Effects of a health information system data quality intervention on concordance in Mozambique: time-series analyses from 2009–2012

Publication Date:

26 Mar 2016


Wagenaar BH, Gimbel S, Hoek R, Pfeiffer J, Michel C, Manuel JL, et al. (2015). Effects of a health information system data quality intervention on concordance in Mozambique: time-series analyses from 2009–2012. Popul Health Metr. 13(9). doi: 10.1186/s12963-015-0043-3



We assessed the effects of a three-year national-level, ministry-led health information system (HIS) data quality intervention and identified associated health facility factors.

Monthly summary HIS data concordance between a gold standard data quality audit and routine HIS data was assessed in 26 health facilities in Sofala Province, Mozambique across four indicators (outpatient consults, institutional births, first antenatal care visits, and third dose of diphtheria, pertussis, and tetanus vaccination) and five levels of health system data aggregation (daily facility paper registers, monthly paper facility reports, monthly paper district reports, monthly electronic district reports, and monthly electronic provincial reports) through retrospective yearly audits conducted July-August 2010–2013. We used mixed-effects linear models to quantify changes in data quality over time and associated health system determinants.

Median concordance increased from 56.3% during the baseline period (2009–2010) to 87.5% during 2012–2013. Concordance improved by 1.0% (confidence interval [CI]: 0.60, 1.5) per month during the intervention period of 2010–2011 and 1.6% (CI: 0.89, 2.2) per month from 2011–2012. No significant improvements were observed from 2009–2010 (during baseline period) or 2012–2013. Facilities with more technical staff (aβ: 0.71; CI: 0.14, 1.3), more first antenatal care visits (aβ: 3.3; CI: 0.43, 6.2), and fewer clinic beds (aβ: -0.94; CI: −1.7, −0.20) showed more improvements. Compared to facilities with no stock-outs, facilities with five essential drugs stocked out had 51.7% (CI: −64.8 -38.6) lower data concordance.

A data quality intervention was associated with significant improvements in health information system data concordance across public-sector health facilities in rural and urban Mozambique. Concordance was higher at those facilities with more human resources for health and was associated with fewer clinic-level stock-outs of essential medicines. Increased investments should be made in data audit and feedback activities alongside targeted efforts to improve HIS data in low- and middle-income countries.


Read the Full Article


Stand with HAI

Stand with HAI


When you support Health Alliance International, you take a stand for a more equitable and respectful model of global health. Your donation not only helps us expand our reach, it is an investment in our shared values of health equity and solidarity. 

Join the Alliance

Our alliance is made up of supporters, partners, staff, and volunteers who share our commitment to universal access to quality health care. Just like a health system, every person plays a role in keeping us working toward this ultimate goal. Will you join us? 

Get Engaged

The kind of change we seek requires sustained action.  Whether you want to engage in HAI's advocacy work or help spread HAI's mission and model, we rely on our friends and supporters to stand beside us when we stand up for equity in global health.

Didn't find what you were looking for?

Didn't find what you were looking for?