Sop For Hmis Jun 2017

ROUTINE HMIS DATA
STANDARD OPERATING
PROCEDURES (SOP)
VERSION ISSUED ON EFFECTIVE FROM

2.0 09 June 2017 Approval date
PREPARED BY CHECKED BY APPROVED BY
Haron NJIRU Dr. Muhsin Sheriff
Consultant Health Specialist (Data & Evidence)
UNICEF UNICEF
Haron NJIRU
UNICEF Somalia
HMIS Consultant |njiru@outlook.com
STANDARD
OPERATING PROCEDURES
DOCUMENT OUTLINE
List of tables and figures ....................................................................................................................... 2
List of abbreviations .............................................................................................................................. 3
Definition of terms ................................................................................................................................. 3
1.0 Introduction ............................................................................................................................... 5
1.1 Situation analysis ....................................................................................................................... 5
1.2 About the document ............................................................................................................. 5
1.3 Proposed dissemination plan ................................................................................................ 5
2.0 Data Management System ........................................................................................................ 6
2.1 Preamble ................................................................................................................................ 6
2.2 Data protection ...................................................................................................................... 6
2.3 Data security .......................................................................................................................... 7
3.0 Data Collection and Reporting .................................................................................................. 9
3.1 Data collection tools .............................................................................................................. 9
3.2 Data collection procedure ................................................................................................... 10
3.3 Data reporting procedure .................................................................................................... 11
3.4 Late reports ...........................................................................................................................13
4.0 Data Quality Audits ................................................................................................................... 11
4.1 Overview ............................................................................................................................... 11
4.2 DQA objectives ...................................................................................................................... 12
4.3 DQA data management ........................................................................................................ 12
4.4 Procedures for conducting DQA exercise .......................................................................... 14
4.5 DQA assessment report ........................................................................................................15
4.6 HMIS scorecard .................................................................................................................... 16
4.7 Staff roles and responsibilities in DQA ............................................................................... 16
5.0 Data Demand and Use ............................................................................................................. 18
5.1 Data utilization at Facility level............................................................................................ 18
5.2 Data analysis beyond the Facility Level .............................................................................. 20
5.3 Typical procedure for Data analysis and Presentation ...................................................... 24
6.0 SOP Responsibilities ................................................................................................................ 29
7.0 Future considerations .............................................................................................................. 30
7.1 HMIS reforms ....................................................................................................................... 30
7.2 Electronic Data capture ....................................................................................................... 30
8.0 Revision History ........................................................................................................................31
9.0 References ................................................................................................................................31
10.0 Annexes .................................................................................................................................... 32
Annex 1: District data log ................................................................................................................. 32
Annex 2: Regional data log .............................................................................................................. 34
Annex 3: National data log .............................................................................................................. 36
Annex 4: DQA Template .................................................................................................................. 38
Annex 5: HMIS Scorecard ................................................................................................................ 39
Annex 6: HMIS Data visualization ................................................................................................... 40
Annex 7: HMIS Supportive Supervision Tool .................................................................................. 41
Annex 8: Mentorship Guidelines and SOP ...................................................................................... 42
Annex 9: DQA Log ............................................................................................................................ 44
SOMALIA MoH HMIS SOPs Ver 2.0 Jun 2017 Page 1 of 44

STANDARD
LIST OF TABLES AND FIGURES
Table 1: Registers used for HMIS data collection ................................................................................. 9

Table 2: HMIS registers’ numbering system ....................................................................................... 10
Table 3: Typical flow of patient data .................................................................................................... 11
Table 4: Monthly Forms used for HMIS data reporting ...................................................................... 11
Table 5: Dimensions of data quality ..................................................................................................... 11
Table 6: Indicators and sources per program area.............................................................................. 12
Table 7: Data validation rules for DHIS data entry and general mentorship .....................................13
Table 8: DQA/Score card color-codes ................................................................................................. 16
Table 9: Possible list of priority indicators for HF monthly tracking ................................................. 19
Table 10: HMIS data analysis plan ....................................................................................................... 26
Figure 1: An illustration of Page Summary section from PNC register .............................................. 10

Figure 2: An approach to enhance DDU capacity to improve data demand and use ...................... 18

STANDARD
LIST OF ABBREVIATIONS
ANC Antenatal clinic MFL Master Facility List

AWD Acute Watery Diarrhoea MNCH Maternal, neonatal and child health
CQA Continuous Quality Assurance MoH Ministry of Health
DDU Data Demand and Use OPD Outpatients Department
DHIS District Health Information System OPV Oral polio vaccine
DQA Data Quality Assessment / Audit PHU Primary Health Unit
EPI Expanded program on immunization PNC Post-natal care
HF Health Facility RDT Rapid diagnostic kit
HIS Health Information System SOP Standard Operating Procedures. A set
HMIS Health Management Info. System of instructions to achieve uniformity
IP Implementing partner of the performance of a specific
IPV Inactivated Polio Vaccine function or practice.
LLIN Long lasting insecticide treated nets TB Tuberculosis
M&E Monitoring and Evaluation VCT Voluntary counselling and testing
MDT Multi-disciplinary team
DEFINITION OF TERMS
AWD Acute watery diarrhoea refers to passage of 3 or more loose or watery stools per day
with or without dehydration.
Data Raw, unorganized facts that need to be processed. Data can be something simple and
seemingly random and useless until it is organized.
Data analysis Organising and manipulating data using statistical concepts to generate information.
Data quality How well the information system represents the reality (accurate and reliable).
DDU Efforts to build capacity and improve data utilization and demand by all stakeholders
DQA Data quality assessment refers to a statistical evaluation of a data set to determine its
validity and adequacy for its intended use.
Evaluation Periodic assessment of the efficiency, impact, relevance and sustainability of the
project’s actions.
HMIS This is a routine integrated system of collection, collation, analysis, presentation,
dissemination and utilization of relevant health‐related information. It is specially
designed to assist in the management and planning of health programmes. a
Information This is data that is processed, organized, structured or presented in a way that makes
it useful.
MFL This is a list that contains all the health facilities in a defined geographical region.
Monitoring Continuous assessment that aims at providing stakeholders with early detailed
information on progress of program activities.
a WHO (2004). Developing health management information systems: a practical guide for developing countries

STANDARD
1.0 INTRODUCTION
1.1 SITUATION ANALYSIS
All public health facilities (HFs) are provided with standard registers and summary forms
for HMIS dataa. Inside covers of the revised HMIS tools contain standard guidelines on the
collection, reporting of HMIS data. The tools are also identical irrespective of the level of
service delivery, except primary health units (PHUs) which have unique registers b. With
the nationwide introduction of DHIS, the country has shifted from Excel/Access reporting
to DHIS online reporting thus eliminating the need for manual aggregation of data. The
focus is now on data quality, data analysis, presentation and use. There is a Monitoring
and Evaluation framework to guide monitoring of the Health Sector Strategic Plan (2013 -
2016), however, there are no guidelines for data quality audits (DQA) and data analysis.
1.2 ABOUT THE DOCUMENT
This document serves multiple purposes: It describes the THESE PROCEDURES APPLY
procedures for data collection, data management and TO BOTH PUBLIC AND
PRIVATE HEALTH FACILITIES
security procedures for routine health management
information system (HMIS). HMIS data should be collected, recorded and managed in
accordance with the Ministry of Health policies to protect patient confidentiality. This
document aims at ensuring that quality data is collected in a more efficient way by
describing how to carry out operations correctly and consistently. Following these
procedures will help in achieving uniformity in carrying out HMIS activities. This document
should therefore be available at every unit where HMIS data is either being generated,
aggregated or analysed, be it a public or private HF. It describes the steps required to
prepare for and conduct DQA and presents templates to be used in DQA process. Gives
guidelines for basic data analysis, interpretation and presentation using selected
indicators from the national HMIS indicators list. It complements the national HMIS
tool’s procedures and training manual, hence the two should be used together.
1.3 PROPOSED DISSEMINATION PLAN
The SOP should be disseminated in a hierarchical cascade. The national HMIS teams should
be trained first; the team should then train the regional teams, who should train the district
teams. District teams should train and mentor HF teams to complete the cascade.
aData from private HFs is largely underreported making it impossible to know the precise burden of morbidity and mortality.
bInitially, there were different types of registers and summary forms for HCs and Hospitals even when the service mix was uniform which
made data aggregation for analysis and subsequent utilization cumbersome.

STANDARD
2.0 DATA MANAGEMENT SYSTEM
2.1 PREAMBLE
1. There should be a trained HMIS data focal person at all levels where HMIS data is
either generated, aggregated or processed.
2. Each facility should have a unique code from the master facility list (MFL)
maintained by national HMIS office. The code should be indicated on all HMIS tools
at the HF. Having an MFL is important for establishing the exact number of HFs, and
for resource allocations including supportive supervision.
3. All HMIS data shall be collected using standard health facility registers. The inside
cover of each register clearly explains what data should go to each column. This is
hoped to minimize data collection and reporting errors.
4. Data should be summarised using standard monthly summary forms. The forms
contain guidelines on how to summarize data from the various registers.
2.2 DATA PROTECTION
All person-identifiable data must be treated with utmost confidentiality.

1. Patient records should be accessible only to authorized minimum number of people
needed to ensure the smooth delivery of medical services.
2. Staff accessing medical data shall be made aware of their responsibility to maintain
patient confidentiality. The Staff should undertake an initial training prior to
assignment and a refresher training every 6 months. The training should include
data ethics especially regarding patient data handling. See footnote for courses.a
3. Data containing patient names should not be transmitted in a way that could allow
unauthorised interception. Such ways include email attachments, sending flash
disk and CD-ROMS containing patient data by postal or courier services.
4. Such data should only be analysed at the health facilities where it is generated.
ALL MEDICAL DATA SHOULD BE SECURELY STORED TO

SAFEGUARD AGAINST UNAUTHORISED ACCESS
a Some International Online Ethics Training Links and Certificates

Forum on Education Statistics: http://nces.ed.gov/forum/dataethics_course.asp
US NIH: http://phrp.nihtraining.com TREE: http://elearning.trree.org/ CITI: https://www.citiprogram.org
FHI: http://www.fhi360.org/training/en/RETC2/index.html USNSF: http://www.responsibleresearch.org/

STANDARD
2.3 DATA SECURITY
Security of non-electronic data
Data generated through the HMIS system should be securely stored at all levels.
1. Data should be securely stored at all levels, preferably metallic cabinets or lockable
wooden cabinets.
2. The most current health files (last 2 years) should be kept within the records office
while files older than 2 years should be safely archived.
3. Data should be stored chronologically and alphabetically using clear labels to ease
retrieval. E.g. January 2016 reports should be adjacent December 2015 reports while
Bay region should appear before Sool in the filing cabinet.
4. Anyone seeking access to the aggregated HF data should obtain permission from
the regional or district health offices or the HF in-charge. Such request should
include the reason why data is being requested, the variables and period of interest.
5. Anyone seeking access to patient-level records from HF registers should obtain
written permission from the national HMIS office. Such request should include the
reason why data is being requested, the variables and period of interest.
Exceptions to this requirement include supportive supervision / mentorship visits
by relevant authorities.
Security of electronic data
1. Electronic data should only be stored on devices that are routinely and securely
backed up:
a. A daily back up of data is recommended. This should be done on the

computer’s hard-disk AND an external hard disk.
b. A weekly backup should be done on a CD-ROM or external hard drive. This
should be kept in a separate location.
c. To reduce risk of overwriting newer files with old data, names of electronic
files should include the date the file was last saved.
d. Backup requirements for DHIS data should be observed (see User Manual).
2. Data for analysis should be anonymised and contain only minimum personal
identifiers necessary for analysis such as age, sex and geographic location. Patient
names should never appear in the summary tools or reports of analysed data.
3. Patient data must not be stored or transmitted on removable media or laptops
without encryption.
4. Computers used to enter or access data should have updated anti-virus software
to safeguard against data corruption and phishing.

STANDARD
5. Access to the data should be limited to authorised personnel. Each user of the
system should have a password protected individual account.
6. Assignment of access rights to DHIS should be handled by the national HMIS

coordinator. S/He should keep a record of authorised users and their access levels.
7. Users should be advised against sharing their database login details with anyone.
8. The database should have an audit trail for any edits made to the data (this is inbuilt
in DHIS). The trail should include original value, date of the change and user details,
and a brief explanation of why the change was made.
9. New staff should be taken through an induction program to familiarize them with
the HMIS system and data safety.
ACCESS TO ELECTRONIC MEDICAL DATA SHOULD BE LIMITED

THROUGH PASSWORD PROTECTED USER ACCOUNTS
**
NO DATA SHOULD BE CHANGED OR DELETED THROUGH THE
VERIFICATION AND VALIDATION PROCESS WITHOUT PROPER
DOCUMENTATION.

STANDARD
3.0 DATA COLLECTION AND REPORTING
3.1 DATA COLLECTION TOOLS
1. HMIS data should be collected using the standard HMIS tools developed and
produced by the Ministry of Health. As a basic requirement, each health facility
should have all the necessary registers. These are shown in Table 1.
2. For ease of reference, and to reduce the overlap of register numbers across service
delivery levels, data recording tools have a unique number depending on the level
of service delivery. These are shown in Table 2.
3. Organizations and implementing partners whose services and activities utilise the
existing health facilities should report through the respective HFs using the
national HMIS registers.
4. Existing HMIS tools should not be updated or edited without the approval of the
Ministry of Health.
5. For harmonisation and standardization, no additional data collection and reporting
tools should be introduced without the approval of the Ministry of Health.
6. Any changes or updates to the system must be documented as part of a change
control process and the relevant parts of the system revalidated.
7. All health workers should be trained on the data collection and summary tools.
Table 1: Registers used for HMIS data collection

Register / tool PHU HC/RHC Hospital Revised New label
Monthly Summary Forms F01 F02 Split See Table 4
PMTCT (ANC & Maternity) Registers Integrated -
Immunization tally sheet Yes F4A
OPD over 5 register R01 R51 Merged R01
OPD under 5 register R02 R52 Merged R02
Immunization register R03 Yes R03
Labour, Delivery and Maternity register R04 R54 Merged R04
ANC register R05 Yes R05
PNC register R06 Yes R06
Birth Spacing Register Yes R07
Pre-ART register R09
ART register R10
Appointments and Defaulter register New R11
HIV exposed infants register New R12
PHU OPD register Yes R31
PHU Birth & Death registers Merged R32
Inpatient register R53 Yes R53
Theatre register R55 No R55
Lab register R56 No R56
Lab results R57 No R57
Note: This list is not exhaustive. It only focuses on the revised HMIS tools.
Refer to HMIS Procedures and Training Manual for details on how to use these registers.

STANDARD
Table 2: HMIS registers’ numbering system
Register numbers Level of service delivery

R01 to R30 Health centres and referral health centres
R31 to R50 Primary health unit registers
R50 upwards Hospitals
3.2 DATA COLLECTION PROCEDURE
Data for HMIS should be collected from each PHU, HC, RHC and Hospital. All persons
involved in the collection and management of patient-related information must ensure
that the uses of those data do not "compromise" patients’ confidentiality.
1. Client data should be first captured in the designated patient medical cards / charts
by the health care provider.
2. The provider should immediately transfer the data recorded on medical forms into
appropriate registers (see Table 1 on page 9).
3. The registers should be updated regularly with each patient visit.
4. Each month should start on a new page of the register.
5. At end of each month, staff should add up page totals to get monthly summary.
6. The clinician should compute the page summaries at bottom of each fully
completed page of the register. This should be done at the end of each day for all
the completed pages. Figure 1 below is an illustration of page summary section.
7. MoH and IP should strengthen this process through routine supportive supervision,
mentorship, DQAs and flip-chart reference sheets.
Figure 1: An illustration of Page Summary section from PNC register
Each register and data reporting tool should have Version Number and Version date
clearly printed on the cover page. This reduces chances of using outdated registers.
The inside of the front cover of every register / reporting tool should:
1. Specify where the registers should be placed in the HF
2. Describe what data should go to which column or cell
3. State if the tool is to be used together with any other tool e.g. tally sheet.

STANDARD
3.3 DATA REPORTING PROCEDURE
Data should be reported using the designated MoH standard reporting tools. This should
be done within the stipulated time to ensure availability of data for timely decision making.
Table 3 shows the general data flow for monthly reports and the reporting deadlines.
Table 3: Typical flow of patient data

Source Destination Deadline
Individual patients Register Immediately
HF register Facility Summary Form End month
Facility District (or DHIS) 5th day
District Region (or DHIS) 7th day
Region National level (or DHIS) 10th day
Where DHIS is in use, data is keyed into DHIS at the HF, district or regional level. This should
happen within 5 days after receiving data. Accordingly, all data should be available in DHIS by
the 15th Day of every month.
At the Health Facility level:

1. Health facilities should compile the monthly report in triplicate using data from the
page summaries (and EPI tally sheet). This should be done using designated
standard Monthly Facility Report Forms shown in Table 4.
2. The person completing the Monthly Report Forms should indicate his/her name and
designation, and sign in the appropriate sections of the form.
3. The facility in-charge should cross-check the reports for errors before submitting to
district. Use DQA Forms and Data Validation Rules (Table 7) as a guide.
4. If the report has no errors, the in-charge should sign the requisite sections of the
report. If any errors are identified, request form to be done again, and review
afresh. Ensure all expected reports have been prepared for submission.
5. Two copies of the report should then be submitted to the district HMIS by 5th day
of the subsequent month. Data entry to DHIS should occur by 10th of the month.
6. The facility should retain a copy of the report for their records as well as for data
quality audits (DQAs) by district/regional officers and implementing partners.
Table 4: Monthly Forms used for HMIS data reporting

Form title Form #
Stock Summary and General Statistics Summary Form F01
Morbidity and Mortality Summary Form F02
Malaria, HIV and Tuberculosis Summary Form F03
Immunization Summary Form F04
Safe Motherhood, Birth Spacing and Nutrition Summary Form F05
Diagnosis, Laboratory and Surgery Summary Form F06
Human Resources and Cost Sharing Summary Form F07
PHU Monthly Summary Form F08
Please refer to HMIS Procedures and Training Manual for details on how to use these forms.

STANDARD
At the District level:

1. The district HMIS officer should ensure that s/he has received all expected reports
from all functional health facilities in the district and update the district monthly
data log (see Annex 1 for the District data Log template).
2. The HMIS officer should check DHIS to ensure that:

a. All expected reports have been received and update Annex 1b.
b. All the fields in the received health facility reports are filled.
c. Stamp and date all the received reports.
3. S/he should contact any facilities whose reports are either missing or incomplete
for clarifications before compiling the district report and update the district
reporting performance report (See Annex 1b).
4. All data queries should be resolved before submitting the data to the next level, or
before entering data into DHIS.
5. The district HMIS report should then be compiled using the standard Ms Excel
template. Skip this step if using DHIS.
6. District Monthly Excel file, the District Data Log and Annex 1b should then be
submitted to the regional HMIS officer by 7th day of the month.
At the Regional level:

1. The regional HMIS officer should ensure that s/he has received all expected reports
from all the districts in the region and update the regional quarterly data log (see
Annex 2 for the Regional data Log template).

b. All the fields in the received district monthly reports are completed.
c. Stamp and date all the received reports.
3. S/he should contact any districts whose reports are either missing or incomplete
for clarifications before compiling the regional report.
4. All data queries should be resolved before submitting the data to the next level, or
before entering data into DHIS.
5. The regional HMIS report should then be compiled using the standard Ms Excel
template. Skip this step if using DHIS.
6. Region’s Monthly Excel File, and copies of District, Regional Data Logs and Annex
2b should then be submitted to national HMIS office by 10th day of the month.

STANDARD
At the National level:
1. The National HMIS coordinator or his/her designee should ensure that s/he has
received all expected reports from all the regions and update the National monthly
data log (see Annex 3 for the National data Log template).

b. All the fields in the received regional monthly reports are completed.
3. S/he should contact any regions whose reports are either missing or incomplete for
clarifications before compiling the national HMIS report.
4. All data queries should be resolved before commencing data analysis.
5. National HMIS report should then be compiled and shared with various
stakeholders and feedback provided to regions and districts. The analysis is done
using DHIS visualization features, pivot tables (exported to Excel) or both.
Any queries identified after running DHIS validation rules should be discussed with
respective facilities and resolved: HFs should recheck registers and make necessary
adjustments on summary forms. Such changes should be documented in DHIS for
reference. This is done by double-clicking the value that is being modified.
3.4 LATE REPORTS
1. In case of delayed facility reports, the HMIS officer supporting the HF should
contact the HF requesting status of the report within a day after the deadline.
2. If it’s not possible to receive the report for compilation in good time, the officer
should update the data log accordingly with the available reports, and submit.
3. Reports submitted after the deadline should still be entered into DHIS.
DATA SUMMARY REPORTS

Each year, a data summary report should be form. include data from previous years to
produced to document the HMIS activities and provide a frame of reference for the present
summarize the data collected during the year. year’s data. Documentation of prevailing
The report should contain the following main conditions that may influence the year’s
sections: (1) Summary: Brief data summary, performance should also be included. (5)
findings of interest, and DQA highlights. (2) Quality assurance: Summarise basic quality
Introduction: Give background, purpose and assurance and quality control measures taken
objectives including HIS structure (3) Methods: to ensure the quality of data. Discuss any
Summary of HIS activities conducted regarding significant DQA findings. (6) References: Show
activities reports for more details. (4) Results: relevant literature cited. (7) Appendices:
Summarise data in graphical and / or tabular Detailed data tables, list of HFs, maps etc

STANDARD
4.0 DATA QUALITY AUDITS
4.1 OVERVIEW
Routine monitoring activities of health programmes generate important data for patient
care and programme improvement. This data should therefore be of high quality. Data
quality assessment help identify errors and provide detailed information of the facilities’
data and mentorship needs to strengthen good data practices at health facilities.
This SOP contains detailed instructions for conducting HF data quality audits (DQAs). It
looks at completeness of data records and compares facility register records with
documentation on the monthly HMIS and DHIS reports.
The DQA process verifies key data characteristics, facilitates the process of evaluating set
data standards and provides a score against data qualities. Table 5 below shows the various
dimensions of data quality.
Table 5: Dimensions of data quality
Characteristic Definition
Accuracy This is one of the components of data quality and refers to whether
the data values stored are the correct values. To be correct, a data
values must be the right value and must be represented in a consistent
and unambiguous form.a
Completeness Measure of availability of all data fields within a set of data collection
tool. Are all fields in monthly reporting form complete? Does report
capture all patients in the register during the reporting month?
Consistency Logical coherence among related aspects of data. e.g. Number of ANC
women given Iron/Folate for treatment should not be greater than
number of anaemic pregnant women. Please see Table 7
Validity The ability of data to reflect events/outcomes that is measured. E.g.
Screening children’s nutritional status by other means besides MUAC
and weight/Height is not valid.
Reliability The ability of data to show similar results when indicators are
measured more than once, using similar ground/characteristics. It is
the extent to which we can rely on the source of the data, therefore
the data itself. E.g. The Total Number of HIV infected clients should be
consistently extracted from all the HIV testing points (e.g. VCT
register, ANC Register and Delivery Register), not just some of the
registers.
a Data Accuracy: http://etutorials.org

STANDARD
4.2 DQA OBJECTIVES
1. To check data variables for timeliness and completeness.
2. To evaluate data consistency, through comparison of data in the monthly HMIS

reports, and DHIS online database with data recorded in MoH registers.
3. To appraise data reliability against data summaries on MoH registers and forms.
4. To assess validity of reported data by confirming method of measurement from

source documents (and facility staff).
5. To assess the accuracy of data through double checking all data variable fields
against source documents.
4.3 DQA DATA MANAGEMENT
HMIS data is aggregated from different sources, the design of DQA is to compare
reported data against these sources. Due to time-consuming nature of DQAs (4 hours on
average), the DQA team only focuses on selected data elements for each program area.
The arbitrary list of DQA indicators and their source documents are shown in Table 6.
Table 6: Indicators and sources per program area

Program area Indicator Register Form
OPD 1. Malaria cases confirmed by RDT/slide F01
2. Number put on A+L for malaria treatment OPD registers F02
3. Number of new patients treated at the HF PHU OPD Register F03
4. Cases of watery diarrhoea among under 5s F08
Nutrition 5. Number of children screened
6. Number with normal results PHU OPD Register F05
7. Number moderately malnourished OPD under 5 register F08
8. Number severely malnourished
ANC 9. Number of clients with 4+ ANC visits
10. Number screened for syphilis ANC register F05
11. Number with positive syphilis test result
Deliveries 12. Number of deliveries in the health facility
13. Number monitored with partograph L&D register F05
14. Number of LBW babies
Immunization 15. Number of children <1 who received Penta 1
16. Number of children <1 who received Penta 3 EPI Tally Sheet (F4A) F04
17. Number of children <1 who received Measles
PNC 18. Total number with first PNC within 2 days
PNC register F05
19. Number counselled on IYCF
Laboratory 20. Number of RDTs for malaria
Lab results register F03
21. Number of positive RDTs
OPD registers F06
22. Positive tests with plasmodium species indicated
Store 23. RDT opening balance ORS opening balance
24. RDT kits received ORS sachets received
Bin card F01
25. RDT kits utilized ORS sachets utilized
26. RDT kits in the store ORS sachets in the store
PMTCT 27. Number of pregnant women counselled and test for HIV
(ANC) 28. Number of ANC women with positive HIV test result
ANC F05
29. Pregnant women put on ART (Option B+)
30. Infant prophylaxis issued to mothers
HRH 31. Staff who attended refresher training during the month Training reports/plans F07
Note: Form F08 is only applicable to primary health units (PHUs)

STANDARD
Table 7: Data validation rules for DHIS data entry and general mentorship
Form Value 1 Rule Form Value 2

F01 New < 5 visits + <5 Revisits = F02 Total <5 OPD
F01 New > 5 visits + >5 Revisits = F02 Total >5 OPD
F01 Number of admissions = F02 Total inpatient admissions
F01 Starting balance + Received - Used = F01 Ending balance
F01 Inpatient Deaths (2.1 E) = F02 Inpatient deaths (3.1)
F01 Total females under 5 (visits + revisits) = F02 Total females
F01 Total males under 5 (visits + revisits) = F02 Total males
F03 Total RDT done >= F03 Positive RDT
F03 Total Slides done >= F03 Positive slides
F03 Positive RDT + Positive slides = F03 Vivax + falciparum
F03 Total A+L = F01 A+L used this month
F03 Total RDT done = F01 RDT used this month
F03 Uncomplicated malaria (confirmed) = F02 8b
F03 Uncomplicated malaria (confirmed = F02 7a
F03 Section 3: number counselled >= F03 Number tested
F03 Section 3: number tested >= F03 Number positive
F03 Section 3: number positive >= F03 Number referred for ART
F03 Section 4: Positive TB + Negative TB <= F03 Number screened (smear)
F03 Section 4: Number co-infected with HIV <= F03 Number tested for HIV
F04 BCG <1 year FIXED < F04 Measles <1 year FIXED
F04 Penta 1 <1 year FIXED < F04 Penta 3 <1 year FIXED
F04 BCG total <= F01 BCG used this month
F05 ANC 1 visits (Section 1a) <= F05 ANC 4+ (Section 1d)
F05 Number screened for syphilis (1i) <= F05 Syphilis positive (1j)
F05 IPTp 1st dose (1f) <= F05 IPTp 3rd dose (Section 1h)
F05 Births monitored with partograph (3f) <= F05 Total births (3e)
F05 Early initiation of breastfeeding (3i) <= F05 Total births (3e)
F05 Babies below 2500 grams (Section 4d) <= F05 Total births (3e)
F05 Total births (3e) <= -- Estimated birth in population
F05 # counselled for HIV (ANC+ labor+ PNC) >= F05 # tested HIV (ANC+ Lbr+PNC)
F05 # tested HIV (ANC+ Lbr+PNC) >= F05 # HIV Posit (ANC+ Lbr+PNC)
F05 Infant prophylaxis (ANC+ Lbr+PNC) <= F05 (6a + 6b + 6e) in ANC, Lbr, PNC
F05 8b+8c+8d = F05 8a
F05 8e <= F05 8d
F05 Total anaemic = F02 Section 1 (13b)
F05 8c + 8d >= F05 9a + 9b + 9c
F08 Confirmed malaria (2) = F08 Total positive RDT (22a)
F08 Positive RDTs (22a) >= F08 Falciparum + Vivax (22b)
F08 Total positive RDTs (22a) = F08 Total treated with A+L (23)
F08 Delivered at home (24) = F08 Live birth (25) + Still birth (26)
F08 Severe (33) + Moderate (34) >= F08 Malnourished referred (35)
F08 Suspected pneumonia (part 2 (9)) <= F08 ICCM pneumonia

STANDARD
4.4 PROCEDURES FOR CONDUCTING DQA EXERCISE
Preparing for DQA
The following steps should be completed before leaving the office to go to the field to
conduct the facility DQA. These steps are appropriate and crucial for a successful DQA.
1. Contact health facility in charge/management to schedule a DQA visit: date, time

and itinerary. Inform IPs about the confirmed date and request their participation.
2. Familiarize the DQA team with results from previous DQA assessments at the
targeted health facility.
3. Refer to the DQA process checklist to be sure that all steps are completed:
preparation, conduct and follow-up of DQA.
4. Using the MoH monthly HMIS report, and DHIS review the predetermined
indicators for DQA and populate the template with DHIS data prior to the visit.
5. Contact HF in-charge to ensure all registers/source documents will be available.
Identify any missing reports earlier to plan future mentorship support of the
facility in documenting and reporting using the MoH tools. Copies of any
missing reports should be delivered to the HF during the DQA visit.
Steps for Conducting DQA
1. Brief IP & HF staff and MoH officials about purpose and steps of conducting DQA.
2. Open the DQA Excel tool and enter the facility name, DQA date, and names of the
staff conducting the DQA into the appropriate cells (Annex 4).
3. Obtain copies of MoH HMIS monthly reports and relevant registers.
4. Start the DQA process addressing all DQA areas documented in Table 6 above.
Give time for short discussions that may arise during the DQA exercise.
5. Enter data in the Excel sheet. Percent error will be calculated automatically.
6. Complete the HMIS supportive supervision tool (Annex 7).
7. At the end of the DQA, hold a joint meeting with the facility staff to discuss in
detail the results and plan how to resolve the identified gaps or inconsistencies.
8. A copy DQA report with action plan should be kept by HF for reference. IP also
keeps a copy for review and preparation for tailored mentorship to the facility.
9. The HF documents the just concluded QA in their QA monitoring log. The
monitoring log should contain the following information: Date of DQA, DQA
score, action items and dates when the action items are resolved.
MoH and IP shall help facilitate feedback to the facilities through graphs and tables
that will summarize the findings of the DQA. M&E staff should use these sheets during
their presentation of DQA findings to health facility staff and clinical staff. Ideally,
these pages should be printed out for the facility staff to review and post on their walls.

STANDARD
DQA timelines
DQA should be conducted at each facility every three months. This provides an
opportunity to review gaps, weaknesses and see the strengths that will help shape the
strategies for conducting tailor made mentorship or any training needs.
These are some of the criteria to be applied in DQA:
1. Conduct DQA every three months (or earlier for immediate follow up DQA).
2. Data for the current month should not be included in the DQA process since it is likely
to be incomplete and therefore not representative.
3. Examine register entries for current month for completeness and appropriate
mentorship.
4. DQA feedback and follow up action items to be agreed immediately after completing
the DQA exercise.
5. During each DQA exercise, the team should review monthly reports for previous 3
months against source documents, as well as DHIS entries.
District and Regional HMIS officers, and program managers together with IPs should
support and mentor facilities on proper recording and reporting to ensure that all the
MoH reports are complete, accurate, reliable and timely. See Annex 8 for Mentorship
Guidelines and Standard Operating Procedures.
4.5 DQA ASSESSMENT REPORT
There should be a written report of every DQA. The report should include specific guidance
for facility staff on how to improve data collection and recording, it should indicate the
timelines for joint review of the set priority activities. In addition, the DQA team should
generate a HMIS scorecard highlighting performance levels (See Section 4.6 on page 16).
For the DQA to be helpful to the program and facility staff:
1. Present and discuss the DQA report: A written final DQA report should be shared with
facility staff within 7 days after the DQA.
2. Include DQA reports in quarterly data review meetings: Two or three slides in the
quarterly data review presentation should be dedicated to DQA. The slides
summarise HF levels and district/regional DQA results and should always include
measures on how to improve collection and recording of data.
3. Mentor staff on implementation of corrective measure: After the facility DQA report
is shared and discussed with facility staff, mentorship on implementation of
corrective measures should be provided by appropriate MoH and IP staff. Follow-up
is critical for improving data. Continued mentorship is expected to result in improved
DQA results over time.

STANDARD
4.6 HMIS SCORECARD
To improve the quality of HMIS data, a scorecard has been developed to assess and
improve the health management and information system. The scorecard is one of the
outcomes of a data quality audit. The scorecard assists in comparative assessment of HMIS
performance at HF, district, region and national level. The scorecard uses data quality
aspects from DHIS (timeliness, completeness, data values and data validation rules), HF
registers records and Monthly Summary Forms to show relative position of a service
delivery unit (HF, District, Region, State) using a composite index. The composite index
combines a number of indicators in a standardised way in order to assess the overall
performance of the level.
The objectives of HMIS scorecard (Annex 5) are to:
1. Provide visual presentation of status of different HMIS indicators.

2. Compares levels of service indicators using composite index.
3. Highlight differences across HFs/regions etc. for focused mentorship.
4. Encourage competition for data quality across all levels fostering data use culture.
The HMIS scorecard is generated using the DQA template (Annex 4). The template
generates a score for tools in each program area, and an aggregate score for the health
service unit. The performance results are colour-coded into 3 groups as shown in Table 8.
Table 8: DQA/Score card color-codes
Score Colour Implication

50% and below Red Immediate and intensive data mentorship required
51 to 74 % Yellow Routine mentorship/support supervision required
75% and above Green Routine Mentorship not required
4.7 STAFF ROLES AND RESPONSIBILITIES IN DQA
Collaboration of IP staff, district/region MoH staff and HF staff is essential for effective
implementation of DQAs. This section describes the roles of these players in DQA process.
Facility staff and MoH Managers

• Avail all the required data tools (3 months summary forms and current registers)
• Allocate a date and time for the DQA exercise every quarter.
• Notify all HF about the exercise and ensure clinical services are not disrupted.
• Actively participate in conducting DQA.
• Review results and identify measures for improving data.
• Facilitate feedback sessions at HFs to share DQA results with all facility staff.
• HFs and HMIS team should maintain an updated log showing DQA dates and
respective scores, and dates feedback was provided to all levels (Annex 9).

STANDARD
Health facility records officers

• Directly participate in the DQA exercise at facilities.
• Distribute facility reports to clinical staff and discuss strategies for
implementing data improvement measures.
• Provide refresher trainings for health facility staff on correct patient data capturing
in the patient records and registers.
Health Management and Information officers

• Support in abstracting data from registers and other sources and enter results in
DQA spread sheet for comparison purposes.
• Meet staff to discuss DQA findings and data improvement measures.
• Facilitate DQA assessments at assigned facilities.
• Compile DQA reports in collaboration with programme multi- disciplinary staff and
send to programme manager for review.
Implementing Partner Data/Programme Officers

• Contact HF in-charge to agree on date and time for DQA exercise
• Oversee DQA process to ensure (1) All agreed indicators are assessed, (2) HF
understand the purpose and support the process of DQA, (3) Staff know how to
use the DQA excel sheet and interpret results.
• Review DQA report to ensure data improvement measures are clearly articulated
• Schedule a meeting with facility management, preferably same day, to discuss the
DQA report and data improvement measures
• Provide refresher trainings for HMIS and data recording staff on protocols for
recording data in registers, if necessary.
• Submit Excel spreadsheets, DQA reports and quarterly DQA feedback slides to
regional and national HMIS Officers and IP data focal person.
• Prepare feedback slides for quarterly data review presentation.
Descriptive epidemiology covers time, place, and person. This is achieved using
the 5W's of descriptive epidemiology:
What = health issue of concern

Who = person affected
Where = place or geographical location
When = time
Why/how = causes, risk factors, modes of transmission
Health data should be presented in a way that enables decision makers answer
these 5 questions. Data analysis and appropriate presentation is key.

STANDARD
5.0 DATA DEMAND AND USE
HMIS data should be presented in a form appropriate for the needs of various
stakeholders. As such, data should be analysed at all levels to generate outputs that will be
provided as feedback to improve health service delivery. To achieve this, capacity should
be built in data use core competencies.
Figure 2 is an illustration of data demand and use (DDU) capacity improvement. The goal
of DDU capacity-enhancement efforts is increased use of data for decision-making and
advocacy, and improved health outcomes.
Source: MEvala
Figure 2: An approach to enhance DDU capacity to improve data demand and use
The following procedures are recommended for improving DDU capacity at various levels:
5.1 DATA UTILIZATION AT FACILITY LEVEL
1. Facility staff involved in data management should be trained on basic data analysis,
presentation and interpretation skills.
2. HFs should identify 5 priority indicators (from the national HMIS indicator list) for
tracking and visualisation (see Table 9 for possible list of priority indicators).
3. HFs should hold monthly data review meetings to review the 5 indicators, prior to
submission of the Monthly reports. This is the first stage in DDU.
4. HF data analysis should at the minimum include trend analysis. Analysis of the
trends should help facility management assess progress towards set targets.
a MEASURE Evaluation Technical Brief (Nov 2015).

STANDARD
5. Facilities should be supported to generate graphs showing monthly trends to

encourage use of data for decision making. Support could include standard A3
templates for graphing selected indicators (See Annex 6) or building their skills so
access DHIS 2 and generate their own dashboards and graphic displays.
6. MoH and IPs should facilitate quarterly forums where facilities can present their
analysis, exchange lessons learnt and receive feedback from regional teams.
To encourage competition and data use at HF level, a scorecard criteria should

be established. The HF scorecard should aggregate values based on multiple
performance indicators, including DQA score. Facility with the highest score
should be recognised and rewarded with a certificate during quarterly meetings.
Table 9: Possible list of priority indicators for HF monthly tracking
Indicator
1 % pregnant women utilizing ANC services
Numerator: Women who made first ANC visit during the month
Denominator: Estimated number of pregnant women in the community
2 ANC dropout rate
Numerator: Women who made ANC1 MINUS women with 4 or more ANC visits
Denominator: Women who made first ANC visit during the month
3 % ANC women who are tested for HIV and know their status
Numerator: Women making first ANC visit
Denominator: Women who get tested for HIV during the first ANC visit
4 % of deliveries conducted by skilled birth attendants
Numerator: Deliveries conducted by a skilled birth attendant in a health facility
Denominator: Estimated number of deliveries in the catchment population
5 % delivering women attending PNC
Numerator: Number of women who made first PNC visit during the month
Denominator: Estimated number of deliveries in the catchment population
6 % children under 1 immunized with Penta 3
Numerator: Children <1-year-old provided with Penta 3 vaccine
Denominator: Estimated number of <1 children in catchment population
7 Immunization dropout rate
Numerator: Children <1 who received Penta 1 MINUS Children <1 who got Penta 3
Denominator: Children <1 who received Penta 1 vaccination during the month
8 % children aged 6-59 months treated with ORS and Zinc for AWD
Numerator: Children with AWD who are treated with ORS and Zinc
Denominator: Number of Children diagnosed with AWD during the month
9 % of patients with malaria who are treated with A+L
Numerator: Number of patients treated with A+L
Denominator: Number of patients with a positive RDT or positive malaria Slide
10 % of malnourished children seen in OPD
Numerator: Number of children who are moderately or severely malnourished
Denominator: Children screened for malnutrition

STANDARD
5.2 DATA ANALYSIS BEYOND THE FACILITY LEVEL

5.2.1. Overview
1. HMIS data received from facilities through DHIS THE ULTIMATE GOAL IS NOT
should be regularly analysed and feedback provided TO GAIN INFORMATION, BUT
to facilities. Information products emanating from TO IMPROVE ACTION
such data are useful for updating dashboards, generating talking points,
identification of success stories and areas of improvement.
2. There must be a data quality check prior to data analysis. Quality checks should
include checking for missing data, missing reports, numbers that are outside the
expected range (outliers) and any inconsistencies. Any errors identified should be
corrected using the source documents. See Section 4.0 for DQA procedures.
3. Such analysis should include trend analysis (to show seasonal variations),
comparison of performance across geographical regions, and efforts to identify
possible causes of the observed trends e.g. weather conditions, government
policies etc. Chi-square test of associations and simple logistic regressions can be
performed at this level to test for the existence and strength of any associations.
4. Findings of the analysis should be shared with relevant stakeholders through

meetings, print media and appropriate information products.
5. An annual HMIS report should be prepared for sharing with relevant stakeholders.
6. Every 5 to 10 years, trend reports should be prepared based on comprehensive

statistical analysis of HMIS and other data. The objectives of trend reports are to:
a. Show patterns and trends in resources.
b. Report new characteristics in resources.
c. Look for any correlations among different variables.
d. Identify any predictors of disease burden.
e. Provide interpretation of data in regional, national and global context.
IF DQA RESULTS CONSISTENTLY SHOW DATA IS OF DISMAL QUALITY, CAUTION SHOULD

BE EXERCISED BEFORE ANALYSING AND USING SUCH DATA FOR ANY DECISION MAKING
A NOTE ON DATA SECURITY

If health facility data is to be exported for statistical analysis, all patient-identifiers must be
removed from the dataset prior to transmission. In exceptional cases where files containing
patient identifiers have to be shared for off-site analysis, such files must be encrypted and
password protected before transfer. Passwords to such files should be communicated to the
recipient in a separate communication.

STANDARD
5.2.2 Basic epidemiological concepts
To make sense of data, officers managing data should have an understanding of basic
epidemiological concepts and skills that will help them to analyse and interpret the data.
Below is a brief introduction to the basic terms that will be relevant when analysing routine
HMIS data.
Average Sum of a list of numbers divided by the length of the list.
Illustration
The weight of 4 children in OPD is 11, 15, 16, 18 kilograms
Sum of the numbers = 11+15+16+18 = 60
Length of the list = 4 children
Average = 60 / 4 = 15 kilograms
Completeness Completeness rate measures how sufficient is the data that’s available.
& Can be at the tools level or at a facility/region/state level. This is also
Timeliness rate referred to as reporting rate. Timeliness on the other hand refers to
being done or occurring at a favourable or useful time.
Illustration: Form 02 has 4 sections that should be populated every

month. If some sections are blank, then the mortality and morbidity
report is not complete. On the other hand, Vingt Region has 21 health
facilities, so 21 copies of Form 02 are expected every month. If only 18
Forms are submitted, the completeness rate would be 18/21 = 86.7%.
If 5 of the 18 reports were submitted after the submission deadline,

then the timeliness rate for the month would be (18-5)/18 = 72.2%
Composite This is an indicator formed when individual indicators are compiled into
indicator a single index.
Illustration: Body mass index (BMI) is a common composite indicator.

It is a measure of body fat based on two variables: height and weight.
Coverage This is the extent to which an intervention applies to everyone who

should have received the intervention.
Illustration: Vingt Village has 12,000 children under the age of 5 years.
If only 6000 of these children are dewormed, then the coverage for
the service is 6000/12000 = 50%

STANDARD
Cumulative This refers to the process of increasing a quantity by successive

additions.
Illustration: The following children were seen in OPD between January

and April: 11, 15, 16, 18. In this case, the cumulative number of children
seen in OPD during these 4 = 11+15+16+18 = 60 children
Dropout rate This refers to the percentage that fails to complete a service as
required. In immunization program, dropout rates represent the
proportion of children who receive at least one vaccine in a schedule,
but do not receive the next dose in the series.
Illustration: If 10 children receive Penta 1 and only 5 receive Penta 3, the

dropout rate would be (10-5)/10 = 5/10 or 50%
Penta drop out is an indicator of perceived satisfaction and operational

problems. A drop-out rate of 10% or more suggests a problem with the
immunization services.
Fraction This is a quantity that is not a whole number. It’s part of a whole. It is
also known as a proportion. The top number (the numerator) says how
many parts three are while the bottom number (the denominator)
says how many parts the whole has.
Illustration: The fraction 5/10 means that we are looking at 5 units out
of a total of 10 units. 5 is the numerator while 10 is the denominator.
Incidence This is measure of the number of new individuals who contract a

disease during a particular period of time.
Illustration: The Vingt village has a population of 5,000, in January 50

persons were diagnosed with HIV while another 25 were diagnosed
with HIV in February. The incidence of HIV in January was 50/5000 = 1%
Indicator This is a single measure that is reported on regularly and that provides
relevant and actionable information about population health and/or
health system performance and characteristics. An indicator can
provide comparable information, as well as track progress and
performance over time.

STANDARD
Maximum Maximum refers to the highest value in a list of values, while Minimum
Minimum is the lowest value.
Illustration
Maximum weight = 11 kilograms
Minimum weight = 18 kilograms
Median The middle number in a list when the entries are sorted in an ascending
or descending order.
Illustration
The weight of 5 children in OPD is 11, 15, 16, 18, 20 kilograms . In this
case the median weight is 16 kilograms
Mode The most recurrent number in a list.

Illustration: The weight of 5 children in OPD is 12, 15, 16, 12, 20 kilograms
The modal weight is 12 kilograms.
Percentage This is a fraction that is expressed out of 100

Illustration: The fraction 2/5 expressed as a percentage would be
(2/5) * 100 = 40%
Prevalence This is a measure of all individuals affected by the disease at a particular

time.
Illustration: The Vingt village has a population of 5,000, in January 50
persons were diagnosed with HIV while another 25 were diagnosed
with HIV in February. Therefore by end of February, a total of 75
persons (50 + 25) had been diagnosed with HIV. If all these persons
were still alive, then the prevalence of HIV in Vingt village would be
75/5,000 = 1.5 %
Proportion See description of fraction.
Range This is the difference between the lowest and highest values.
Illustration
Lowest weight = 11 kilograms
Highest weight = 18 kilograms
Range = 18 – 11 = 7 kilograms

STANDARD
Ratio A fraction in which the numerator is not part of the denominator.

Illustration: A classical example of this is the maternal mortality ratio
which is the number of maternal deaths per live births. Numerator is
the mothers who die while denominator is the number of live births.
Performance This is a measure of how a service delivery level (HF, district, region
etc.) is faring either against set targets (or expected coverage) or
against set standards.
Illustration: The estimated number of pregnant women in Vingt village

is 12,000, if only 2,000 women seek ANC services, Vingt performance
in terms of uptake of ANC services would be 2000/12,000 = 16.7%.
Trend A pattern of gradual change in a condition or the general tendency of

data over time. Trends are best represented using ling graph with time
on x-axis.
5.3 TYPICAL PROCEDURE FOR DATA ANALYSIS AND PRESENTATION
In addition to the routine analysis of HMIS data that is presented in the DHIS dashboards,
the following steps are recommended when preparing for quarterly data review meetings.
It expected the results of the HMIS data analysis would be shared during the data review
meeting possibly in terms of a PowerPoint presentation.
Purpose: This section of HMIS SOPs describes the typical procedure for carrying out
statistical analysis of HMIS data. The document is meant for use by MoH HMIS officers.
Create analysis database: Since DHIS data is continuously being updated by regional and
facility HMIS officers, it is necessary to note the date of analysis. Any data queries arising
should be referred to the HMIS officer for resolution, and the new date noted.
Conduct a DQA
- Check reporting rates to confirm all reports have been received.
- Run validation rules to confirm al data fields have been correctly entered
- If both are acceptable, decide on an analysis and presentation plan.
- If not drill down to flag out HFs with missing and outlier variables.
- Contact HF in-charges to recheck the correct values from source documents
- Proceed with analysis one the DHIS data is cleaned.

STANDARD
Which errors can the HMIS officer correct and which ones must be referred to
HF for confirmation? Questionable results and extreme outliers must not be
changed without written confirmation from the facility in-charges. The same
corrections should be effected on the respective monthly reporting forms at the
HF level, and marked on the forms at the data entry point for consistency and
proper paper trail, before effecting the changes in DHIS. Data should be rejected
if facility more than 80% of facility entries do not pass validation rules.
Data analysis plan (Table 10 gives a general guide. Modify indicators as needed)
- Review your data analysis plan to identify what data is available or not
- Identify data sources (some data analysis is already done by DHIS for others you
may have to download as pivot tables and manipulate data in Excel)
Data interpretation and presentation

- Tables are the simplest presentation; however, graphs are easier to visualise.
- Make an interpretation of the data based on the context. Extrapolate if need be.
- Look for any additional data to complete the interpretation
- Aim at providing sufficient details on Person, Time and Place using the 5Ws.

STANDARD
Table 10: HMIS data analysis plan
Program area Program Indicator How to

HMIS -- - HMIS scorecard This is generated from DQA exercise.
It gives you a measure of how accurate the data
Service uptake OPD - Monthly average last quarter Available in dataset reports and pivot tables
- OPD workload trends last 12 months
- Age/Sex distribution
- Leading causes of OPD visits and their % contribution to OPD cases
- Prevalence of leading causes of OPD visits
Inpatient - Monthly average admissions last quarter Available in dataset reports and pivot tables
- Admissions trends last 12 months
- Ward statistics
- Leading causes of admissions
- Leading cause of death in hospitals
Child health EPI - BCG coverage (and missed opportunities cf Birth Polio) Available in dataset reports
- Penta dropout rate
- Measles coverage
- Percent of Unimmunized children
- Vaccine wastage rate
AWD - Absolute number of AWD cases and monthly trends Available from dataset reports
- Proportion of OPD visits attributable to AWD % to be calculated
- % AWD treated with Zinc and ORS
ARI - Absolute number of ARI cases and monthly trends Available from dataset reports
- Proportion of OPD visits attributable to ARI % to be calculated
- % ARI treated with antibiotics
Nutrition - Number (and %)of children screened for nutrition status Available from dataset reports
- % of children per each of the 3 screening outcomes % per screening outcome to be calculated
- % malnourished children referred for nutritional management
- % provided with Vitamin A
- % dewormed

STANDARD

Maternal health ANC - ANC coverage Available from pivot tables
- % ANC women screened for syphilis (Quality measure) May need to calculate some proportions
- % ANC women provided with MMN (Quality measure)
- % anaemic treated with Iron/Folate
- ANC completion rate (ie ANC4+)
- ANC dropout rate
- % ANC women counselled on IYCF
- % ANC provided with IPTp1&2
- % issued with LLIN
Delivery - % Institutional deliveries Available from pivot tables
- % Deliveries that were complicated
- % births monitored with partograph
- % infants put on breastmilk within 1 hour
- % births notified
- % LBW births
PNC - PNC coverage Available from pivot tables
- % PNC visits made within 2 days
- % with 2+ PNC visits
FP - New and repeat clients by FP method – trends Available from pivot tables
- % FP visits counselled on modern BS
- % HFs with stock-out of any FP commodity during the period
EPI - TT coverage among pregnant women Available from pivot tables
- TT coverage among women of child bearing age
PHUs OPD - Monthly average last quarter Available from pivot tables
- OPD workload trends last 12 months
- Age/Sex distribution
- Leading causes of OPD visits and their % contribution to OPD cases
- Prevalence of leading causes of OPD visits
- % of clients with suspected Tuberculosis (TB)
Births/ - Total home deliveries reported Available from pivot tables
Deaths - Total deaths occurring at homes

STANDARD

Nutrition - Number (and %)of children screened for nutrition status Available from dataset reports
- % of children per each of the 3 screening outcomes % per screening outcome to be calculated
- % malnourished children referred for nutritional management
Disease specific HIV - Total clients counselled for HIV by site (VCT, OPD, ANC, Delivery) Available from dataset reports
- % of counselled that were tested for HIV Proportions to be calculated
- % tested that had a positive test result
- % HIV positive pregnant women put on Option B+
- % of HIV positive pregnant women issue with infant prophylaxis
Anaemia - % anaemic clients in OPD, ANC, Labour and PNC Available from pivot tables
- % anaemic treated with Iron and Folate
TB - % OPD clients with suspected TB (by Age) Available from pivot tables
- Number and % screened for TB
- % TB screening outcomes
- % TB patients tested for HIV
- % HIV co-infected TB patients
- %TB-HIV con-infected patients put on ART
Malaria - % of OPD visits attributable to malaria Available from pivot tables
- Trends of tests done and test results by test, age and sex Not all LLIN data is in DHIS
- Monthly Average and monthly trends of confirmed malaria (OPD)
- % Confirmed cases put on A+L
- % unconfirmed uncomplicated malaria put on treatment
- LLIN distributed (mass and routine)
Miscellaneous -- - Indicate progress towards targets Divide annual target by 12 to get monthly target
- Cumulative progress
- Monthly target = annual/12

STANDARD
6.0 SOP RESPONSIBILITIES
To ensure adherence to these standard operating procedures, the following are

recommended:
Health facility staff: - Appoint a focal person for HMIS data reporting
- Accurate data generation and timely submission of monthly
reports.
- Utilize data by active visualization and data use for decision
making
HMIS officers: - District HMIS officers to support and mentor health facility staff
- Regional HMIS officers to support and mentor district teams and
HF staff
- Zonal HMIS officers to support and mentor Regional and district
team
- Initiating and participating in the DQA processes.
Implementing - Support MoH staff in adherence through mentorship and

partners: training
- Demand data to guide decisions on programs and funding
issues.
- Provide feedback to health facilities, districts, regions and
zones.
Ministry of Health - Ensure standard registers data tools are available at HFs
- Insist usage of standard tools for all reporting purposes.
- Ensure staff are adequate and sufficiently trained.
- Sharing HMIS data with national and international stakeholders.
- Oversee periodic review and update of these SOPs.

STANDARD
7.0 FUTURE CONSIDERATIONS
7.1 HMIS REFORMS
STANDARDIZE
For harmonized reporting, HMIS data collection and
INTEGRATE
reporting tools have been reduced to a minimum, SIMPLIFY
similar registers have been merged depending on the COMPUTERIZE
DECREASE DATA COLLECTION BURDEN
level of services a facility is equipped to provide. E.g.
OPD registers for hospitals and HCs are now the same. In addition, the introduction of DHIS
as the national online reporting system w.e.f January 2017 has now shifted the focus to
data quality. However, some parallel reporting exists especially for donor funded vertical
programs e.g. HIV and Tuberculosis.
7.2 ELECTRONIC DATA CAPTURE
Electronic medical registers and records is one of the latest developments in HMIS where
traditional paper registers and data tools are either partly or completely replaced with
electronic versions. EMRs have the advantage of speed, accuracy and efficiency. As such,
EMRs is the future of HMIS.
1. An EMR readiness assessment should precede the introduction of EMRs.

2. Introduction of EMRs should entail keying in of historical data for continuity.
3. Electronic data capture systems should reflect the layout and design of hard copy
data capture documents to minimize data entry errors.
4. Electronic systems should include data validation, range checks and consistency
checks to ensure good data quality.
5. The systems should be secure to prevent unauthorised access to the data.
6. Levels of access and privileges should be integrated in the system to restrict access
and only allow access to relevant functions for the particular user.
7. As a minimum basic requirement, such systems should be able to generate routine
HMIS reports (and if possible, push the reports to DHIS every month).
8. For audit tracking, electronic systems should imprint a user identity, time and data
stamp for each record at the time of data entry.
9. All data capture and entry should be undertaken by suitably trained personnel.

STANDARD
8.0 REVISION HISTORY
DATE REVISION HISTORY

25/02/2016 Draft Routine HMIS data management SOP
06/06/2017 Added data analysis and data quality audits procedures
Removed annexes referring to HMIS tools, added reference to HMIS tools SOP
Made necessary adjustments factor in the introduction and use of DHIS
09/06/2017 Added data validation rules for DHIS and HF data entry use
9.0 REFERENCES
DQA Standard Operating Procedures for Somalia (Muhsin Sheriff, Jul 2014)
EPHS M&E Training Plan (Muhsin Sheriff)
HMIS Training manual for Somalia (Haron Njiru, 2016)
HUD Exchange. HMIS Data Quality Monitoring Toolkit (Aug 2010)
MEASURE Evaluation Technical Brief (Nov 2015)
MEASURE Evaluation, Data Quality Assurance Tools. http://tiny.cc/s8suly
Mentorship for ME systems for Somalia (Muhsin Sheriff, 2013)
MoH Kenya Data Quality Assurance - ICAP Kenya. SOPs (Muhsin Sheriff, June 2011)
MoH Rwanda. Health centres and Posts. Standard Operating Procedures for Management of
Routine Health Information (2016)
Monitoring and Evaluation within the Joint Health and Nutrition Programme. DRAFT Standard
Operating Procedures (January 2014)
Somali National HMIS indicators (Haron Njiru, 2015)
Supportive supervision guidelines for Somalia (Muhsin Sheriff, 2013)
The District Health Information System (DHIS) as support mechanism for strengthening the
health care system (Christa van den Bergh, Mar 2009)
UNICEF Agora course: Immunization Coverage
UNICEF Agora course: Research and Evidence at UNICEF
UNICEF. Methodological Brief No.10: Overview: Data Collection and Analysis Methods in
Impact Evaluation
WHO. Health Measurement and Accountability Post 2015: Five-Point Call to Action (Jun 2015)

STANDARD
10.0 ANNEXES
ANNEX 1: DISTRICT DATA LOG

Name of District: Month and year:
Name of Region: Number of health facilities that submitted reports:
Registered health facilities Number of HFs with incomplete reports:
Functional health facilities: Number of missing reports:
Reports expected during the month Reports received during the month Is report complete? (closely examine) Total
(Yes = 1, No = 0) (Yes = 1, No = 0) (Yes = 1, No = 0)
Surgery / Inpatient
Surgery/ inpatient
Surgery/inpatient
Name of health facility
Incomplete
Maternity
Maternity
Maternity
(Include all HFs in the District)
Missing
Total
Total
Total
HRH
HRH
HRH
OPD
OPD
OPD
ANC
ANC
ANC
PNC
PNC
PNC
Lab
Lab
Lab
EPI
EPI
EPI
Log completed by: Date:
Designation: Signature:

STANDARD
Annex 1b: District reporting performance report
Name of District: Number of operational health facilities in the district:

Name of Region: INSTRUCTIONS:
Registered health facilities: Please type T for timely report, L for late reports, and N if a facility does not submit any report
Name of health facility Month of the year Total % Timely

(This list includes all HFs in the District) Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
Number of reports expected

Number of Timely reports (T)
Number of Late reports (L)
Total reports received (T+L)
Timeliness rate
Reporting rate

STANDARD
ANNEX 2: REGIONAL DATA LOG
Name of Region: Month and year of the report:

Number of registers health facilities: Number of functional health facilities during reporting period:
Number of HF with missing reports: Number of health facilities that submitted reports:
Number of HF with incomplete reports: Number of districts with missing reports:
Number of HFs offering the service HF reports received this month Number of HFs with incomplete reports Total
Name of District
Surgery / IPD
Surgery/IPD
Incomplete
Maternity
Maternity
Maternity
(Include all districts in
Surgery
Missing
the Region)
Total
Total
Total
HRH
HRH
HRH
OPD
OPD
OPD
ANC
ANC
ANC
PNC
PNC
PNC
Lab
Lab
Lab
EPI
EPI
EPI

STANDARD
Annex 2b: Regional reporting performance report
Name of Region: INSTRUCTIONS:

Number of districts in the Region: Please type T for timely report, L for late reports, and N if a district does not submit any report
Name of District Month of the year Total % Timely

(This list includes all Districts in the Region) Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec

Timeliness rate
Reporting rate

STANDARD
ANNEX 3: NATIONAL DATA LOG
Number of registered health facilities: Month and year of the report:

Number of HF with missing reports: Number of functional health facilities during reporting period:
Number of HF with incomplete reports: Number of health facilities that submitted reports:
Number of districts with missing reports: Number of regions with missing reports:
Number of HFs offering the service HF reports received this month Number of HFs with incomplete reports Total
Name of Region
Incomplete
Maternity
Maternity
Maternity
Surgery
Surgery
Surgery
Missing
(Include all Regions)
Total
Total
Total
HRH
HRH
HRH
OPD
OPD
OPD
ANC
ANC
ANC
PNC
PNC
PNC
Lab
Lab
Lab
EPI
EPI
EPI

STANDARD
Annex 3b: National reporting performance report
Number of regions: INSTRUCTIONS: Please type T for timely report, L for late reports, and N if a Region does not submit any report
Name of Region Month of the year Total % Timely

(This list includes all Regions in the country) Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec

Timeliness rate
Reporting rate

STANDARD
ANNEX 4: DQA TEMPLATE
This is the word version of the DQA tool. Accompanying Excel file automatically calculates the scores
NAME OF HEALTH FACILITY
DATE OF DQA
NAMES OF STAFF CONDUCTING DQA
Please complete table below using values obtained from HF register, Monthly Form and the DHIS.
Indicate analysis (%) in the last 2 Columns if values in the 3 sources are Available and/ or Matching.
Program area Indicator Register Form DHIS Available Matching

OPD 1. Malaria cases confirmed by RDT/slide
2. Number put on A+L for malaria treatment
3. Number of new patients treated at the HF
4. Cases of watery diarrhoea among under 5s
Nutrition 5. Number of children screened
6. Number with normal results
7. Number moderately malnourished
8. Number severely malnourished
ANC 9. Number of clients with 4+ ANC visits
10. Number screened for syphilis
11. Number with positive syphilis test result
Deliveries 12. Number of deliveries in the health facility
13. Number monitored with partograph
14. Number of LBW babies
Immunization 15. Number of children <1 who received Penta 1
16. Number of children <1 who received Penta 3
17. Number of children <1 who received Measles
PNC 18. Total number with first PNC within 2 days
19. Number counselled on IYCF
Laboratory 20. Number of RDTs for malaria
21. Number of positive RDTs
22. Positive tests with plasmodium species indicated
Store 23. RDT opening balance
24. RDT kits received
25. RDT kits utilized
26. RDT kits in the store
PMTCT 27. of pregnant women counselled and tested for HIV
(ANC) 28. Number of ANC women with positive HIV test result
29. Pregnant women put on ART (Option B+)
30. Infant prophylaxis issued to mothers
HMIS 31. Timeliness
32. Reporting rate
33. Validation passes (DHIS internal validation rules)
34. DQA score from supportive supervision FORM
SUMMARY
Total indicators selected
Total indicators with available entries (# & %)
Total indicators with matching entries (# & %)
In absence of complete DQA, DHIS validation rules, and the reporting and timeliness rates will be
used to assess the quality of data. The score would be the average of the two values.
For HF DQA, please do a visual inspection of all the forms submitted to identify the proportion of
missing data elements, use the supportive supervision form and mentor accordingly. When using
DHIS and Paper forms, check the delays in data entry based on DHIS date and Date on the forms.
SOMALIA MoH HMIS SOPs Ver 1.0 Feb 2016 Page 38 of 44

STANDARD
ANNEX 5: HMIS SCORECARD
INSTRUCTIONS
This is the paper version of the HMIS scorecard. The Excel version automatically calculates the
scores per program area. Enter % values that were available and / or matching for every program
area, and the % of validation rules passed per program area.
The final score for unit would be the average of all entries in Column i. the final score is then coded
Red, Yellow or Green as shown in the table at the bottom of the page.
Note: This scorecard is used to assess the status of HMIS data. However, scorecards can also be
used to assess the quality of clinical services and overall performance of a program.
Program Register vs Forms Forms Vs DHIS Overall

Area Available Matching Available Matching Available Matching Validations % Overall
A B C D e f = (b+d)/2 g = (c+e)/2 h i = (f+g+h)/3
OPD
Nutrition
ANC
Deliveries
Immunization
PNC
Laboratory
Store
PMTCT (ANC)
Timeliness
Reporting
Validation
HF DQA score
Average
DQA/SCORE CARD COLOR-CODES
Score Colour Implication

50% and below Red Immediate and intensive data mentorship required
51 to 74% Yellow Routine mentorship/support supervision required
75% and above Green Routine Mentorship not required

STANDARD
ANNEX 6: HMIS DATA VISUALIZATION
Information products should be Provided at the point of service delivery. They should
communicate key messages from data including the place, person and time to allow for
effective decision making.
This will be discussed with the regional officers and finalised during the data
analysis and presentation trainings in July/August 2017.
Possible solutions:
- Development of wall chart A3 templates for HFs to track and report their
performance
- Arrangements to access/email HF dashboards from DHIS to the facility in-
charges.
- Frequency and format / templates for data review meeting
Other issues to be covered under visualization

- Graph construction: What goes to x and y axis
- Title placement for tables and graphs
- Types of graphs and when to use each type
- Getting graphs from DHIS to Powerpoint using snipIt and printscreen
- Practical use of Excel pivot tables

STANDARD
ANNEX 7: HMIS SUPPORTIVE SUPERVISION TOOL

Name of Health Facility: MFL CODE
Supervisor’s Name(s):
Name of facility In-charge:
Respondent Name: District:
Respondent’s signature: Date of previous supervision:
Date of supervision: Date of last DQA:
1. Reporting and storage of reports

a. How many monthly reports does the facility sent to MOH/Supporting agency each month?:……………(= y)
b. Count to confirm the number of reports filed in the facility for LAST 6 MONTHS before this supervisory visit:
Month Current 1 2 3 4 5 6 Total Average Average
# of reports seen Month Total / (y*6) * 100
# reports in DHIS (Total seen / Total in DHIS)*100
Timely (Y/N) (Timely / Seen ) * 100
2. Reporting period
(a) Does the facility in-charge know the deadline for reporting? Yes [ ] No [ ] (b) Which deadline: ………..
3. Accuracy: Check accuracy of data for the LAST 2 MONTHS and record in table below:
Month 6: Month 5: Average
# Indicator
Register Report Variance* Register Report Variance* Variance **
A OPD: # of malaria cases confirmed by RDT or Slide (choose ONE)
B OPD: Total # of patients treated at the facility
C Nutrition: # children screened–severely malnourished
D EPI: # of children Under 1 year received Penta 1
E EPI: # of children Under 1 year received Penta 3
F EPI: # of children Under 1 year received Measles
G ANC: # of clients made 2nd ANC visit
H ANC: # pregnant women screened for syphilis
I Deliveries: # of normal deliveries at health facility
J PNC: Clients with PNC within first 2 days
Total == == == == == ==
Score = (Total / 10) * 100 == == == == == ==
* Variance = Register – Report; ** Average variance = (Month 5 + Month 6) / 2
4. Display of Data
Please list indicators that are displayed in the wall of the health facility
a. d.
b. e.
c. f.
5. Choose 5 registers at random and check how many have updated page summaries: …….. OUT OF 5 = ……%
6. How many of the registers have columns completed as per HMIS Tools guidelines? …….. OUT OF 5 = ……%
7. Does the facility have all required Registers & Forms depending on its range of services? Yes [ ] No [ ]
8. If computers are used: (a)Are antiviruses updated? Yes [ ] No [ ] (b) Are there regular backups? Yes [ ] No [ ]
9. Are the following SERVICES / EQUIPMENT / SUPPLIES available?
(Discuss with PHC coordinator if there is need to combine other issues during supervision)
Service / Equipment/ Supplies Available? (Yes / No) Functioning? (Yes / No) Comment
a.
b.
c.
10. Any other comments on Supervision Activities from Supervisor or facility staff and your final remarks:
DQA Score = (Q1b/3+Q3+Q5+Q6)/4 ……………………………………

STANDARD
ANNEX 8: MENTORSHIP GUIDELINES AND SOP

BACKGROUND
The Somali health sector is committed to high quality health situation requires a mentorship program to improve capacity of the
services provision. However this is not possible without good health system to be able to respond to the health needs of the
quality monitoring systems. This includes adequate documentation population appropriately and adequately. This section provides
tools, trained human resource and resources for oversight of the tips on the mentorship system while focusing on health systems
health systems. There is an existing supportive supervision monitoring and evaluation.
concept which is lacking in implementation and effectiveness. This
‘High-quality monitoring and evaluation is not only a donor requirement; it is how the impact of interventions is measured and
attainment of goals assessed’
Mentorship (and supportive supervision) is a joint effort capacity of health facilities to achieve their aims. Mentorship is a
(partnership) between the mentor and health worker to improve relationship between a mentor and mentee to bring about
motivation, knowledge, skills and performance of the latter in his exchange of learning and cause development. Systems and skills
work situation. Mentorship and supportive supervision have are required in data collection, collation, aggregation,
several commonalities. However it is differentiated significantly in summarising, validation, cleaning, submission, data analysis,
the sense that it is less hierarchical, more hands on and improves interpretation, display and dissemination.
skills of health workers while producing significant improvement in
‘Enabling the public health workforce to collect and use data to guide programs and policies’
GOALS AND OBJECTIVES OF MENTORSHIP
Goal: The goal of the data systems mentorship is to provide health workers with
Importance of mentoring staff
the necessary knowledge and skills to undertake appropriate tasks required for
• Contributes to the development of the
effective running of health facilities and systems.
organization's talent
• Helps new staff members acclimate to a
Objectives: To improve knowledge and skills of health workers on:
new role and the organizational culture more
quickly
1. Assessing data systems at health facilities.
The need for data and information. • Promotes diversity
2.
3. Data Quality Audits (DQA). • Provides broader perspective on the
4. Data collection and recording using the MoH registers and tools. challenges facing the organization,
5. Data cleaning. divisional, regional and country offices
6. Data reporting (using MoH monthly reporting tool). • Creates a greater sense of involvement
7. Data flow. • Offers insight into the culture of the
8. Simple data analysis to provide information for decision making pertinent to organization
the health facility. • Supports an innovative work environment
9. Data presentation.
10. Skills on data use and decision making, as well as Effective mentors
11. To improve knowledge and skills of IPs on UNICEF reporting tools. • Serve to role model effective organizational
behaviours and attitudes
THE MENTOR AND MENTEE • Give actionable advice and feedback
• Resist the temptation to solve the problems
Who can be a mentor? of those they mentor
• Challenge the people they mentor to
Anyone who has undergone the necessary mentorship training, has knowledge, develop a plan for success
skills and experience in the field under focus, and possesses the characteristics • Create a foundation of support
of a mentor. See box to the right. • Suspend judgment
Characteristics of a mentee https://agora.unicef.org/mod/book/view.php?id=4852
1. Understands the needs of the health facility

2. Able to accept constructive criticism
3. Transparent and sincere
4. Practices what mentor guides him/her
5. Asks relevant questions to improve his/her knowledge, skills and performance
6. Keeps his/her work supervisor informed on progress
7. Documents progress made during the mentorship program.

STANDARD
MENTORSHIP PROCESS
Preparing for a mentorship visit

1. Regular schedule to be agreed between mentor and mentee with approval of facility in charge.
2. Review past visit documentation and mentorship plan.
3. Prepare for the topic to be dealt with during the planned visit e.g. Hand-outs, exercises, tools required.
How to mentor
1. Communicate
2. Listen patiently
3. Work plan
4. Acknowledge achievements
5. Identify areas of strengths and weaknesses
6. Identify challenges and opportunities in the work environment
7. Identify and utilise appropriate resources
8. Document all mentorship processes, agreements, progress and plan
How to mentor health workers on data monitoring
Data system mentorship encourages continuous capacity building of health workers to provide high quality data records, reports,
dissemination and use. Mentorship is required to strengthen the systems and skills necessary for HMIS. Focus should therefore be on the
following systems and skill areas:
1. Collection 6. Cleaning
2. Collation 7. Reporting
3. Aggregation 8. Data analysis
4. Summarizing 9. Interpretation
5. Validation 10. Data display, presentation and dissemination
DATA SYSTEMS MENTORSHIP
The following procedures are proposed for data systems’ mentorship:
1. Assess needs for individual health facilities based on DQA and health facility assessment reports.
2. Identify staff and specific topic requiring capacity building.
3. Preparation:
a. Identify a mentor for the topic from the in-country team.
b. Agree on date and topic of mentorship visit with facility in-charge ensuring that the relevant staff will be available on that date.
c. Ensure you will have at least 2-3 hours of dedicated time with the relevant staff.
d. Review past mentorship activity reports, results and needs.
e. Ensure familiarity with the topic.
f. Prepare short exercise to improve skills. Ensure data from the identified health facility is used for the exercise.
g. Ensure all necessary resources are available (stationery, funds, transport, communication equipment and airtime).
h. Ensure all team members are dedicated and available for the visit.
4. Mentorship visit:
a. On the day of visit, plan to reach the facility well in advance to allow at least 2-3 hours of dedicated time with the relevant staff.
b. On arriving at the health facility:
c. Introduce yourself, by name, designation and agency, to the health facility in charge and all staff.
d. Inform them about the purpose of the visit and that you had prior appointment.
e. Obtain all staff name and designation especially the HMIS data point person. This may be the nurse at the facility.
f. Agree on point person (HMIS officer/nurse) with who will be the mentee.
g. Review tools. Ensure all needed registers are available.
h. Perform a quick DQA and assess data tools, data flow, monthly data reports, data display and use.
i. Identify and agree on strengths and weaknesses.
j. Develop work plan for mentorship and improvement plan with timelines.
k. Provide mentorship for knowledge and skills building.
l. Debrief with all staff.
m. Agree on next visit date and areas for mentorship.
5. Post-mentorship visit
a. Prepare mentorship visit report; attach the mentorship plan agreed with the facility staff and share with supervisor.
b. Discuss with IP team and report at quarterly UNICEF/MoH review meetings.
c. Follow-up on mentorship plan and prepare for next visit.

STANDARD
ANNEX 9: DQA LOG
INSTRUCTIONS
This log should be maintained for every HF, District and Region, and an overall one for national
level DQAs. It should be updated every time a DQA is conducted so as to be able to track the
quality trends at that particular HF, district, region etc. The log should be filed together with the
DQA template used and the DQA report.
Name of HF, district etc.

Level of DQA (mark one): HF [ ] District [ ] Region [ ] National [ ]
Names of DQA team
members
Key action points

DQA Feedback DQA Timeliness Reporting Next
Date date Score (%) rate Date DQA date
Description of key action points
resolved

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ROUTINE HMIS DATA

VERSION ISSUED ON EFFECTIVE FROM

SOMALIA MoH HMIS SOPs Ver 2.0 Jun 2017 Page 1 of 44

LIST OF TABLES AND FIGURES

Table 1: Registers used for HMIS data collection ................................................................................. 9

Figure 1: An illustration of Page Summary section from PNC register .............................................. 10

SOMALIA MoH HMIS SOPs Ver 2.0 Jun 2017 Page 2 of 44

ANC Antenatal clinic MFL Master Facility List

SOMALIA MoH HMIS SOPs Ver 2.0 Jun 2017 Page 3 of 44

1.1 SITUATION ANALYSIS

1.2 ABOUT THE DOCUMENT

1.3 PROPOSED DISSEMINATION PLAN

SOMALIA MoH HMIS SOPs Ver 2.0 Jun 2017 Page 5 of 44

2.0 DATA MANAGEMENT SYSTEM

2.2 DATA PROTECTION

All person-identifiable data must be treated with utmost confidentiality.

ALL MEDICAL DATA SHOULD BE SECURELY STORED TO

a Some International Online Ethics Training Links and Certificates

SOMALIA MoH HMIS SOPs Ver 2.0 Jun 2017 Page 6 of 44

2.3 DATA SECURITY

Security of non-electronic data

Security of electronic data

a. A daily back up of data is recommended. This should be done on the

SOMALIA MoH HMIS SOPs Ver 2.0 Jun 2017 Page 7 of 44

6. Assignment of access rights to DHIS should be handled by the national HMIS

ACCESS TO ELECTRONIC MEDICAL DATA SHOULD BE LIMITED

SOMALIA MoH HMIS SOPs Ver 2.0 Jun 2017 Page 8 of 44

3.0 DATA COLLECTION AND REPORTING

3.1 DATA COLLECTION TOOLS

Table 1: Registers used for HMIS data collection

SOMALIA MoH HMIS SOPs Ver 2.0 Jun 2017 Page 9 of 44

Table 2: HMIS registers’ numbering system

Register numbers Level of service delivery

3.2 DATA COLLECTION PROCEDURE

3. The registers should be updated regularly with each patient visit.

4. Each month should start on a new page of the register.

Figure 1: An illustration of Page Summary section from PNC register

SOMALIA MoH HMIS SOPs Ver 2.0 Jun 2017 Page 10 of 44

3.3 DATA REPORTING PROCEDURE

Table 3: Typical flow of patient data

At the Health Facility level:

Table 4: Monthly Forms used for HMIS data reporting

SOMALIA MoH HMIS SOPs Ver 2.0 Jun 2017 Page 11 of 44

At the District level:

2. The HMIS officer should check DHIS to ensure that:

At the Regional level:

2. The HMIS officer should check DHIS to ensure that:

SOMALIA MoH HMIS SOPs Ver 2.0 Jun 2017 Page 12 of 44

At the National level:

2. The HMIS officer should check DHIS to ensure that:

4. All data queries should be resolved before commencing data analysis.

3.4 LATE REPORTS

DATA SUMMARY REPORTS

SOMALIA MoH HMIS SOPs Ver 2.0 Jun 2017 Page 13 of 44

4.0 DATA QUALITY AUDITS

Table 5: Dimensions of data quality

a Data Accuracy: http://etutorials.org

SOMALIA MoH HMIS SOPs Ver 2.0 Jun 2017 Page 11 of 44

4.2 DQA OBJECTIVES

1. To check data variables for timeliness and completeness.

2. To evaluate data consistency, through comparison of data in the monthly HMIS

4. To assess validity of reported data by confirming method of measurement from