Why fixing Africa’s data gaps will lead to better health policies

There’s been a data revolution around the world driven by advances in information technology and a need for research that responds to complex developmental issues.

African countries are also experiencing the revolution when it comes to volume, types, sources, frequency and speed of data production. This is particularly true in the population and health sector. There’s more population and health information available in the public domain than ever.

Ministries of health in most African countries conduct periodic health programme reviews to establish whether policies are producing the desired results. Countries also undertake assessments on the incidence, distribution, and control of diseases. This is done through frequent analysis of routinely collected data with the aim of improving programmes.

These periodic reviews usually serve as important input for national strategic plans. But there are still challenges with the collection of accurate and timely data, their utility, use and analytical capacity. This means that it remains difficult for many countries to develop evidence-based policies.

Mapping the issues

A number of challenges face countries trying to improve the collation and use of reliable data. Here are some of them.

Coordination: There are multiple sources of health data. These include household surveys, census, health facilities, disease surveillance, policy data and research studies. Datasets are increasingly spatially referenced and would be valuable in informing health programmes and monitoring performance. But they remain relatively under-used. It’s important to find a way to bridge this gap and increase discovery and use of data.

A platform for analytic support and triangulation of available data is needed. This would reduce fragmentation and duplication while improving efficiency.

Frequency of analysis: The premise of evidence-based decision making is that health data lack value unless they are analysed and actually used to inform decisions.

This is why coordinated and systematic analysis and review of all available data is essential. The analysis and reviews must be done at regular intervals. Regular programme assessments are critical, but are often lacking or insufficient.

Data structures: Periodical population and health surveys often consist of quantitative, qualitative and geospatial data that is voluminous and/or comprehensive. This requires well trained staffs with appropriate analytical skills to make meaning of these data.

Routinely collected health service or register-based data is common in the health sector and is traditionally used for reporting purposes. This data are longitudinal and provide wider coverage – geographically and in terms of the items recorded. This allows for trends in the use of services to be estimated. But the use of routinely collected data in most African countries has been far from optimal. This is mainly due to a lack of analytical capacity and low government demand for the data.

Data Quality: Health data, especially routinely collected service data, often have quality issues. These include missing values and errors in data entry and computation.

These errors can lead to wrong results, wrong conclusions and wrong recommendations. They can also mean that new priorities, policies and programmes based on the data will be wrong.

In addition, data analysis, dissemination and use in the sector are held back. This is a problem because the use of information sources beyond routine health management information is already weak.

Good quality data are essential for proper planning, budgeting and implementation of development activities, particularly those in essential services sectors such as public health. In the absence of quality data public resources investments are often based on guessed estimates, this leads to wastage.

Data Cost: Data collection, handling, archival and analysis is still expensive in terms of capacity, logistics and financial implications for most countries in sub-Saharan Africa. National statistical offices don’t have the necessary technological, financial and human resource capacities to collect, process and disseminate the required data.

Making data work

African countries continue to work towards achieving national and regional commitments to improving data collection and use. But it’s critical that governments invest in relevant, timely and accurate data production for decision-making.

Data actors including data managers, statisticians and data analysts need to be involved at every stage. They need to be part of mapping out the problems as well as designing research methodologies and figuring out how to collect, analyse and disseminate data.

A wide range of data, including earth observation and geospatial data, needs to be leveraged to review progress in meeting health and wellbeing targets. This is critical to improving the effectiveness and sustainability of health systems.

And there’s an urgent need to shift the focus from data to information and knowledge. This includes working with end users, like health departments, to create tools to access information.

Finally, governments need to make resources available to meet commitments to providing quality and affordable health care for all. This could be done by mobilising domestic resource, setting standard data indicators (for collection, analysis and reporting) and strengthening national statistics bodies.

Commitment may be the first step towards affordable health care. But more needs to be done to harness the power of data for public health.


This article was first published in The Conversation and written by Damazo T. Kadengye

Award-winning journalism hitting hard in social accountability

September 2017 – Malawian journalist Alick Ponje received the inaugural Southern Africa Media Award in Social Accountability Reporting during the Telkom-Highway Africa Awards Gala Dinner held yesterday evening at the 21st annual Highway Africa conference, the world’s largest gathering of African journalists, at Rhodes University in Grahamstown, South Africa.

Presented by Highway Africa and the Partnership for Social Accountability (PSA) Alliance, the award recognises journalists from Malawi, Tanzania, Mozambique and Zambia whose investigative reporting on social accountability has contributed to improved services in public health and agriculture, particularly in the areas of HIV and sexual and reproductive health and rights (SRHR), and food security.

Ponje’s article ‘Private Hospitals Breach Government Pact’, published in the Malawi News, a newspaper of the Times Group, on 4 February 2017, documents how privately run clinics and mobile clinics are breaching their contracts with the Ministry of Health. The clinics order drugs from the district health office and also demand fees from patients for under-five and maternal health services, which are supposed to be free. The situation has reportedly contributed to the depletion of drugs for publically run health facilities.

“Ponje successfully draws upon and weaves together multiple sources of information, including documentation from the district council, input of officials during council proceedings, and interviews with the Ministry of Health,” stated Highway Africa’s Director Chris Kabwato. “His reporting provides insight into a critical issue of social accountability in the use of public resources, which has affected both health budgets as well as the provision of affordable services.”

 “The news media have a critical role to play in holding governments to account for the provision of quality public services,” said Rachel Gondo, Senior Programme Officer at Public Service Accountability Monitor (PSAM). “Ponje has clearly shed the spotlight on the need for governments to closely monitor and regulate the services provided by privately-run but publically-funded health facilities, both in Malawi and across southern Africa.”

SAfAIDS’ Deputy Director Rouzeh Eghtessadi applauded Ponje for interrogating the provision of sexual and reproductive health services at local clinics. “We need more journalists who are willing to delve into the real-life challenges people face in accessing health services, in an unsensational and discriminatory manner. Without such reporting, mismanagement of scarce public resources goes undetected, resulting in a decline in the quality and effectiveness of healthcare services.”

Ponje, 28, now a special projects reporter at the Nation Publication Group, joined the mainstream media in 2014 after graduating as a teacher from the University of Malawi. “Receiving this award is going to motivate me. It shows that people are recognising the efforts we put into our work. I’m in the early years of my career and this will give me the confidence to work on these issues [of social accountability] going forward,” said Ponje.

Ponje applauded Highway Africa and PSA Alliance for initiating the award. “With awards like this, journalists will be more motivated to track how public funds are being utilised. And, at the end of the day, some of these problems might be history.”

Partnership for Social Accountability Alliance is led by ActionAid International together with Public Service Accountability Monitor (PSAM), Eastern and Southern Africa Small Scale Farmers’ Forum (ESAFF), and SAfAIDS, and supported by the Swiss Agency for Development and Cooperation (SDC).

Can Social Accountability Strengthen Family Planning Programming?

With a view to facilitate mutal learning among social accountability practitioners and thinkers across the globe, the Community of Practitioners on Accountability and Social Action in Health (COPASAH) launched it Social Accountability Dialogue Series in March 2017.

The series intends to enrich the field of social accountability with insights and experiences from the field of accountability practice. The first in the series of Social Accountability Dialogues was held on March 15, 2017, 14.30-15.30 (IST). COPASAH Global Convener, Dr. Abhijit Das shared insights and experiences from small scale efforts in India on the theme – Can Social Accountability Strengthen Family Planning Programming?

The Dialogue witnessed participation of nearly 21 persons from different geographical locations including Turkey, Pakistan, Myanmar, New Zealand and India.COPASAH coordinator, E. Premdas Pinto set out the context for the webinar with introduction to COPASAH, the Dialogue series and the speaker for the day along with the modalities of participation in the Dialogue.

To find out more, engage with the discussion on family planning, and follow future discussions, go to:

http://www.copasah.net/accountability-dialogue.html