Accuracy And Completeness Of Hypertension Data In The Dhims-2 In Selected Health Facilities In The Greater Accra Region

ABSTRACT

Background: Hypertension is a major public health challenge in Ghana and with the prevalence increasing over the years, accurate estimation of the burden of the disease is required for effective prevention and control measures. The GHS in 2012, introduced a web-based database; DHIMS-2, to ensure quality health data however, aspects of this database; the maternal and neonatal data was reported to be good and reliable, yet the EPI data was poor, aside the lack of evidence based research on the morbidity data. The aim of this study therefore was to determine the quality of Outpatient Hypertension Data in the DHIMS-2 by assessing how accurate and complete hypertension data reported into the database is, and factors influencing hypertension data management in health facilities.

Methodology: Through a mixed method approach using secondary data from patient’s folders for the third quarter of 2016, two hospitals and two polyclinics were randomly selected out of highly ranked administrative units in the Greater Accra region. A structured Data Abstraction form and a semi-structured interview guide were used to extract information in relation to the study objectives. Hypertension data were assessed for accuracy (error rate) and completeness (% missing data). Primary source data from patient’s folders and consulting room registers were totalled, gathered and comparison was made with facility aggregate forms as well as the DHIMS-2. Twelve health staff were interviewed and through thematic analysis, factors influencing hypertension data quality were assessed.

Results: A total of 2268 of data from consulting room registers and patient folders were inspected. The mean completeness of hypertension data among the four health facilities was 60.69% (95% iii C. I =49.32%–72.06%). Comparing new cases of hypertension in consulting room registers to patient folders, the mean percentage error was 72.9% (95% C.I=52.20% - 93.62%). The study found an overall of 21.5% (95% C.I= 4.49% – 38.48%) error rate in the transfer of hypertension data from consulting room registers to the monthly OPD morbidity form. There was 100% accuracy in transferring hypertension data from facility monthly aggregate form to the DHIMS-2, however, in comparing the DHIMS-2 data to new cases of hypertension captured in patient folders, the mean error detected was 79.2% (95% C.I= 49.02% - 109.42%). Factors contributing to incomplete and inaccurate hypertension data included, lack of understanding on indicators, less priority on hypertension data quality and lack of validation activities focusing on hypertension.

Conclusion: Over 50% of data captured into the consulting room registers were accounted for in the web-based database, but the accuracy of hypertension data in the DHIMS-2 did not reflect what existed in primary sources and this disparity was wide. Factors affecting hypertension data quality in hospitals and polyclinics were related to inadequate data verification, poor data management and inadequate training of staff on data management, therefore there is the need to regularly validate hypertension data and consistently train staff directly linked to managing hypertension data.