An Innovative Approach to Improving Health Data Quality in Ethiopia

On Nov 17–19, John Snow Research & Training Institute, Inc. (JSI) and its partner, the Gobee Group, in collaboration with the Ethiopian Federal Ministry of Health (FMOH), conducted a co-creation workshop in Adama, Ethiopia. The workshop was organized under the Ethiopia Data Use Partnership (DUP) and brought together more than 35 people from the different directorates of the FMOH, regional health bureaus, and universities. Its purpose was to build consensus on rolling out the use of human-centered design (HCD), a key implementation strategy that DUP is deploying to improve the use of quality data at all levels of the health system.

Participants in the meeting hall. Photo credit: Benti Ejeta, JSI.

Why Co-Create?

Dr. Desalegn Tegabu, the director of Policy and Planning Directorate at the FMoH. Photo credit: Benti Ejeta, JSI.

Dr. Desalegn Tegabu, the director of Policy and Planning Directorate (PPD) at the FMOH, who made the opening remarks, noted that the HCD approach will help accelerate the implementation of the Information Revolution (IR) Roadmap—a FMOH strategy to revolutionize the collection and use of health data and improve decision-making at all levels. This workshop, as per the director’s remarks, will play a significant role in helping participants understand and apply the HCD approach. Dr. Theo Lippeveld, the Project Director of DUP, while welcoming the participants, took the opportunity to introduce the objectives and strategies of the project.

Following a brief introduction of HCD by Dr. Jaspal Sandhu, managing partner of the Gobee Group, participants gathered to discuss data use practices both within and outside of the FMOH. The participants listed the needs and challenges of using quality data effectively and consistently. During the second day, participants were grouped around specific themes to look into more detailed areas of engagement. Using the wave exercise, participants were able to map out promising practices and approaches for data use in the long and short term, as well as existing bottlenecks that slow down the effective and efficient use of information for decision making. Wave is a metaphor to express an environmental scanning facilitation approach to help groups collaboratively develop an understanding of the “big picture” that surrounds their shared work. The activity created an opportunity for the participants to see where priority interventions are in relation to the timeline and to specific needs. In the process, participants learned about the concept of ideation, prototyping, and designing innovative solutions. In the last half day, participants focused on strategies to introduce innovation and innovation teams into their respective organizations.

Benefits of Using HCD to Co-Create

Mapping out ideas using the Wave Exercise. Photo credit: Benti Ejeta, JSI.

The highly participatory nature of the workshop was a completely new experience for the majority of the participants. It enabled deep and frequent engagement over the course of the two and a half days. The consistent movement of joining new groups kept the participants alert and motivated, allowing every voice to be heard. The creative facilitation approach not only warded off fatigue and dizziness—common in most PowerPoint oriented presentations—but also helped many participants see the challenges from different perspectives. HCD is considered an innovative approach for exploring issues from a 3600 point of view and placing the end user’s needs and desires in the forefront of data use improvement strategies.

The approach also helped the participants deeply explore the topics and challenges. An idea which seemed distant from the real challenge at hand in the first instance was transformed into a springboard for innovative solutions. For most of the participants, the move from a series of simple ideas to the production of creative solutions, based on local experiences was the most surprising experience of the workshop. The workshop also provided opportunities to generate new thinking on data use improvement based on local experiences.

Anne LaFond, director of JSI’s Center for Health Information, Monitoring & Evaluation, gave the closing remarks and outlined the three major themes that came out of the workshop:

  • the need to incentivize data use practices;
  • the importance of engaging and strengthening performance review teams; and
  • the demand to establish accountability and ownership of data quality.

She assured the participants that the ideas raised during the workshop would be worked on in future endeavors. According to LaFond, the workshop helped to unpack the HCD approach. She also highlighted how the first six innovation labs, one at the federal and five at the regional levels, will contribute to the creation of an information culture in the Ethiopian health system.

Eyob Kebede, director of the Health Information and Technology Directorate at the FMOH, who participated in the workshop, referred to HCD as an interactive and fantastic approach to identify problems, and to design, prototype, and apply solutions to the prevailing challenges in the health system, in particular, and in the country in general. He also stated that HCD is very useful in developing user-friendly digital applications which is one of the primary objectives of his directorate.

University group discussion in an open area outside the building where the workshop was taking place. Photo credit: Benti Ejeta, JSI.

Dr. Desalegn, in his closing remarks, said that the workshop helped the participants understand the need and challenges of data quality and use much more than they did before. He promised the participants that the FMOH, in collaboration with DUP consortium partners, will work toward realizing the Information Revolution and maintained that HCD is the right approach for the purpose. He was also hopeful that universities will use the approach in the provision of a revised package of health informatics courses so that they support health managers, care providers, and communities in adapting the proposed innovative solutions to local challenges.

The Ethiopia Data Use Partnership (DUP) is a collaborative endeavor of the FMOH to advance the country’s healthcare. The DUP is a dynamic, responsive team of partners that is led by JSI and currently includes Regenstrief Institute, University of Gondar, and the Gobee Group. The DUP aims to improve the collection and use of high-quality routine information in the health sector, leading to better quality, efficiency, and availability of primary health and nutrition services at all levels of the health system. It is funded by the Bill & Melinda Gates Foundation.

 

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