Les Données de Santé Communautaire: Expérience de MAHEFA pour assurer la qualité des données de santé au niveau communautaire

The program was implemented by JSI Research & Training Institute, Inc. (JSI) in partnership with Transaid and The Manoff Group, in close collaboration with the Ministry of Public Health, the Ministry of Water, Sanitation and Hygiene, and the Ministry of Youth and Sports. The program was implemented in six regions in the north and northwest of Madagascar, including Menabe, SAVA, DIANA, Sofia, Melaky, and Boeny. During the program's lifespan, 6,052 community agents (AC) were trained, equipped, and supervised to provide basic health services in areas such as maternal, neonatal, and child health; family planning and reproductive health, including the prevention of sexually transmitted infections; water, sanitation, and hygiene; nutrition; and malaria prevention and treatment. The AC were selected by their community members, trained, and supervised by the managers of the basic health centers. They provided services according to the mandate assigned to them in the National Community Health Policy (PNSC). The program's approach focused on integrated community health activities, introducing several innovations, and making the community agents responsible for managing different types of health activities and associated interventions. This required a significant volume of data to be collected and verified at the community level. MAHEFA supported 6,052 AC in 24 districts through local partner organizations, which served as an interface between the AC and the program's regional offices. The program's field teams worked at the commune level, providing direct support to the AC, while the AC were supervised by the Chiefs of Basic Health Centers (CSB) in the sector of public health. To address the challenge of ensuring the quality of data collected by the AC, who had a low level of education and limited experience in data reporting, MAHEFA implemented specific activities to involve and support the AC, as well as other actors such as technical accompaniment technicians (TA) and CSB Chiefs. The efforts aimed at ensuring good data quality were carried out in a spirit of collaboration and formative support rather than control and inspection. The activities related to data quality assurance (DQA) aligned with the nine functional components of a monitoring and evaluation (M&E) system, as listed in the annex. MAHEFA considered all the components in the design and implementation of its M&E system, with this technical note detailing the components of its M&E system that required particular attention to meet the needs of the AC. To adapt and/or develop data collection and reporting tools for the AC, MAHEFA evaluated, reviewed, and adapted existing tools, taking into account the achievements and tools of previous health programs implemented by the Ministry of Health. The program also designed and developed new tools and reporting templates, simplified and adapted to the level of instruction of the users, including feedback from the AC. The first edition of the new tools was tested in the field for about eight months in 2012, collecting feedback from users, particularly on the format and mode of filling out the tools. Some examples of changes made are presented in the annex. To ensure the reliability of data, verification, and archiving, the reporting forms were established in the form of autocopies in tri folio to facilitate the reliability of data, verification, and archiving. MAHEFA also developed a manual of M&E for AC and TA, which described the data reporting circuit, including deadlines. The program's efforts to ensure good data quality were carried out in a spirit of collaboration and formative support rather than control and inspection. The community agents (AC) played a crucial role in the implementation of the program, as they were responsible for collecting and reporting data on various health indicators. To ensure the quality of the data collected by the AC, MAHEFA implemented a system of data quality assurance (DQA), which aligned with the nine functional components of a monitoring and evaluation (M&E) system. The program adapted and developed data collection and reporting tools, simplified and adapted to the level of instruction of the users, including feedback from the AC. The DQA system included the following components: 1. Capacities, roles, and responsibilities in M&E 2. Training 3. Directives for data reporting 4. Definitions of indicators 5. Data collection and reporting tools 6. Data management processes 7. Mechanisms and controls for data quality 8. Links with the national reporting system 9. Use of data The program's approach to DQA was based on a collaborative and formative support approach, rather than control and inspection. The efforts aimed at ensuring good data quality were carried out in a spirit of collaboration and formative support, rather than control and inspection. The implementation of the DQA system by MAHEFA had several benefits, including: * Improved data quality and reliability * Increased efficiency in data collection and reporting * Enhanced collaboration and communication among stakeholders * Better decision