in with other information? 8. What is the local context? 9. What should you do about the situation? 10. How could you implement that?

  • DIFFERENT INFORMATION REQUIRE DIFFERENT INTERPRETATION

  • TRESPASSERS WILL BE SHOT !SURVIVORS WILL BE SHOT AGAIN !!NO TRESPASSING

  • EXERCISEThe manager of a clinic in a peri-urban area was surprised by the very low numbers of male patients attending the OPD with urethral discharge. She was sure that the facility reporting system worked well. What could be the cause?

  • Example of reasoning on infoUse of MUDs1 as data element for prevalence of STIIs problematic because it only relates to malesof whom few go to health facilitiesdue to the dominance of women and children in PHC facilities and a perceived lack of privacy?STIs not very stigmatizing in a male-dominated environmentbut embarrassing vis--vis female neighbors! many males prefer to go to a private GP!1MUD = male urethral discharge

  • EXERCISEYou are presented with a graph for a district in Uganda showing 3 indicators on the Overall TB Cure Rate, Overall TB Success Rate and DOTS (Directly Observed Treatment Shortcourse) for each quarter of 2006. How would YOU interpret the information contained in the graph?

  • Chart2

    455363

    406550

    707180

    406180

    Overall TB Cure Rate

    Overall TB Success Rate

    % Patients on DOTS

    %

    TB INDICATORS FOR AN UGANDAN DISTRICT, 2003

    Chart1

    455363

    406550

    707180

    406180

    Overall TB Cure Rate

    Overall TB Success Rate

    % Patients on DOTS

    %

    TB INDICATORS FOR UGANDAN DISTRICT, 2003

    Sheet1

    455363

    406550

    707180

    406180

    Overall TB Cure Rate

    Overall TB Success Rate

    % Patients on DOTS

    Q1Q2Q3Q4

    Sheet1

    Overall TB Cure Rate

    Overall TB Success Rate

    % Patients on DOTS

    %

    TB INDICATORS FOR AN UGANDAN DISTRICT, 2003

    Sheet2

    Sheet3

  • To interpret this information YOU would ask the following questions.

    What are the definitions of the indicators that are used?What does the graph show?What else do you need to know?Is it enough to make a decision?Is this the best way to present this information?

  • Matching information to reality

  • USE = Assessing coverage and quality of health servicesWHO GETS SICK ?WHAT HEALTH SERVICES EXIST ?

  • Assessment of coveragewho gets sick? Description of people who attend health services: age and gender breakdown community distribution Use of individual patient data to construct aggregated routine data Definition of population catchment target for specific services at risk

  • Assessment of qualitywhat services exist ?For whom? AccessibilityCatchment populationTarget populationUtilizationWhat?AppropriatenessType and range ContinuityWhy?Political vs functional

    When?AcceptabilityConvenience to clients and staffWhere?DistributionIntegrationHow ?AffordabilityResources StaffMaterialsMoney

  • Applying the systems model to data and indicatorsInputs. resourcesProcesses . activitiesOutputs . resultsOutcomes impacts

  • The path from Data to InformationInput .Raw Data quantity and quality of data elements (MDS !) data collection tools (tally sheets, registers, client cards)Process Analysis turning raw data into useful information planning tools (targets, indicators)Output Information used for effective decision-making assessment tools (aggregation, graphs, reports)Outcome Coverage and quality of health services management planning (strategic & operational) monitoring & evaluation Impact: Health status

    Clarify learning outcomes reinforce that this is a practical sessionUnpack illustrate with appropriate examplesUnpack with relevant examples Reinforce that although different interpretations are possible, one must always seek that which is appropriate remain context & content specific Reinforce covered in Module 1In order to interpret effectively, one needs a minimum of 6 months data, of good qualityReinforce & emphasize importance of local knowledgeemphasize the need to explore aspects of both coverage and quality of health care in order to develop a comprehensive district profile (outcome of stage 1)

    Unpack aspects of coverageExplore the patient profile of persons who attend health services & compare with the catchment & target populations & utilization ratesExplain the concept of assessing for realism comment on the need to check for external inconsistencies (comment that this will be explored more fully when doing accuracy checks for data quality T4 S5)

    how health services can be assessed for quality in terms of each health programme that is provided using the PHCA 4 As

    Explore the central role played by information in management decision-making reinforce how each stage of the information cycle facilitates decision-making & the type of decisions made at each stage of the info cycle explore how all this impacts on health status