Integrating social and behavior change communication indicators into a national health information management system: The Ghana experience

Summary:

A lack of a robust M&E system and SBCC indicators for measuring Ghana Health Service Health Promotion Division (GHS/HPD) interventions was identified by the division as a major challenge for several years. This negatively impacted SBCC data capture, analysis, reporting and the profile of GHS/HPD nationwide. In 2015, Health Promotion Department of the Ghana Health Service as part of its core mandate of strengthening the capacity of HPD staff to coordinate and deliver evidence-based SBCC interventions led the path to develop a robust M&E system and SBCC indicators for HP In total 33 SBCC indicators were developed, 22 of which are captured routinely by health staff at various levels and entered into the DHIMS2 platform. Eight primary data collection tools (all paper-based) and three reporting forms were also developed. Both C4H USAID and UNICEF supported the training of all regional and district Officers across the entire country on the use of the tools. Data collection registers are printed and distributed throughout the country and data is entered monthly and quarterly through HP datasets in the DHIMS2 (GHANA Health Service Database) platform. Since August 2017, SBCC indicators have been captured into DHIMS2 with close to 100% reporting rates across the entire nation with quarterly monitoring and data verification visits, and yearly review meetings Data collection and reporting routinely into DHIMS 2 is still ongoing, quarterly monitoring and supervisory visits are also conducted with checklist developed, half-year rapid assessments are done to assess impact of our interventions and yearly review of data collection tools to incorporate recommendations from supportive supervisory and monitoring visits and assessments/surveys conducted.

Background/Objectives:

Very few Ministries of Health and departments have comprehensively developed and incorporated Social and behavior change communication (SBCC) indicators into their health management information systems. A lack of a robust M&E system and SBCC indicators for measuring Ghana Health Service Health Promotion Division (GHS/HPD) interventions was identified by the division as a major challenge for several years. This negatively impacted SBCC data capture, analysis, reporting and the profile of GHS/HPD nationwide. In 2015, Health Promotion Department of the Ghana Health Service as part of its core mandate of strengthening the capacity of HPD staff to coordinate and deliver evidence-based SBCC.

Description of Intervention and/or Methods/Design:

A consortium of partners comprising HPD/GHS ,C4H, UNICEF, Policy Planning, Monitoring, and Evaluation Division/GHS, Family Health Division / GHS and USAID implementing partners (Evaluate for Health and Systems for Health) formed a 15-member technical working group which developed a road map for a robust M&E system for HP. Capping a period of seven months the group held several meetings and brainstorming sessions which resulted in the development of a results framework and indicator table; collation, review and revision of existing data collection and reporting forms; development of new tools and reporting forms as needed and companying data dictionaries; stakeholder engagements which reviewed and provided needed inputs; and pretesting and finalized tool/forms. These led eventually to a Boot Camp (an out of town working session with key stakeholders) in late 2015 where SBCC indicators were eventually incorporated into DHIMS2 Platform co-funding by USAID and UNICEF.

Results/Lessons Learned:

In total 33 SBCC indicators were developed, 22 of which are captured routinely by health staff at various levels and entered into the DHIMS2 platform. Eight primary data collection tools (all paper-based) and three reporting forms were also developed. Both C4H and UNICEF supported the training of all regional and district Officers across the entire country on the use of the tools. Data collection registers are printed and distributed throughout the country and many copies are required to sustain continued data collection. Printing paper-based registers comes with a huge burden that governments and partners might not be able to sustain. Hence a sustainability plan is to use the E -tracker, an electronic based data collection system.

Discussion/Implications for the Field:

Since August 2017, SBCC indicators have been captured into DHIMS2 with close to 100% reporting rates across the entire nation. Collaboration among partners has been key to the development and implementation of a robust M&E system for HP as partners brought on board diverse technical expertise and resources. GHS/HPD capacity was built through a learning by doing model with its involvement right from design to implementation of the M&E system A sustainability plan ensuring continued reporting of SBCC indicators into DHIMS2 and use of data for decision making has been drawn Some key components of the Health Promotion, M&E.

Abstract submitted by: 

Yvonne Cynthia Ampeh

Dominic  Atweam

Anthony Ofosu