title: Assessing and improving data quality from community health workers: a successful intervention in Neno, Malawi.
abstract: METHODS
  A community health worker (CHW) program was established in Neno District, Malawi, in 2007 by Partners In Health in support of Ministry of Health activities. Routinely generated CHW data provide critical information for program monitoring and evaluation. Informal assessments of the CHW reports indicated poor quality, limiting the usefulness of the data.
  
  
  OBJECTIVE
  1) To establish the quality of aggregated measures contained in CHW reports; 2) to develop interventions to address poor data quality; and 3) to evaluate changes in data quality following the intervention.
  
  
  METHODS
  We developed a lot quality assurance sampling-based data quality assessment tool to identify sites with high or low reporting quality. Following the first assessment, we identified challenges and best practices and followed the interventions with two subsequent assessments.
  
  
  RESULTS
  At baseline, four of five areas were classified as low data quality. After 8 months, all five areas had achieved high data quality, and the reports generated from our electronic database became consistent and plausible.
  
  
  CONCLUSIONS
  Program changes included improving the usability of the reporting forms, shifting aggregation responsibility to designated assistants and providing aggregation support tools. Local quality assessments and targeted interventions resulted in immediate improvements in data quality.
authors.affiliation: Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA.
authors.forename: A J
authors.initials: AJ
authors.lastname: Admon
authors.affiliation: Partners In Health, Boston, Massachusetts, USA ; Abwenzi Pa Za Umoyo, Neno, Malawi.
authors.forename: J
authors.initials: J
authors.lastname: Bazile
authors.affiliation: Abwenzi Pa Za Umoyo, Neno, Malawi.
authors.forename: H
authors.initials: H
authors.lastname: Makungwa
authors.affiliation: Abwenzi Pa Za Umoyo, Neno, Malawi.
authors.forename: M A
authors.initials: MA
authors.lastname: Chingoli
authors.affiliation: Partners In Health, Boston, Massachusetts, USA ; Department of Global Health and Social Medicine, Harvard Medical School, Cambridge, Massachusetts, USA.
authors.forename: L R
authors.initials: LR
authors.lastname: Hirschhorn
authors.affiliation: Partners In Health, Boston, Massachusetts, USA.
authors.forename: M
authors.initials: M
authors.lastname: Peckarsky
authors.affiliation: Partners In Health, Boston, Massachusetts, USA ; Abwenzi Pa Za Umoyo, Neno, Malawi.
authors.forename: J
authors.initials: J
authors.lastname: Rigodon
authors.affiliation: Partners In Health, Boston, Massachusetts, USA ; Abwenzi Pa Za Umoyo, Neno, Malawi.
authors.forename: M
authors.initials: M
authors.lastname: Herce
authors.affiliation: Ministry of Health, Neno District, Malawi.
authors.forename: F
authors.initials: F
authors.lastname: Chingoli
authors.affiliation: Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA ; Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan, USA.
authors.forename: P N
authors.initials: PN
authors.lastname: Malani
authors.affiliation: Department of Global Health and Social Medicine, Harvard Medical School, Cambridge, Massachusetts, USA.
authors.forename: B L
authors.initials: BL
authors.lastname: Hedt-Gauthier
keywords: lot quality assurance sampling; quality improvement; supervision