The use of routine case record data to evaluate quality of inpatient hospital care for newborns and children in Kenya

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Quality of care assessment is one of the ways of evaluating what the health system is providing and can allow monitoring and evaluation exercises to track progress and identify gaps. Such monitoring however depends on an ability to measure quality with the availability of high quality data being central to these assessments. In low-resource settings routine health or hospital information system data are very limited, often of poor quality, and are typically summarized (e.g. total cases per ward) before being entered into the national health information system database. Such routine data very rarely include any information on a patient’s clinical findings or treatment. Thus at present routine data that are collected do not provide for individual patient level analyses of the process of care. This work is from a group of studies that seek to demonstrate how case record data may be used to evaluate quality of care in routine hospital settings in Kenya and by doing this promote the availability of quality data and its effective use as one means to promote improvement in services provided in Kenyan hospitals. This work provides important insights into whether hospitalized children and newborns are receiving the correct care are using process of care assessments conducted in relatively large numbers of cases, across multiple locations and across time. We apply more advanced statistical methods including hierarchical modelling, propensity scores and multiple imputation as some of the approaches of getting the most from routine data.

About the Speaker: David is a research officer with Health Systems Research Group (HSRG) at KEMRI/Wellcome Trust Research Programme Nairobi. He studied Bsc. Nursing at Moi University Kenya and holds a Master of Science in Epidemiology from the London School of Hygiene and Tropical Medicine. He is currently a PhD student, registered at the University of Amsterdam. Since joining KEMRI/Wellcome Trust Research Programme in August 2008, his research work has spanned a range of disciplines including, clinical trials, evaluation of quality of care within hospitals and exploration of the application of various statistical methods (propensity score analysis, multi-level models and statistical process control) to routine data. David also hold different responsibilities including being an executive member of the International Epidemiology Association-Kenyan Chapter and in 2015 he was co-opted into the national Ministry of Health technical working group on Monitoring and Evaluation. David has broad interests’ health informatics and its integration with epidemiology to monitor disease trends, interventions effects, identify quality of care gaps and the use of this data for effective decision making.