As a critical aspect of any successful health care program, accurate and timely data reporting gives a real-time evidence-based overview of resources, interventions, and progress at all levels and is essential to measure performance, identify areas for improvement, and make informed decisions for improved healthcare.

In Lagos State, Nigeria, dedicated state monitoring and evaluation (M&E) officers – Oloyede Oluwatobi, Noah Muhammed, Calfos Oluwatosin and Sanusi Adijat – play a vital role in improving the effectiveness and efficiency of the state’s data reporting system. They ensure adherence to reporting standards at both public and private health facilities on District Health Information System (DHIS2) platform, identify areas for improvement, and bridge the gap between data collection and informed decision-making. They also provide technical coaching to the 20 local government M&E Officers, as part of a structured approach to monitoring health data across the primary health care program areas in the state.

Before The Challenge Initiative (TCI) engaged Lagos State in July 2021, 210 public facilities (out of 318) and about 200 private health facilities were provided with mobile tablets by the state government, aimed at facilitating seamless and timely reporting on DHIS2. However, technical glitches, poor internet access, unclear processes, loss of passwords, among other issues hampered progress. Many facilities in Lagos State were not even reporting on the DHIS2 platform, leading to poor data quality and unreliable decision-making.

Recognizing this challenge, TCI – in partnership with the state – engaged stakeholders in a meeting that identified issues like poor documentation, low reporting rates, sub-optimal use of the reporting tools (including the devices), and communication gaps between those generating data and those reporting and monitoring it. TCI then collaborated with the M&E unit at the Primary Health Care Board (PHCB) to enhance the State Data Management System by strengthening the data control room through a user-friendly system for improved data reporting, quality, and timeliness through inspection, validation, feedback, documentation, issues tracking and reporting, as well as the development of data management mitigation plans.

TCI’s intervention significantly transformed data reporting in Lagos State, as corroborated by M&E officer Oloyede Oluwatobi, who said:

Comparing pre-TCI and during TCI, if you check on DHIS2, you will realize that throughout the previous year, our reporting rate was on an unsteady average of 80% but when the TCI team started supporting the control room, the reporting rate improved steadily to an average of 95% except during times of DHIS2 downtime. As a result of the proactive follow-up from the control room, LGA M&E officers submit data by the 15th of each month, knowing they will be contacted if their data is not on DHIS2”

TCI coached control room M&E officers with targeted capacity building to troubleshoot common issues. TCI also helped them to develop and use a template to flag family planning data errors, and improve follow-up communication channels with LGA M&E Officers and health facilities.

According to M&E officer Noah Muhammed:

The template created to identify errors has really helped in making the work seamless and less stressful. It has really improved the quality of data reported on DHIS, so we need to add more error calculation templates such as this for other program areas.”

The support to the control room has further influenced other data processes positively, such as facility-level data validation, data reviews, and data harmonization, contributing to an improved reporting rate and timeliness as shown in the figures below. Figure 1 shows a clear picture of reporting rates improving in 2023 with the highest reporting rates recorded across all the months. The period between October 2021 and October 2023 witnessed a remarkable 9% increase in reporting. Notably, August 2023 recorded the highest reporting rate with 98.3% This data not only demonstrates a positive trend but also reveals interesting variations in reporting consistencies across the three years.

Figure 1: Lagos State’s reporting rate – 2021 to 2023. (Data Source: DHIS2).

Figure 2 clearly demonstrates a 38% increase in timely reporting between October 2022 and October 2023.

Figure 2: Lagos State timeliness reporting rates – 2021 to 2023 (Data Source: DHIS2).