MINISTRY OF HEALTH RESOURCE CENTRE QUARTERLY REPORT. JULY SEPTEMBER 2011 Q1 Financial year 2011/12

Transcription

1 MINISTRY OF HEALTH RESOURCE CENTRE QUARTERLY REPORT JULY SEPTEMBER Q Financial year / Compiled: 9 th November

2 Table of contents Ministry of Health Resource Centre. Introduction.... HMIS Reporting Completeness Timeliness.... Section Analysis Maternal and Perinatal conditions Antenatal Maternity....4 HIV/AIDS Counseling and Testing....5 Essential Drugs, Vaccines and Contraceptives Quarterly League Table Sorted by district... 8 APPENDIX:... 5

3 . Introduction The Health Management Information System facilitates data collection during health service delivery which is critical for tracking performance and trend analysis. The HMIS has the following categories of information: data on individual clients, information on curative services, information on preventive services, resource management e.g. inventories (staff list, health facility, equipment), logistics and commodities, finance / user fees and Village Health Teams (Integrated Community Case Management). The Ministry of Health Resource Centre is responsible for the collection, processing, analysis, and dissemination of national health data collected through the Health Management Information System (HMIS). The MoH Resource Centre is ensuring that quality and timely data is collected through the revised HMIS tools to facilitate decision making, policy formulation as well as accountability. The roll out and utilization of the revised HMIS tools by all the health facilities nationwide started in July and the process is still continuing. The Resource Centre has provided support to the district health teams and the health facilities throughout this reporting period to appreciate and correctly utilize these HMIS tools through trainings and support supervisions. This report gives an account of the reporting from the health facilities across the country for the period July September. The activities from the functioning health units are reported using HMIS 5 and 8 for Outpatient and Inpatient, respectively to the districts. The district then aggregates the health unit reports within their respective districts into HMIS and HMIS 4 for Outpatient and Inpatient data, respectively. This report compares performance for the various indicators with previous quarterly performance. Also provided is the Quarterly District League Table for Q of FY/ Information in this report has been generated to reflect trends of certain diseases/ conditions in specific thematic areas like Malaria, Antenatal, Maternity, HIV/AIDS counseling and testing Maternal and perinatal conditions and Essential drugs, vaccines and contraceptives. In order for us to comprehend and appreciate the reporting status from the different districts in terms of completeness and timeliness, graphical presentations have been incorporated. The Resource Centre however still has a challenge of limited personnel who are dedicated to data entry, cleaning and supporting in the basic analysis. This has contributed to a backlog in the databank for reports to be entered in the electronic system especially for Inpatient data.

4 . HMIS Reporting. Completeness Table below shows the extent to which the HMIS reports are submitted and captured in MoH- RC from the various districts across the country. The total number of districts as of Q FY/ is. All these districts are supposed to receive HMIS 5 and HMIS 8 reports from the various health units and aggregate them into HMIS and HMIS 4, respectively. The HMIS and HMIS 4 reports constitute information collected from the Outpatient and Inpatient sections of the health units, respectively. It can be observed from Table below and Figure below that Inpatient completeness in reporting is low as compared to Outpatient completeness in reporting with an average of 6 for inpatient and 8 for outpatient for this reporting period Table : Reporting Trends / Q / Reporting Trends / Q / Q / Q4 / Q / OPD Completeness IPD Completeness of HFs Reporting OPD of HFs Reporting IPD

5 Figure : Reporting Trends FY/ and Q FY/ Percentage Q / Q / Q / Q4 / Q / Quarters OPD Completeness IPD Completeness of HFs Reporting OPD of HFs Reporting IPD Furthermore on the results above, the proportion of health units reporting for Outpatient (average=9) is consistently higher that for Inpatient (average = 8) as seen in Fig above. 5

6 Figure : Outpatient Reporting per month Figure : Inpatient Reporting per month 6

7 Figure and above show the trends in number of reports for Outpatient and Inpatient respectively by month from July to September the end of this reporting period.. Timeliness The timeliness of reporting in HMIS is derived from the reports received and compared to the date at which the report was submitted and received at MoH-RC through any means (hand copy, /electronic, faxed/scanned, etc...) and the expected date for these reports to be submitted that is 8 th of the following month for HMIS and HMIS 4. The computation is independent of the districts who never submitted reports but dependent on reports submitted. Figure 4: Outpatient & Inpatient Reporting Timeliness FY / and Q FY/ All efforts have been undertaken by the MoH-RC team to encourage the District Heath Teams through the DHOs and district biostatisticians to compile and submit these reports in a timely manner. From Figure 4 above, it can be seen that for Inpatient and Outpatient timelines, the trend evolves almost similarly. This is expected because in most cases the district biostatisticians/hmis focal persons compile and submit these two reports together. It s only in a few cases where report submission for HMIS and 4 are different in time. Furthermore,

8 for reports that have been submitted over time per month the trend shows an improvement in timeliness reporting.. Section Analysis. Maternal and Perinatal conditions In this section we present a view of the total cases reported from Q-/ to the current quarter Q-/ for abortion and Malaria in pregnancy. There is decline in the number of abortions reported from the previous quarter 68 to the current quarter 55. The malaria cases in pregnancy have also reduced from an average of 5 to 988 in the current reporting period. Figure 4: Trends of Malaria in Pregnancy and abortion for the periods given below. Antenatal This section present trends for the quarters below for ANC re-attendance, New ANC attendance and postnatal visits. Figure 5 below shows a relatively stable trend in reporting for New ANC attendance.there has been a reduction in Q-/ for new ANC attendance as well for the ANC re-attendance (4 th visit). During this reporting period, the postnatal visits have also reduced as compared to the 4 previous quarter national wide. 8

9 Figure 5: Trends in Antenatal ANC Attendance for the period / Presented in Figure 6 below are the trends in the ANC referral from units and referrals to unit. It can be envisaged that the total referrals from units have been remained stable. A trend line inserted indicates a stable horizontal trend. On the other hand, the referrals to the units have had an increasing trend though not significant. Figure 6: Trends in Antenatal Referrals to and from unit for the period / 9

10 Figure below shows the distribution of the IPT doses (IPT and IPT ) administered during the antenatal sessions over the reported quarters. For both the st and nd IPT dose, there has been a stable trend of the doses administered over time. Figure : Distribution of the IPT doses over the reported quarters

11 . Maternity Maternity section of the HMIS (OPD) has variables which are used to generate maternal health indicators as specified in Table below. This report presents the reported cases for each variable over the different quarters. Furthermore, Figure 8 below shows selected maternity variables (Deliveries HIV positive in unit, Babies born to HIV positive mothers given ARVs, and Deliveries HIV positive who swallowed ARVs) over the quarters. Ideally, babies born to HIV positive mothers should be followed up, monitored and given ARVs to prevent HIV transmission. On average, of the babies born to HIV positive mothers were given ARVs. Additionally, an average of of the HIV positive deliveries (mothers) swallowed ARVs.

12 Table : Cases of maternity indicators reported over the quarters specified Diagnosis Q / Q / Q / Q4 / Q / Admissions Babies (born to HIV positive mothers) given ARVs Babies born with low birth weight (<.5kg) Birth Asphyxia Deliveries by private practitioners Deliveries HIV positive in unit Deliveries HIV positive who swallowed ARVs Deliveries in unit Deliveries with TBA Live birth to HIV positive mothers Live births in unit Maternal deaths Referrals from unit Referrals to unit Still births in unit 8 8 6

13 Figure 8: Selected maternity variables reported over the quarters.4 HIV/AIDS Counseling and Testing The HMIS collects information on HIV/AIDS counseling and testing (HCT) aggregated by gender and age. Figure 9 below shows the summary from the districts within this reporting period for HIV tested in laboratory, those found HIV positive (Prevalence computed), and the individuals found positive who started on Cotrimoxazole prophylaxis (CTX). National wide there has been an increase in individuals who were offered a test in laboratory. This also can represent the individuals who are seeking HCT on average. All Individuals who are found HIV positive are supposed to be started on CTX prophylaxis and from the graph below an average proportion 8 HIV positive are started on CTX prophylaxis. The HIV prevalence in OPD attendance over the quarters has an average of.5 slightly higher than the national average of 6..

14 Figure 9: Individuals Tested from laboratory, those found HIV positive and those given CTX prophylaxis.5 Essential Drugs, Vaccines and Contraceptives The HMIS collects information regarding the number of health units for which the drugs, vaccines or contraceptives (aligned to the HSSIP indicators) were out of stock at any one time during the month preceding the month of reporting. Presented below is a trend of the quarterly summary of the proportion of health facilities with no stock out for a selected HSSP tracer drug items (First line drug for malaria, Measles vaccine, Fansidar, ORS sachets, Cotrimoxazole tabs and Depo-Provera). The Objective of this indicator is to ensure No Stockouts of essential medicines at all times in order to deliver the Uganda Minimum Healthcare Package. From Table and Figure below, it can be seen that there has been a substantial improvement of reported no stock out in this reporting period as compared to the previous for essentially all the items. 4

15 Table : Health Facilities with No stock-out of any of the tracer medicines FY / and Q FY/ Percentage of HF with NO STOCKOUT by Quarter Tracer Drugs Q / Q / Q / Q4 / First line drug for Malaria Q / Measles vaccine Fansidar ORS Sachets Cotrimoxazole Depo-Provera Figure : Trend of percentage of Health facilities with no stock out over the quarter below Additionally presented below is a table that shows the top districts that reported more health facilities with stock out for the above indicator items. As can be seen in Table 4 below, the most recurrent districts in reporting health facilities with stock outs are GULU, MASINDI, NAKAPIRIPIRIT, SIRONKO and SOROTI. MOROTO district only reported the highest and once in stock out of Fansidar drugs during this reporting period. 5

16 Table 4: Top Ten districts reporting Stock out Health facilities for each indicator items Cotrimoxazole Tabs Depo-Provera Fansidar Rank District No. HFs Stock out Rank District No. HFs Stock out Rank District No. HFs Stock out GULU 5 GULU 5 MOROTO MASINDI 49 MASINDI 4 GULU 5 NAKAPIRIPIRIT 4 NAKAPIRIPIRIT 4 MASINDI 4 4 SIRONKO 8 4 SIRONKO 6 4 MITYANA 45 5 KAMWENGE 5 5 SOROTI 5 TORORO 4 6 SOROTI 6 NAMAYINGO 6 NAKAPIRIPIRIT 4 TORORO 6 KAYUNGA 8 SOROTI 4 8 ISINGIRO 6 8 MITYANA 8 SIRONKO 4 9 KAYUNGA 5 9 MOYO 9 BUGIRI BUNDIBUGYO JINJA 9 MAYUGE First Line drug for Malaria Measles Vaccine ORS Sachets Rank District No. HFs Stock out Rank District No. HFs Stock out Rank District No. HFs Stock out GULU 5 GULU 49 GULU 5 MASINDI 48 MASINDI 48 MASINDI 4 NAKAPIRIPIRIT 4 NAKAPIRIPIRIT 4 NAKAPIRIPIRIT 4 4 SIRONKO 9 4 SOROTI 4 KAMWENGE 5 BUGIRI 9 5 SIRONKO 5 SOROTI 5 6 KAABONG 6 BUGIRI 6 SIRONKO SOROTI KAYUNGA 8 BUGIRI 8 8 KAYUNGA 8 BUNDIBUGYO 8 BUNDIBUGYO 5 9 MOYO 9 9 JINJA 9 KAYUNGA 9 NAKASONGOLA MAYUGE MAYUGE 9 6

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18 4. Quarterly League Table 4. Sorted by Rank Q / LEAGUE TABLE DISTRICT Population Estimate Number of Health Facility Reports OPD Health Unit Reporting OPD Reporting Timeliness DPT for < yr on Schedule ANC Re-attendance 4th visit Deliveries in Govt and NGO health facilities Pregnant women receiving nd dose Fansidar for IPT Planned Outreach Activities Conducted Pregnant Women attending Antenatal Clinic. (Antenatal Coverage) Malaria positivity rate for children under 5 years TOTAL RANKING Score Score Score Score Score Score Score Score Score KALANGALA ISINGIRO BULIISA SERERE ZOMBO

19 5 RUKUNGIRI LYANTONDE MPIGI MANAFWA MUKONO DOKOLO BUTALEJA KISORO BUIKWE KYENJOJO OTUKE MITYANA BUSHENYI MBARARA KYEGEGWA NAKAPIRIPIRIT

20 MASAKA SIRONKO 8 LAMWO 6 6 NWOYA 5 9 RUBIRIZI WAKISO 96 6 OYAM KABAROLE MBALE PALLISA NAKASONGOL A TORORO SEMBABULE 9 69 BUDAKA AMOLATAR 4 GOMBA MOROTO

21 NAMUTUMBA IBANDA MASINDI KAMWENGE 9 9 KAYUNGA APAC 6 9 PADER 96 6 KOLE SOROTI KABALE MAYUGE HOIMA 499 BUHWEJU BUVUMA KANUNGU KAPCHORWA JINJA

22 KIBAALE KALUNGU 5 IGANGA NAPAK 65 6 NTUNGAMO LWENGO BUDUDA LIRA 4 BUGIRI YUMBE LUUKA KOTIDO 46 5 RAKAI ABIM 55 8 KIRUHURA KOBOKO 96 6 BUNDIBUGYO

23 6 BUYENDE MOYO KABERAMAIDO KAMULI KWEEN AMURU BUKOMANSIM BI NAMAYINGO KITGUM MUBENDE KAMPALA KAABONG KATAKWI BUSIA AMURIA BUKWO BUKEDEA

24 SHEEMA 4 GULU 4 68 KASESE NTOROKO KALIRO NAKASEKE KIBUKU AMUDAT LUWERO ADJUMANI AGAGO ALEBTONG 5 ARUA BULAMBULI BUTAMBALA 96 KIBOGA 859 KIRYANDONG O 85 KUMI 8 KYANKWANZI

25 MITOOMA 888 NEBBI 86 NGORA 44 NYADRI APPENDIX: A: TIMELINESS PER DISTRICT 5

26 District Date for monthly reports---> Abim Adjumani JAN FEB Cod e 8th Feb 8th Mar MAR APR MAY 8th April 8th May 8th June JUN 8th July 6 JUL 8th Aug. AUG 8th Sept. 5 L T T T L L T N N 5 T N T T T T N L N Agago T T T T T T L N T SEP Report s on time report s receiv ed T L 8th Oct. T C timely late 44 N not received No Expect. reports Alebtong N N N N N N N N N 9 9 Amolatar 4 L T L L T T L L T Amudat L T T T T T N N T Amuria 5 T T T T L L L T N 5 9 AMURU 5 T T T T T T T T T 9 9 Apac 5 T T T T L T T T T 8 9 Arua 5 L T L T T T N N N Budaka 5 T T T T T T T T T 9 9 Bududa 5 9 T T T T T T T T T 9 9 Bugiri 5 4 T T T T T T T L T 9 9 Buhweju L L T L N L L T T 5 9 Buikwe T T T T T T T T T 9 9 Bukedea 5 8 T T L L T T N T N 5 9 Bukomansim bi N T T T T T T N T 9

27 District JAN FEB MAR APR MAY JUN JUL AUG Bulambuli L L T L L N N N N Bukwo T L T T T T N T L 5 Buliisa 6 T T T T L T T T T 5 Bundibugyo 5 T T T T T T T N T 5 Bushenyi 6 T T T T T L T T T 5 Busia T T N N T T T T T 55 Butaleja T T T T T T T T T Butambala L T L T T L N N T Buvuma T T T T T T T T T Buyende L L L L L T N L L 5 Dokolo 5 T T T T T T T T T Gomba L T T T T T L T T 5 Gulu 8 T T T T T T T N T 5 Hoima 9 T T T T T T T T T 55 Ibanda 8 T T T T T T T T T 5 Iganga T T T T T T T T T Isingiro T T T T T T L T T SEP Report s on time 6 44 report s receiv ed T L N No Expect

28 District Jinja Kaabong Kabale Kabarole Kaberamaid o Kalangala Kaliro JAN FEB MAR APR MAY JUN JUL AUG SEP 5 T T L T T T T T T 55 9 T T T T L T T T T 5 T T T T T T T T N 5 T T T T T T T T T 5 4 T L L T T T L T T 5 5 T T T T T T T T T T L L L T L L T T Kalungu L L T T T T T T T 5 Kampala 6 T T T T T T T T T 5 Kamuli T T T T T T T L N 5 Kamwenge 8 T T T T T T L L T 5 Kanungu 9 T T T T T T T T T 5 Kapchorwa T T T L N T T T T 5 Kasese L T T T T T T N N 5 Katakwi L T T T T T T N T 5 Kayunga T T T T T T T T T 5 Kibaale 4 T T T T T T T T T Report s on time report s receiv ed T L N No Expect

29 District JAN FEB MAR APR MAY JUN JUL AUG Kibuku T T T L T N N T T 5 Kiboga 5 T T T T T T T T T Kiruhura T T T T T T T T L Kiryandongo L L L L T L L T T 5 Kisoro 6 T T T T T T T T T 5 Kitgum T T T N L T T N T Koboko T T T L L T L N T Kole L T T T T N T T T 5 Kotido 8 T T T T T L T T T 5 Kumi 9 T T T T T T N T T Kween L N T T T T N T T Kyankwanzi L T T T T T N N T Kyegegwa L L T T T T T T T 5 Kyenjojo T T L T T T T T T Lamwo T T L T T T T T T 5 Lira T T T T T T T T T Luuka T T T N T N T T T SEP Report s on time report s receiv ed T L N No Expect

30 District Luwero JAN FEB MAR APR MAY JUN JUL AUG SEP 5 T T L L T T T T T Lwengo N N N N T T T N T 58 Lyantonde T T T L L T L L T Manafwa 6 T T T T T T T T T 5 Masaka T T T T T T T T T 5 Masindi 4 T T T T T T T T N 5 Mayuge 5 T N T T L L T T L 5 Mbale 6 T T T T T T T T T 5 Mbarara T T T L T T T T T Mitooma T N N L T N T N N Mityana 8 T T T T T T T T T 5 Moroto 8 T T T T T T T T T 5 Moyo 9 T T T T T T T T T 54 Mpigi T T T T T T T T T 54 Mubende T T T T T T T N T 54 Mukono T T T T T T T T T Nwoya N T T L N T N T T Report s on time 44 4 report s receiv ed T L N No Expect

31 District Nakapiripirit Nakaseke Nakasongola JAN FEB MAR APR MAY JUN JUL AUG SEP 54 T T T T T T T T T 9 T T T T T T T T T 54 4 T T T T T T L T T Namayingo T L T T T T L L T 5 Namutumba 4 T T T T T T T T T Napak T T T T T T L T T 54 Nebbi 5 T T T T T N L L T Ngora L L T L L N N N N Ntoroko T T T T T T N T T 54 Ntungamo 6 T T T T T T T T N 5 MARACHA T T T T T T T T T Otuke T N T L L T T L T 5 OYAM T T T T T T T T T 54 Pader T T T T L T T T T 54 Pallisa 8 T T T T T T L T L 54 Rakai 9 T T T T T T L L T Rubirizi T T T T T T T T N Report s on time 6 6 report s receiv ed T L N No Expect

32 District Rukungiri JAN FEB MAR APR MAY JUN JUL AUG SEP 55 T T T T T T T T T Serere L T T L T T T T T Sheema L T T N T N L N N 55 Ssembabule T T T T T T T T T 55 Sironko T T T T T L T T T 55 Soroti L T L L T L L T T 55 Tororo 4 T T T T T T T T T 55 Wakiso 5 T T T T T T T T T 55 Yumbe 6 T T T T T T T T T Zombo T T T T T T T T T Report s on time 44 report s receiv ed T L N No Expect T (Timely report) timely 68 report L (Late report) late 8 report 9 4 N (No report) not reported

33 District JAN FEB MAR APR MAY JUN Completen ess NATIONAL - Target of reporting is the 8th of the next month JUL AUG SEP Report s on time 9 report s receiv ed T L N No Expect A Timely report is having the report received at Central level within st to 8th of the next month - Late is a report that was received at Central level after the 8th of the next month.