Determinants of COVID-19 data quality in the District Health Information Management System version 2 in Ahafo Region, Ghana

Background In ensuring public health efforts in combating pandemics such as coronavirus disease 2019 (COVID-19), transparent data reporting that is of high quality and easily accessible is crucial for tracking epidemic progress and making informed decisions. In Ghana, no published studies have been conducted to evaluate the quality of COVID-19 data submitted onto the national web-based platform, District Health Information Management System version 2 (DHIMS-2) during the COVID-19 period. In this regard, this study seeks to assess the estimates and determinants of COVID-19 data quality in the DHIMS-2 in the Ahafo region of Ghana.

A facility-based cross-sectional study design was employed, with a desk review of COVID-19 records in DHIMS-2 and primary data sources (registers and monthly reporting forms). This study involved all 23 different levels of healthcare facilities that reported on COVID-19 in the Ahafo region from March 2020 to December 2022. We assessed COVID-19 data quality using three dimensions of completeness, accuracy, and timeliness according to the World Health Organization data quality guide. Mixed-effect logistic regression was then employed to identify the determinants of COVID-19 data quality at a 95% confidence interval.

The overall COVID-19 data quality was estimated at 35.9% (95%CI=32.6%, 39.4%) while the rate of the data dimensions of timeliness, completeness, and accuracy were 50.2% (95%CI=46.7%, 53.8%), 50.6% (95%CI=47.1%, 54.2%), and 72.4% (95%CI=69.1%, 75.5%) respectively. It was found that the availability of a functional data validation team at the health facilities (AOR=18.3; 95%CI=1.62, 20.7; p= 0.019), training of data managers in COVID-19 data management (AOR=9.37; 95%CI=2.56, 34.3; p=0.001), and data managers with two-year professional training (certificate background) (AOR=3.42; 95%CI=1.95, 12.2; p=0.025) were independently associated with COVID-19 data quality.

The overall COVID-19 data quality in the Ahafo region was quite poor. Dimensionally, while the rate of data timeliness was high, that of data completeness, and accuracy were relatively low. The interaction of the independent correlates of COVID-19 data quality requires the healthcare system to identify stringent measures to strengthen the health information system to enhance planning and decision-making, especially during disease outbreaks. Competing Interest Statement The authors have declared no competing interest. Funding Statement This study was funded by The Project for Human Resource Development Scholarship, Japan International Cooperation Agency (JICA), and Nagasaki University School of Tropical Medicine and Global Health, Japan. Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Two ethical approvals were obtained from the Institutional Review Board (IRB), School of Tropical Medicine and Global Health (TMGH), Nagasaki University-Japan (NU_TMGH_2022_229_1), and Ghana Health Service Ethics Review Committee (GHS-ERC) with approval number GHS-ERC 033/01/23. Additionally, written permissions were obtained from the Ahafo Regional and all District Health Directorates. Data managers were made to sign the written informed consent after explaining the content to them. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes Data Availability The datasets collected, generated, or analyzed during this study have been attached as supplementary information.