Developing A Central Analytic Repository To Improve Decision Making By Stakeholders

Background The rise in data analytics has resulted in the need for data to be pooled into centralized large-scale repositories to support more organized analytics. In the health sector, housing health data in a central analytic repository makes it easier for policymakers to access and make faster, more efficient informed decisions that impact the population, especially in cases of emergencies and disease outbreaks. Our study aimed to develop a centralized health data analytics repository for Nigeria called the Multi-Source Data Analytics and Triangulation (MSDAT) platform to improve decision-making by stakeholders. Methods The MSDAT design and development was a data and user-centred process guided and informed by the perspectives and requirements of analysts and stakeholders from the Federal Ministry of Health, Nigeria. The inclusion of health indicators and data sources on the platform was based on: (1) national relevance (2) global health interest (3) availability of datasets and (4) specific requests from stakeholders. The first version of the platform was developed and iteratively revised based on stakeholder feedback. Results We developed the MSDAT for the purpose of consolidating health-related data from various data sources. It has 4 interactive sections for; (1) indicator comparison across routine and non-routine data sources (2) indicator comparison across states and local government areas (3) geopolitical zonal analysis of indicators (4) multi-indicator comparisons across states. Conclusion The MSDAT is a revolutionary platform essential to the improvement of health data quality. By transparently visualizing data and trends across multiple sources, data quality and use are brought to focus to reduce variations between different data sources over time and improve the overall understanding of key trends and progress within the health sector. Hence, the platform should be fully adopted and utilized at all levels of governance. It should also be expanded to accommodate other data sources and indicators that cut across all health system areas

Cost of three models of care for drug-resistant tuberculosis patients in Nigeria

Background: Nigeria accounts for a significant proportion of the global drug-resistant tuberculosis (DR-TB) burden, a large proportion of which goes untreated. Different models for managing DR-TB treatment with varying levels of hospitalization are in use across Nigeria, however costing evidence is required to guide the scale up of DR-TB care. We aimed to estimate and compare the costs of different DR-TB treatment and care models in Nigeria. Methods: We estimated the costs associated with three models of DR-TB treatment and care: Model (A) patients are hospitalized throughout the 8-month intensive phase, Model (B) patients are partially hospitalized during the intensive phase and Model (C) is entirely ambulatory. Costs of treatment, in-patient and outpatient care and diagnostic and monitoring tests were collected using a standardized data collection sheet from six sites through an ingredient's approach and cost models were based on the Nigerian National Tuberculosis, Leprosy and Buruli Ulcer Guideline - Sixth Edition (2014) and Guideline for programmatic and clinical management of drug-resistant tuberculosis in Nigeria (2015). Results: Assuming adherence to the Nigerian DR-TB guidelines, the per patient cost of Model A was 18,528 USD, Model B 15,159 USD and Model C 9425 USD. Major drivers of cost included hospitalization (Models A and B) and costs of out-patient consultations and supervision (Model C). Conclusion: Utilizing a decentralized ambulatory model, is a more economically viable approach for the expansion of DR-TB care in Nigeria, given that patient beds for DR-TB treatment and care are limited and costs of hospitalized treatment are considerably more expensive than ambulatory models. Scale-up of less expensive ambulatory care models should be carefully considered in particular, when treatment efficacy is demonstrated to be similar across the different models to allow for patients not requiring hospitalization to be cared for in the least expensive way

Duplication of effort across Development Projects in Nigeria: An example using the Master Health Facility List

ObjectiveDuplication of effort across development projects is often the resultant effect of poor donor coordination in low and middle income countries which receive development assistance. This paper examines the persistence of duplication through a case study of health facility listing exercises in Nigeria.MethodsDocument reviews, key informant interviews and a stakeholder’s meeting were undertaken to identify similar health facility listing exercises between 2010 and 2016.ResultsAs an outcome of this process, ten different health facility listing efforts were identified.Discussions Proper coordination and collaboration could have resulted in a single list grown over time, ensuring return on investments. This study provides evidence of the persistence of duplication, years after global commitment to harmonization, better coordination and efficient use of development assistance were agreed to.ConclusionsThe paper concludes by making a proposal for strategic leadership in the health sector and the need to leverage information and communications technology through the development of an electronic Health Facility Registry that can archive the data on health facilities, create opportunity for continuous updates of the list and provide for easy sharing of the data across different country stakeholders thereby eliminating duplication