MCH Dashboard and Indicators

MCWH Quarterly Meeting31st January 2012

(The dashboard discussed but is still being finalised)

MCH DHIS DashboardProgramme Indicator

EPIFully immunized at one yearDrop-out rate (DaPT-Hib-IPV3 to Measles1)

Nutrition% of infants exclusively breastfeed at time of Hep B3 immunisation (14 weeks)Vitamin A coverage 1 - 5 yearsSevere Malnutrition Case Fatality Rate

DiarrhoeaIncidence of diarrhoea with dehydrationInpatient case fatality rate

PneumoniaIncidence of pneumoniaInpatient case fatality rate

HIV PCR coverage and positivity rateNo. of infants initiated on ART (not currently available)

School Health% of quintile 1 and 2 schools visited by a school health team to provide ISHP% of Grade R/1 learners in Q1 and Q2 schools assessed using the ISHP learner assessment% of Grade 8 learners in Q1 and Q2 schools assessed using the ISHP learner assessment.

Hospital careInpatient under-one case fatality rateInpatient under-five case fatality rate

ANCEarly booking rate ( <20 weeks)Proportion of eligible women started on HAART

Intrapartum careDelivery rate in facility under supervision of trained personnelStillbirth rate in facilityPost-natal care within 6 days

Newborn CareNeonatal mortality rateLow Birth Weight rate

Women’s HealthCouple year protection rateCervical screening coverage rate

MCH DHIS Dashboard: Q1 and Q2, 2012/13Programme Indicator National

EPIFully immunized at one yearDrop-out rate (DaPT-Hib-IPV3 to Measles1)

93.6 %-8.4 %

NutritionVitamin A coverage 1 - 5 yearsSevere Malnutrition Case Fatality Rate

42.9%12.8%

DiarrhoeaIncidence of diarrhoea with dehydrationInpatient case fatality rate

11.2 per 1,0004.2%

PneumoniaIncidence of pneumoniaInpatient case fatality rate

73 per 1,0003.8%

HIV PCR coverage and positivity rateNo. of infants initiated on ART (not currently available)

94.3% and 2.7%-

School Health % of Grade R/1 learners in quintile 1 schools assessed by ISHP

Hospital careInpatient under-one case fatality rateInpatient under-five case fatality rate

5.6%4.4%

ANCEarly booking rate ( <20 weeks 43.2%

61.2%

Intrapartum careDelivery rate in facility under supervision of trained personnelStillbirth rate in facility

94.3%2.1%

Newborn Care

Neonatal mortality rateLow Birth Weight rate% newborns assessed within 6 days

11.5 per 1,000 live birth13.1%64.6%

Women’s HealthCouple year protection rateCervical screening coverage rate

35.4%56.3%

ANC visit before 20 weeks

• Women who have a booking visit (first visit) before they are 20 weeks (about half way) into their pregnancy as a proportion of all antenatal 1st visits

• Enumerator: Antenatal 1st visits before 20 weeks

• Denominator: Antenatal 1st visits before 20 weeks + 20 weeks or later (All ANC bookings)

Post-natal care

• Mothers who receive postnatal care within 6 days of delivery after discharge from place of delivery as proportion of all deliveries in facility

• Enumerator: Postnatal care mother within 6 days from delivery

• Denominator: Deliveries in facility

Vitamin A coverage (12-59 months)

• Used as a proxy for access to PHC and community-based services

• Rates in younger children are higher – but those in children 12 – 59 months have remained low.

Drop-out:DaPT-IPV-Hib3 – Measles 1

• The proportion of children who dropped out of the immunisation schedule between the third DTP-Hib or DTaP-IPV/Hib doses (normally at 14 weeks / 3.5 months) and the first measles doses normally at 9 months). The DTP-Hib or DTaP-IPV/Hib doses are used for this purpose.

• Enumerator: DTP-Hib/DTaP-IPV/Hib 3rd doses - Measles 1st doses under 1 year

• Denominator: DTP-Hib/DTaP-IPV/Hib 3rd doses

Negative figures suggest problems with administering and recording doses of DaPT-IPV-Hib3

MCH DHIS DashboardProgramme Indicator

EPIFully immunized at one yearDrop-out rate (DaPT-Hib-IPV3 to Measles1)

NutritionVitamin A coverage 1 - 5 yearsSevere Malnutrition Case Fatality Rate

DiarrhoeaIncidence of diarrhoea with dehydrationInpatient case fatality rate

PneumoniaIncidence of pneumoniaInpatient case fatality rate

HIV PCR coverage and positivity rateNo. of infants initiated on ART (not currently available)

School Health % of Grade R/1 learners in quintile 1 schools assessed by ISHP

Hospital careInpatient under-one case fatality rateInpatient under-five case fatality rate

ANC Early booking rate ( <20 weeks)

Intrapartum careDelivery rate in facility under supervision of trained personnelStillbirth rate in facilityPostnatal care mothers within 6 days

Newborn Care

Neonatal mortality rateLow Birth Weight rate% newborns assessed within 6 days

Women’s HealthCouple year protection rateCervical screening coverage rate

ec Nelson Mandela Bay Municipality 26.7

ec Oliver Tambo District Municipality 24.5

nc Frances Baard District Municipality 22.9

lp Capricorn District Municipality 20.7

nw Dr Kenneth Kaunda District Municipality 18.6

fs Fezile Dabi District Municipality 16.9

ec Buffalo City Metropolitan Municipality 16.5

gp City of Johannesburg Metropolitan Municipality 15.7

gp Sedibeng District Municipality 14.1

kz Sisonke District Municipality 14.0

Ten districts with highest NMR

nw Dr Kenneth Kaunda District Municipality 67.3

ec Alfred Nzo District Municipality 70.2

wc Central Karoo District Municipality 71.9

ec Oliver Tambo District Municipality 75.7

nc Pixley ka Seme District Municipality 76.2

kz Zululand District Municipality 76.5

mp Nkangala District Municipality 77.9

kz Amajuba District Municipality 78.6

mp Ehlanzeni District Municipality 79.2

wc Eden District Municipality 79.5

Immunization coverage: ten districts with lowest coverage

gp Sedibeng District Municipality 123.4

gp City of Johannesburg Metropolitan Municipality 119.1

nc Frances Baard District Municipality 109.6

kz Uthungulu District Municipality 109

fs Thabo Mofutsanyane District Municipality 108.5

gp Ekurhuleni Metropolitan Municipality 108.3

gp West Rand District Municipality 107.3

ec Buffalo City Metropolitan Municipality 107.3

kz uMgungundlovu District Municipality 106.2

lp Mopani District Municipality 105.9

Ten “best” performing districts

Conclusion

• Despite some problems with quality of data, DHIS data allow MCWH performance at all levels to be tracked and monitored.

• It is imperative that all health workers and managers engage with the DHIS data and use it to monitor and improve MCWH programmes and outcomes.

A dashboard is necessary for M&E and reporting

Definition of a dashboard

• In management information systems, a dashboard is "an easy to read, often single page, real-time user interface, showing a graphical presentation of the current status (snapshot) and historical trends of an organization’s key performance indicators to enable instantaneous and informed decisions to be made at a glance."

Peter McFadden

Targets: National vrs our district province

NB RealisticProgramme

Indicator National Our target

EPI Fully immunized at one yearDrop-out rate (DaPT-Hib-IPV3 to Measles1)

93.6 %-8.4 %

HIV PCR coverage and positivity rateNo. of infants initiated on ART (not currently available)

94.3% and 2.7%-

School Health

% of Grade R/1 learners in quintile 1 schools assessed by ISHP

ANC Early booking rate ( <20 weeks 43.2%61.2%

Intrapartum care

Delivery rate in facility under supervision of trained personnelStillbirth rate in facility

94.3%2.1%

Newborn Care

Neonatal mortality rateLow Birth Weight rate% newborns assessed within 6 days

11.5 per 1,000 live birth

13.1%64.6%

Examples

Reports and dashboards

• Reports are a traditional way of summarizing data. They may include some visual components—such as graphs or charts but are text-heavy.

• Dashboards are much more interactive in the way data is presented. Relying on visual indicators to display a simple, easily accessible interface that can be accessed by virtually anyone anywhere. -

Create dashboard

• chandoo.org/wp/excel-dashboards

• www.exceluser.com/dash/Cached

• www.youtube.com/watch?v=6HDwYd-8ld8