Data Management

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Data Management

• Dr Samuel Mikhail
• EST/ DHS

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Introduction

• The RDs Annual Report Statistical Annex
  includes more than 70 indicators in 9 tables
  (core indicators).
• Indicators are shown for the most recent year or
  period for which data are available and in most
  tables for an earlier year 2000-2005.
• Most of out of data on the number of indicators
  are used from implied statistical surveys by the
  country and/or international organization mainly
  on the period 1990-1999, and may not favorable to
  nourish our database.

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Cont. Introduction

• Some countries lag behind in some indicators.
• EST unit collect collate, analyze, verify and
  clear data of all EMR member states and follow
  the rules of validating indicators with
  collaboration of countries and technical units.

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Data Pooling
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Barriers and constraints

• General
• In many countries and programs definitions,
  classifications and method of calculation do not
  entirely conform to the WHO or international
  standards.
• People (even in statistical offices) still mix
  between year of estimate and year of reporting.
• Delay of reporting the updated data and sent to
  the EST unit after the deadline either from some
  countries or technical units.
• Related to countries
• Many countries impose upon the indicators figures
  by using the same figures which were implied for
  many years ago for updating recent years.
• Countries generally derive their estimates from
  reported services which are not always available
  and accurate.
• Most countries do not cover the data on various
  types of government and private health services.

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Cont. Barriers and constraints

• Some countries derive these data from survey, but
  since survey questions and definitions differ
  across countries, the estimate may not strictly
  comparable.
• Most countries do not cover the data on various
  types of government and private health services.
• Several figures related to the same indicator for
  the same year received in different values and/or
  previous values.
• Some figures reported from country to various
  regional office units with different values.
• Consistency of the data in some indicators is
  questionable as it is published by several MOH
  units with different figures on the same dates.
• Related to technical units
• Some figures reported to some RO units and never
  been routed to EST unit and/or routed with
  different figures.

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Cont. Barriers and constraints

• Technical units which do not generate statistics
  but use statistics provided by other units,
  sometimes do not comply, they quote statistic
  from UN sources which do not tally with those
  collected in the office such as the CBI.
• Technical units might think that some of the data
  reported by the countries is not accurate or
  reliable.
• Related to EST unit
• EST does not provide future estimations or
  projections except on population based country
  figures while some UN sources do that.
• EST are not covering, collecting and/or reporting
  additional indicators required all users such as
  MDG indicators ( as access to essential drug and
  TB prevalence )

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Examples of discrepancies

• Related to countries
• Egypt
• KSA
• Pakistan
• Related to programs
• Prevalence of smoking
• Women welfare
• MDGs indicators
• Prevalence of Malaria
• Reported AIDs cases (estimated HIV infections)

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A way forward

• Countries and programs should entirely conform to
  the WHO and international standards concerning
  definitions, classifications and methods of
  calculation.
• EST has a wealth of information on health data
  since year 1985, documented and published by EMRO
  and should be used as a reference for any further
  updates.
• EST continues to coordinate and compile data
  collection from countries and from technical
  units as done last year with successful
  collection and unifying of data.
• Additional indicators needed by technical units
  which do not generate data could be added to the
  list of indicators actively collected by EST for
  uses and not included core indicators in profiles
  (e.g. MDGs related indicators to be used by CBI).

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A way forward

• Any projection or estimates needed by technical
  units concerning population can be arranged for
  by EST unit.
• Technical units HAVE TO validate the data they
  receive from their correspondences, inter country
  first through the focal points (i.e. Ministries
  of health) before approving it and routing it to
  the EST, so that data received from countries is
  the same data received from technical units.
• Technical units continue to validate data
  pertinent to their activities and provide them to
  EST.
• Technical units which generate statistics is
  responsible for validating their statistics with
  their national counterparts and provide EST with
  final validated statistics.

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A way forward

• EST unit coordinates a periodic meeting for the
  users to discuss the evaluation and approval of
  the Regional Health database.
• Beside achieving the fore mentioned steps the EST
  unit will be responsible for collecting
  collating, analyzing, verifying and clearing data
  of all EMR member states and follow the rules of
  validating indicators with collaboration of
  countries and technical units.
• Any data to be published MUST pass through and be
  approved by the EST unit.

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• Demographic and health indicators definitions

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I. Demographic indicators definitions

• Population growth rate - Number of persons added
  to (or subtracted from) a population in a year
  due to natural increase and net migration
  expressed as a of the population at the
  beginning of the time period.
• Dependency ratio - The population under 15 years
  and 65 years and over as percentage of the
  population aged 15 to 64.
• Total fertility rate - Average number of live
  births a woman would have by 50 years of age if
  she were subject, throughout her life, to the age
  specific fertility rates observed in a given
  year.

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II. Socioeconomic indicators definitions

• Adult literacy rate 15 (total, male, female) -
  Percentage of the population aged 15 years or
  over who can both read and write, with
  understanding, a short simple statement about
  his/her everyday life.
• Per capita GDP US - Average annual gross
  domestic product (GDP) per capita at constant
  market prices for each year of the time period
  expressed in current US (see exchange rate).

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II. Socioeconomic indicators definitions
(contd)

• Population with access to safe drinking-water ()
  - Percentage of population with access to an
  improved drinking-water source in a given year
• Population with adequate excreta disposal
  facilities () - Percentage of population with
  access to improved sanitation in a given year

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III. Health expenditure indicators
definitions

• Total expenditure on health as of GDP - Sum of
  general government health expenditure and private
  health expenditure expressed as percentage of GDP
  

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IV. Indicators of coverage for primary
health care services

• Population with access to local health services
  () - Proportion of a given population that can
  be expected to use a specified facility, service,
  etc., taking into account barriers to access
  physical (distance, travel time), economic
  (travel cost, fee charged), or social and
  cultural (caste or language barriers).
• Contraceptive prevalence rate () - Percentage of
  women aged 1549 years who are practicing, or
  whose sexual partners are practicing, any form of
  contraception (any method)
• Antenatal care coverage () - Percentage of women
  who utilized antenatal care provided by skilled
  health personnel for reasons related to pregnancy
  at least once during pregnancy as a percentage of
  live births in a given time period.

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IV. Indicators of coverage for primary health
care services (contd)

• Births attended by skilled health personnel () -
  Percentage of live births attended by skilled
  health personnel in a given period of time.
• Infants attended by trained personnel () -
  Percentage of infants up to one year of age
  attended by skilled health personnel per 100 live
  births in the same year.
• One year-olds immunized with, in a given year,
  according to country Expanded Programme of
  Immunization - ..? ..

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V. Health Status indicators

• Life expectancy at birth (years) - Average number
  of years that a newborn is expected to live if
  current mortality rates continue to apply (total,
  male, female).
• Newborns with low birth weight ()
• - Percentage of live born infants with
  birth weight less than 2500 grams in a given time
  period.
• Percentage of children underweight ()
• -Percentage of children under five years
  who have a weight-for-age below minus two
  standard deviations of the National Center for
  Health Statistics (NCHS)/WHO reference median.

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V. Health Status indicators (contd)

• Infant mortality rate per 1000 live births -
  Number of deaths under one year of age per 1000
  live births in given year or period.
• Under 5 mortality rate - Probability of child
  born in a specific year or period dying before
  reaching the age of five, if subject to
  age-specific mortality rates of that period.
• Maternal mortality ratio (per 100 000 live
  births) (see note c) -Number of maternal deaths
  per 100 000 live births during a specified time
  period, usually one year.

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Thank you