In system strengthening, it is essential to stimulate the interest of government officials in data and help them to efficiently utilize and leverage it from existing systems to inform decision making. Hence, all relevant government officials should be well-informed about the desk review findings, which emphasize any problems related to inconsistencies in the reported data and, as a result, their consequences. The top officers of the Department of Planning, Research and Statistics of the Ministry of Health and its agencies – the State Primary Health Care Management Board and the Hospital Management Board – among others, should be engaged during dissemination and advocacy visits. While the latter is in-charge of all primary facilities in the State, the former oversees all the secondary facilities in the State. It is important to emphasize the fact that these agencies operate independently, so there is need to carry each of them along in the process.

It is important to encourage the government to lead the process of the data review from the planning stage. This is as important as the activity itself. When government takes the driver-seat, it will increase its sense of responsibility and commitment not only to the process but also to doing something about the findings, thus ensuring action and sustainability of the process for continual data quality improvements. The Monitoring and Evaluation (M&E) Director of the State Primary Health Care Management Board is often the ideal person to lead the process. This is because, all of the M&E Officers at LGA level who are responsible for data management are under his/her supervision.  

Leveraging is a key efficiency factor in any successful and sustainable program. In conducting the FP data review, it is recommended to look for existing data review activities in the State. In many States in Nigeria, there are several data review activities usually on monthly basis. These data review activities are mostly targeted at specific program data or data elements – for example, malaria and routine immunization – and therefore sponsored by implementing partners for on that specific data. The first step is to identify these activities and who is sponsoring them. Then, meet with the sponsors/organizers of each activity to discuss possible opportunities for leveraging. For example, if there is an existing data review activity on routine immunization organized and sponsored by a partner, reach out to the partner and inquire about the activity. Then, ask whether it is possible to include FP data components in the review. It is likely that they may agree to this request and allow for FP components to be included. They may also politely reject your request based on time limitations.

Useful Tip: Don’t compromise the quality of your data review by insisting that the FP data can be given a short time. Never compromise quality over cost when leveraging on other existing activities. It is fine if you do not see any suitable existing activities to effectively leverage onto. However, it should be noted that, the first choice and consideration is to leverage onto an existing activity.

In a situation whereby, there are no suitable data review activities to leverage on, plan to initiate a new review program. This might be funded either by the State or TCI, for example. Prepare an activity profile and a modest budget, this must be done with full engagement of relevant government officials. Keep the budget as modest as possible, so that the data review meetings once demonstrated can become something that the government can easily take over.

Prior to the commencement of the activity, a planning meeting should be held. The planning meeting should include all key stakeholders, not only the top officials. The ideal participants may include M&E Directors from the Ministry of Health and its agencies, State MCH/RH Coordinator, LGA MCH/RH Coordinator(s), and LGA M&E Officers among others.

During the meeting, issues around data quality and inconsistencies should be discussed. The participants should be enlightened on the importance of data, the need for the data to be valid and of high quality, and consequences poor quality data.

An important output of the meeting should be a simple tool or a checklist for the data review exercise. The tool should be able address the data review needs. For instance, a data review checklist developed to address data inconsistencies may include columns for different types of data sources – FP register, summary forms, etc. – to allow for comparisons of different figures. Moreover, the tool should have a simple data analysis plan. It should also have a section for key findings and actions to be taken. The tool should be developed jointly and be kept very simple and unambiguous.

Having come up with a good plan, it is now the time to hit the ground running. It is time to conduct the review activity. The activity can be conducted at facility level, LGA level, or at State level depending on the need and availability of funds. The checklist developed is used to review and identify data quality issues. This is followed by analyzing the verified and validated data and identifying issues and key points of actions.

Data review meetings also present an opportunity to review and address changes in data collated. The data review meeting will be held monthly or quarterly (depending on the State) at LGA level and will initially target the review of FP data among high volume sites. The review meeting will further target other important service areas to FP such as ANC, Maternal Health, Out-Patient Department, etc. The meeting will be attended by the LGA M&E focal person, FP focal person, LGA coordinator, selected health facilities and a supervisor from the State.

The meetings will be held monthly or quarterly (depending on the State) and aims to improve indices by paying attention to data and using it for decision making. Prior to the data review meeting, all LGA M&E officers send their charts to the State RME officer to review and make corrections. At the meeting, the data from all LGAs is presented for the quarter, highlighting successes and challenges faced. All selected health facilities attending the meeting would be given the opportunity to speak on challenges faced and methods that they find to work.

A concise report should be produced at the end of the activity. The report should include a brief background, objective(s), methodology, key findings, lessons learned, actions taken and feedback. Feedback is as important as the review itself. Any inconsistencies or data quality issues found in the course of the review should be discussed with the service providers and the record officers at the respective facilities.