Evaluating the Quality of MDSR Data Base Management System in, Ethiopia

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Back ground: one of the priority objectives of the Health sector Transformation Plan of Ethiopia is reducing maternal mortality. Knowing the right causes of maternal deaths through use of valid and reliable information is crucial to design appropriate policies, programs, and interventions to prevent avoidable deaths. Maternal Death Surveillance and Response system is a method of collecting information on the level and causes of maternal death in order to provide precise information to improve quality of maternal health. The quality of MDSR data base management system has not been adequately studied in our country. Objective: To evaluate the quality and measure the coverage error of MDSR database management system in Ethiopia. Methods: Institutional based cross-sectional study design with quantitative and qualitative method applied. The MDSR database with data from December 2006 through February 2009 E.C was analyzed using STATA version 14. Point and interval estimates were used to measure the coverage error of maternal death by relating reported death with estimated death for the country and regions. Besides, content errors of the data base were measured by using fundamental quality dimensions completeness, timeliness and consistency .Moreover, the challenges and limitations of the MDSR database system were assessed through thematic analysis of qualitative data collected from key informants who were heavily involved in the development and management of the MDSR database. Result: The overall coverage rate of national MDSR database was 2.98 % with 95% CI (2.85, 3.11) which was below expected level. The incompleteness rate of variables on the database ranged from the minimum of 2.2% to the maximum of 97.2% which was far from acceptable range (80%). The timeliness of national MDRF report was 56.8% which was less than 80% and there were also inconsistent variables on the data base, high gravidity among teenagers and higher number of parity compared with gravidity for some mothers. Periodic changing of reporting tools and their shortage, addition of variables over time, inability of proxy respondents to report on every characteristics of the deceased mother while filling verbal autopsy forms were main causes for the content errors. The main limitation of the MDSR data base was capturing of very few maternal deaths and absence of user friendly software reporting system. Conclusion and Recommendation: - The coverage rate of the MDSR database was too low. The data base had variables with incompleteness and inconsistent. The national timelines of MDRF report is less than acceptable range which is 80% System, organizational, monitoring and evaluation and individual related factors were found to be factors affecting the quality of MDSR database. Thus, the responsible bodies should play active role in supporting and facilitating the database management system. VII | P a g e Acronyms ANC Antenatal care CRVS Civil Registration and Vital Statistics DQ Data Quality EPHI Ethiopian Public Health Institute FBA Facility Based Abstraction FMOH Federal ministry of health HSTP Health Sector Transformation Plan MCH Maternal and Child Health MDG Millennium Development Goal MDSR Maternal Death Surveillance and Response MDRF Maternal Death Reporting Format MMR Maternal Mortality Ratio PHEM Public Health Emergency Management SDG Sustainable Development Plan SNNP Southern Nations, Nationalities and People’s Region. SPH School of Public Health TWG Technical Working Group UNFPA United Nations Population Fund UNICEF United Nations Children’s Fund VA Verbal Autopsy WHO World Health Organization



Evaluating the Quality of MDSR Data Base