An innovation to improve health outcomes in Amajuba district, KwaZulu-Natal, South Africa

Figures & data

Table 1. Professional nurses’ responses regarding municipal ward-based health data.

	Frequency, n (%)
Collection of municipal ward-based health data, n = 131
Yes	123 (93.9%)
No	7 (5.3%)
Do not know	1 (0.8%)
Frequency of analysing municipal ward health data, n = 115
Weekly	9 (7.8%)
Monthly	63 (54.8%)
Quarterly	13 (11.3%)
As the need arises	30 (26.1%)
Rationale for analysis of municipal ward-based health data, n = 116
Prevalence	38 (32.7%)
Trends	27 (23.2%)
Health-seeking behaviour	14 (12, 1%)
Prevalence + trends	14 (12, 1%)
Prevalence + trends + health-seeking behaviour	23 (19.8%)
Frequency of submission of municipal ward-based health data to district, n = 131
Monthly	110 (84%)
Quarterly	11(8.4%)
Sometimes	4 (3.1%)
Never	6 (4.6%)
District’s responsiveness regarding feedback to professional nurses, n = 131
Yes	43 (32.8%)
No	58 (44.3%)
Sometimes	20 (15.3%)
Do not know	10 (7.6%)

Table 2. Participants’ comments on ward-based data collection by job category.

Job category	Comments
Operational managers	To understand the disease burden and the disease trend per municipal ward, we need to understand the disease profile and to determine which age group is affected and why, and involve the community to reduce the burden of disease. It was important to understand the epidemiology and demographic profile of the population served in order to mitigate the disease burden To identify the disease burden of the specific ward and to have measures of how these problems or diseases are going to be addressed to the community that we are serving You will be able to do the budget according to the profiling of the clients. If you’ve got the number of the clients you are able to budget for that particular disease when planning
WBOTs	To identify problems experienced by the community focusing on the ward, for example if they do not immunise their children because it causes diseases To give us an alarm for which places are vulnerable, need attention; what do we need to do? To understand the clinic catchment, how many people the clinic sees? Identify diseases on the peak The purpose is to identify problems of the wards and plan for them and for relevant interventions. For example, if you identify a specific ward has TB, you are able to plan awareness to prevent the spread of TB and to plan for health promotion. So as ward-based teams we know exactly which are the main problems facing which ward It helps the district plan according to community needs As outreach teams it will also help us to trace specific clients who are supposed to be seen at the clinic, it facilitates location of the client
PHC supervisors	Purpose is to plan for our communities; different wards, when we have identified the need we then plan for them and then intervene, then our people will live long Our strategies are going to be focused because we are going to be focusing on that particular ward and our resources on that particular ward Another reason is for campaign purposes, because if we have identified that there is an outbreak of diarrhoea in a certain ward, so the personnel, Department of Health personnel, will go there to do the campaign

TB = tuberculosis.

Table 3. Participants’ comments on current functioning of municipal ward-based health data collection.

Job category	Comments
Operational managers	The previous tool was user friendly, it was better, people were able to collect data according to the disease that was prevailing at that particular time It is functional because now we can be able to understand your own wards, how many HIV, TB patients we are having and the ages. Then it is good for you because you can be able to plan maybe for an awareness in case you have them, teenage pregnancy. I think it is functional I have always had a problem with this. Perhaps I am one of the people who need a workshop so that things will be fine. I have identified that you sometimes repeat one and the same person and you will perceive that the number is high and you find out you repeat, one person on the very same visit. Sometimes you would not know that person has come and visited that facility the previous two weeks and in the same month you report that person double
WBOTs	It is functional, at month end we discuss statistics with staff including myself, identify gaps, for example, if vitamin A falls, and discuss outbreak of diseases, trying to intervene It is helping because we are able to work according to what we found. Where there is a need go to the war rooms, increase awareness and talk about the information we want to share It is difficult to know the health outcome, much as you write a referral letter, you do not know whether the patient attended or not As the WBOTs, there are clients that we see like defaulters that are not in our data collection tools. There is nowhere where we record and submit, for example, defaulters. There is no specific tool for these clients. Like, defaulters that we trace are not recorded anywhere; so we cannot use that information There is a communication breakdown because we submit data but after a week or two we are asked to submit the same data. I feel data should be received by the relevant person at the district
PHC supervisors	It is not used as it is supposed to; they do not intervene as they are supposed to. If it were, we would be seeing a lot of awareness, a lot of campaigns or interventions Data are mostly under-reported What I noticed is that our war rooms are not properly represented by different stakeholders. You find the Department of Health as the biggest percentage, the other stakeholders do not attend war rooms, so making it difficult really to discuss the problems re ward-based data

TB = tuberculosis.