title: Data for Program Management: An Accuracy Assessment of Data Collected in Household Registers by Community Health Workers in Southern Kayonza, Rwanda.
abstract: Community health workers (CHWs) collect data for routine services, surveys and research in their communities. However, quality of these data is largely unknown. Utilizing poor quality data can result in inefficient resource use, misinformation about system gaps, and poor program management and effectiveness. This study aims to measure CHW data accuracy, defined as agreement between household registers compared to household member interview and client records in one district in Eastern province, Rwanda. We used cluster-lot quality assurance sampling to randomly sample six CHWs per cell and six households per CHW. We classified cells as having 'poor' or 'good' accuracy for household registers for five indicators, calculating point estimates of percent of households with accurate data by health center. We evaluated 204 CHW registers and 1,224 households for accuracy across 34 cells in southern Kayonza. Point estimates across health centers ranged from 79 to 100% for individual indicators and 61 to 72% for the composite indicator. Recording error appeared random for all but the widely under-reported number of women on modern family planning method. Overall, accuracy was largely 'good' across cells, with varying results by indicator. Program managers should identify optimum thresholds for 'good' data quality and interventions to reach them according to data use. Decreasing variability and improving quality will facilitate potential of these routinely-collected data to be more meaningful for community health program management. We encourage further studies assessing CHW data quality and the impact training, supervision and other strategies have on improving it.
authors.affiliation: Inshuti Mu Buzima (IMB)/Partners In Health (PIH), P.O. Box 3432, Kigali, Rwanda, tmitsunaga@gmail.com.
authors.forename: Tisha
authors.initials: T
authors.lastname: Mitsunaga
authors.forename: Bethany L
authors.initials: BL
authors.lastname: Hedt-Gauthier
authors.forename: Elias
authors.initials: E
authors.lastname: Ngizwenayo
authors.forename: Didi Bertrand
authors.initials: DB
authors.lastname: Farmer
authors.forename: Erick
authors.initials: E
authors.lastname: Gaju
authors.forename: Peter
authors.initials: P
authors.lastname: Drobac
authors.forename: Paulin
authors.initials: P
authors.lastname: Basinga
authors.forename: Lisa
authors.initials: L
authors.lastname: Hirschhorn
authors.forename: Michael L
authors.initials: ML
authors.lastname: Rich
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Winch
authors.forename: Fidele
authors.initials: F
authors.lastname: Ngabo
authors.forename: Cathy
authors.initials: C
authors.lastname: Mugeni
mesh_terms: D000293:Adolescent; D000328:Adult; D002675:Child, Preschool; D003151:Community Health Centers / Q000706:statistics & numerical data; D003150:Community Health Workers / Q000458:organization & administration* / Q000592:standards; D003625:Data Collection / Q000592:standards*; D005190:Family; D005193:Family Planning Services / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D055810:Lot Quality Assurance Sampling; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment / Q000592:standards*; D062486:Public Health Surveillance / Q000379:methods*; D012432:Rwanda; D055815:Young Adult