Data Use and Quality Improvement in Tanzania: Guidance for Councils Using a Situation Room Approach, Version 1

In April 2021, USAID/Tanzania engaged Data.FI to scale up use of quality data to improve health programming and accountability in selected districts. Data.FI coordinated with representatives from the President's Office Regional Administration and Local Governance (PORALG) and the United Nations International Children's Emergency Fund (UNICEF) to develop a technical advisory group (TAG), composed of experts from PORALG, the Ministry of Health, Community Development, Gender, Elderly and Children (MOHCDGEC), USAID, and UNICEF. The TAG formally launched in May 2021, along with seven sub-technical groups which will support a TAG Joint Implementation Plan. The Joint Implementation Plan captures a range of activities which will support this data use for QI initiative, with implementation shared among PORALG, Data.FI, and UNICEF in support of PORALG's vision. Data.FI Tanzania is leading several areas of the Joint Implementation Plan, including selection of key priority focus areas and indicators to measure improvements in data use for quality improvement (QI) at the council and national levels. Dashboards in "situation rooms" - meeting spaces with computers showing merged data from existing national Government of Tanzania (GOT) health information systems (HIS) and performance data from health facilities - will display indicators and QI Action Plans. PORALG's Integrated Monitoring and Evaluation System (iMES) will display indicators and data analytics, which stakeholders will use to implement the data use for QI/QA initiative. This document provides guidance for Tanzania Council Health Management Teams (CHMTs) to analyze and interpret data for select health indicators relevant to their unique priorities, as well as the process to guide structured actions that drive quality improvements. National or regional strategic priorities may guide the identification of areas of focus and their family of indicators. This work will take place in "situation rooms," which serve as data repository and analysis hubs to generate analysis and recommendations in support of QI/QA initiatives at the facility and district levels. CHMTs will lead meaningful discussions in the situation rooms about data and oversee detailed activity planning to ensure that strategic priorities and related indicators are addressed methodically. While this guidance targets the CHMT, it can also be used by Regional Health Management Teams (RHMTs) to better structure their support or by Health Facility Management Teams (HFMTs) to better understand the process behind recommended areas for QI activities. The Government of Tanzania believes that the institutionalization of data use and evidence-based decision making throughout the health sector will lead to sustained improvements in care and increased demand for quality information and outcomes at all levels of the health system. This guidance document builds on previous work in Tanzania, as well as global learning, to develop activities which support the strategic priorities of the Ministry of Health and Social Welfare and PORALG. The Health Sector Strategic Plan 2015-2020 and the Monitoring and Evaluation Strengthening Initiative Strategy describe the importance of using data at the national and local levels to inform decision making and improve health outcomes. The use of data has been identified as a key factor in improving the quality of health services and increasing access to healthcare for marginalized populations. The Government of Tanzania has made significant progress in strengthening its health information system, including the development of a national health information system and the implementation of electronic health records. However, there is still a need to improve the use of data at the local level to inform decision making and improve health outcomes. This guidance document provides a framework for CHMTs to use data to inform decision making and improve health outcomes at the local level. The document outlines the steps that CHMTs can take to analyze and interpret data, identify areas for improvement, and develop QI initiatives to address these areas. The use of situation rooms is a key component of this guidance document. Situation rooms are meeting spaces with computers showing merged data from existing national health information systems and performance data from health facilities. These rooms will display indicators and QI Action Plans, which stakeholders will use to implement the data use for QI/QA initiative. The use of data has been identified as a key factor in improving the quality of health services and increasing access to healthcare for marginalized populations. The Government of Tanzania has made significant progress in strengthening its health information system, including the development of a national health information system and