Content Analysis of Inter-Sectoral District Level Health Data in India and Ethiopia

Session: District Decision-Making for Health in Low- and Middle-Income Countries: Assessing the Feasibility of a Data-Informed Platform for Health through Multi-Country Studies

Presenter: Della Berhanu, IDEAS Project, London School of Hygiene & Tropical Medicine

Background: Health data, if collected, shared and used in a coordinated way across the public and private health sectors, can lead to more rational planning and resource allocation. In low resource settings with pluralistic health systems, use of local data is often sub-optimal. As a first step to understanding the untapped potential of health data we analysed the content of information collected by the public and private sector, its flow and sharing, and inter-sectoral data links in India and Ethiopia.

Methods: Between June and September 2012 we visited two districts each in Ethiopia and India and gathered data collection forms from eight purposively selected public health facilities, and four private for-profit and not-for-profit organisations. Semi-structured interviews were conducted with key individuals to understand data flow, sharing and links between sectors. A database of all data elements was created and analysed using the World Health Organization (WHO)’s health system blocks (service delivery, contextual, supplies, workforce, governance, finance).

Results: In India, over 11,810 data elements are collected through 210 forms, whereas in Ethiopia only 13 forms with 4,287 data elements are maintained by public and private sectors. The private sector in India has fewer data elements than Ethiopia (513 versus 2,732). In both countries data collected are representative of WHO’s health system categories, but more than half the data elements in India, and three-quarters in Ethiopia, relate to service delivery, mainly child immunisation and family planning. Data flow within the public health system is sequential and systematic in both countries. Compared with India, Ethiopia has a more developed formal structure for data sharing across and beyond public and private health sectors.

Conclusion: In both Ethiopia and India there is a good foundation for optimising untapped health data use from public and private health sectors and non-health sectors to guide district level decision-making.