The Millennium Villages Project:Use of data to improve decision-making

WHAT is the MV CHW program?

Men and Women

All Ages

Paid

Literate

Nominated by Community

Locally-Based

MVP: Who are the Community Health Workers?

CHW visits a household at least once every 90 days

Millennium Villages CHW Program

Health Surveillance and ReferralsCommunity Case Management and Commodities Distribution

Health Education

DHealth Data Collection by paper forms or phone

Feedback, Management, Prompts for Follow-up Visits

Supported by a Foundation of Management and Supervision

CHW Activities:Household Visits and Service Delivery

Village Clinic

Community Health

Committee

Senior CHW or Health Facilitator

Referral for Advanced Care

Prompts for Follow-Up Visit at

Home

Updates on Community Health

“Social” Supervision

Raw Health Data Transfer

Technical and Supportive Supervision

CHW Manager

Health Coordinator

Supervision / Inform Health Priorities

Performance Reports, Inform Health Priorities

Operations Management, Task-Setting, Performance ReviewsCommunity and

Clinic Reports and Concerns

WHY do we collect “real-time” data?

“The purpose of collecting and analyzing ChildCount+ data is to generate ‘real-time’

information to inform and guide health services delivery by identifying systemic

problems and responding appropriately”

“ChildCount+ data should be viewed along-side clinic-based data and other sources (surveys,

verbal autopsy, etc.)”

CHILDCOUNT+ AND MGV-NET: HOW IT WORKS

5 GOALS FOR CHILDCOUNT+

Register every child

Monitor for malaria, diarrhea, and pneumonia

Full child immunization report

Record all birthsand death

Screen for malnutrition every 90 days

BIRTH AND DEATH REGISTRATION FORM

INDIVIDUAL CONSULTATION FORM

HOW do we use ChildCount+ data?

PACKAGING COMMUNITY DATA: CHILDCOUNT+ REPORTS

PATIENT-LEVELCHW-Patient Report

CHW-LEVELCHW Manager Report

SITE-LEVELHealth Coordinator Report Site

CHW 1

Patient 1

Patient 2

Patient 3

CHW 2

Patient 1

Patient 2

Patient 3

UTILIZATION REPORT + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + +

MVIS INDICATORS FROM CC+

CALCULATED INDICATORS

CHW MANAGER REPORT (by CHW)

OPERATIONAL REPORT (by clinic)

UTILIZATION REPORT

Example: Individual CHW Nutrition Surveillance Case Report

PATIENT MANAGEMENT REPORTS

• SMS Alerts to supervisors for at risk patients• Longitudinal patient records for health

system assessments

• CHW activity reports• Performance Monitoring• Data validation reports (see below)

CHW MANAGEMENT REPORTS

CHW No 86 CHW No 89

Histograms showing frequency of MUACs for children as recorded by 2 CHWs with different levels of precision

Training on data usage for decision-

making

eHEALTH MONTHLY DATA ASSESSMENT

You Should Receive This Assessment

By The 10th of EVERY MONTH

CC+ data inputted daily by CHWs and/or data entry clerks

eHealth Specialist generates MVIS Indicators report, CHW manager report, and utilization report and

puts in dropbox (or sends to Casey)

by the 5th of each month

NYC/MDG Centre Teams conduct preliminary analysis and feedback

QUESTIONS TO ASK WHEN LOOKING AT DATA?

(1) IS THE DATA REPRESENTATIVE?

(3) IS THERE A SYSTEMIC PROBLEM?

(2) IS THE DATA ACCURATE?

(4) ARE THERE PARTICULAR POOR PERFORMING CHWs?

(5) ARE THERE TRENDS OVER TIME?

(6) DOES THE DATA MATCH YOUR IMPRESSION OF THE eHEALTH SYSTEM’S STRENGTHS AND WEAKNESSES?

Perhaps not all CHWs are doing household visits.

Errors, Data entry delay, SMS not working: Not reflecting what CHWs are actually doing (and household health outcomes)

Supply chain? Accident? Floods? CHW/Senior CHW protest? No SMS contract?Some demotivated CHWs? Some CHWs that need retraining? CHWs to replace?

Health risks and patterns? Decreasing quality with increasing workload?

Not enough people? Server down? SMS system down?

DATA FEEDBACK SESSIONS WITH CHWS

Jan Feb March April May June July Aug Sept Oct Nov Dec0

50

100

150

200

250

300

Annociat NabegyesaChristine TumwijukyeEunice MusiimentaFelix AhimbisibweJohn Asimwe MuseveniKobusiigye V DaddyLillian KyokusiimaMacklean ArinaitweNarciscio BazirakeRose Kyomukama

HOW do we use qualitative data?

USE OF THE AIM TOOL IN UGANDA

ACTION REPORT IN RWANDA

1. Explore alternative mHealth options to address current challenge of CC+

2. Strengthen qualitative data collection to provide a more rounded view of programs (spot checks, supervision visits, client interviews)

3. Build comprehensive training platforms for local managers to use data in decision-making

NEXT STEPS

THANK YOU