Improving Malaria Data Quality for Programmatic Decision-Making: Findings from Data Quality Audits in Mainland Tanzania, 2019

Tanzania has seen a 50% reduction in malaria prevalence in the last ten years. In 2019, 6,649,333 confirmed malaria cases were reported by 7,950 health facilities nationwide. While the overall reporting rate (99.6%) and completeness (96%) were high, we conducted a malaria data quality audit (DQA) for the 2019 period to verify the routine malaria data reported by health facilities in Mainland Tanzania. Using the outpatient department (OPD) DQA consistency checklist within the Malaria Service and Data Quality Improvement (MSDQI) tool, the number of patients attending OPD, malaria tests performed and confirmed, and clinical malaria cases were compared between the data reported by health facilities in the District Health Information Software (DHIS 2) and recorded in the health facility OPD register. For every matching value, a point was assigned. Health facility scores were aggregated by region; scores >75% were considered acceptable, 50–75% as par, and <50% as unacceptable. In 2019, 26% (2,098) of health facilities had undergone an OPD data consistency check with the MSDQI tool in Mainland Tanzania. Of those, 851 (41%) had an acceptable score >75%, 832 (40%) had a par score between 50–75%, and 415 (19%) had an unacceptable score <50%. In Njombe Region, only one health facility out of 311 for the entire region had undergone an OPD MSDQI DQA in 2019, and its overall performance was <50%. In the Mtwara region, among the 88/260 (39%) health facilities that had undergone an OPD MSDQI supportive supervision visit, 42 (48%) had an acceptable DQA score >75%, and only four facilities had a score <50%. Disaggregation and review of malaria-related data from DHIS 2 can identify how facilities perform with the consistency of data reported in DHIS 2 and in the OPD registers. Data from the MSDQI tool can be used to guide supportive supervision efforts to address data quality gaps at health facilities.