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3 ways governments can use data to strengthen people-centered primary health care

August 29, 2019 by Jessica Shearer

23713 (1).jpeg Healthcare worker looks at smartphone.

Amadou Ngom, head nurse at Mbem Mbem health post in Senegal, consults his phone. As countries embrace digital platforms and health information systems, the data provided by these technologies can improve primary health care. Photo: PATH/Gabe Bienczycki.

People-centered primary health care puts people at the heart of the design and delivery of health services. Its chief aim: better health for all. How do we get there? Better information—and use of that information—to reduce the causes of poor health, provide patients with targeted diagnoses, and support people to take charge of their own health.

Governments, and citizens themselves, have more data and information about their health than ever before.

But ample data isn’t enough.

Truly people-centered primary health care requires better data—and better use of that data—to identify people’s needs and preferences along their life course. Data can help clinic staff to make better decisions and target resources where they’re most needed. Essential to improving health equity, data can identify the most vulnerable.

PATH is partnering with countries worldwide to innovate how data are captured, shared, and used, whether through novel digital tools or a rich conversation. The goal: improve primary health care (PHC) systems.

Here are three ways governments and other leaders can leverage data to strengthen people-centered PHC:

1. Invest in health information systems that capture individual-level data

More and more countries are introducing digital systems to collect patient data. At the forefront: the ones that track an individual patient’s data across their lifetime, wherever they go to access care. Individual-level data, and the systems that capture them, are key to enabling people-centered PHC. When a health worker has a patient sitting in front of her, she needs immediate access to that patient’s health record to be able to provide the best care, whether the patient is an adult with multiple chronic health conditions or a child due for a life-saving vaccine. 

In Tanzania and Zambia, the BID Initiative has enrolled nearly one million children in electronic immunization registries (EIRs). These information systems capture important data, such as which vaccines children have had and which are due, for each individual child registered. The goal: Ensure every child is vaccinated from birth. By tracking precisely which children haven’t received vaccinations, EIRs unlock the power of individual-level data to help follow up with parents about missed vaccines or send extra resources to under-performing health facilities. When coupled with advances in machine learning and artificial intelligence, these registries help primary health care systems provide more personalized care. 

PATH has begun using machine learning models to target specific children, facilities, or districts with extra support to achieve universal immunization coverage. This cutting-edge combination of digital tools and data science helps to anticipate which children are at risk of coming late for immunization sessions; which health facilities are likely to experience vaccine stockouts; and which health workers may struggle to use the new EIR system.

2. Encourage a culture of performance measurement and improvement

Routine data can reveal important trends in health facility performance and help to detect looming public health threats. Visualize No Malaria, a partnership between PATH, Zambia’s Ministry of Health, Tableau, and other tech partners, uses data to fight the disease. 

Health facilities and community health workers report real-time data on malaria cases into a central database. Those data generate user-friendly dashboards that enable staff at all levels of the health system to see emerging patterns and optimize distribution of resources such as bednets, rapid diagnostic tests, and antimalarial drugs, allowing health workers to record and respond to every last case.

In response to low and inconsistent reporting rates among health workers, PATH worked with program managers and information officers to design a dashboard that enables health workers to review their monthly and seasonal performance. The dashboards also help program managers identify districts and facilities with the lowest reporting levels so they can provide more targeted training initiatives. 

3. Identify what communities want within their health system

In Ethiopia, the Ministry of Health and other stakeholders observed that people weren’t using community-based child health services. The result: preventable deaths. 

Why weren’t parents bringing their children to community health posts? PATH and partners asked the parents directly. Their rich responses were revealing: Health posts were not inviting places to visit. Some parents didn’t know that they offered comprehensive primary health care services so close to home. 

By asking community members what they wanted, we could prioritize and crowdsource solutions and approaches to implementing them. For example, communities in Ethiopia banded together to renovate and showcase community health posts, leading to a marked increase in use by parents and children. Now the community feels ownership over their primary health care services, and health workers think about how to make those services more responsive to community preferences.

At PATH, we aspire to a world where data-driven, people-centered primary health care is the norm, not the exception. This world is within reach.