Today, we surpassed the mark of 10,000 weekly program and stock reports submitted for the management of severe acute malnutrition program in Northern Nigeria. While this number does not compare to the number of responses received by UReport, reporting program and stocks data are a different and more complicated responsibility. The initial registration involves completing five questions and correctly submitting a site ID. Weekly program data includes nine questions and stock report data has six questions.
Since July 2016, we have trained 1,580 persons at 651 outpatient and inpatient sites across nine states. We instruct the trainees to come to the training with their past two months of data to use for practice. When the reporters start to use the RapidPro tool, we are already beginning to receive valid data. The trainees are supervised rigorously by their direct supervisors and then by the trainers during the training to ensure that they understand how to report correctly.
As the number of questions to answer is significant and network problems could impede answering all the questions, we were concerned that the reporting burden was excessive. This was not the case. The rate of completion of all questions in the reporting flows is high (82% for program reporting and 88% for stocks reporting). These robust completion rates demonstrate the capacity of the health center staff to send complete data.
Out of the 10,000 submitted reports, there are errors. Some of these errors are caught through the built-in logic behind the question flows. Also, the trainees are trained to validate all of their submitted data and to send a confirmation. When they identify an error, then they can resend the data for that week with all the necessary corrections. The reporting question flows were designed in advance of the launch of the tool and follow the regional guidelines for reporting on management of severe acute malnutrition. These were piloted in the 2013 attempt with RapidSMS and meticulously tested in advance of the state level trainings.
Some RapidPro experts recommend to start very simple and increase the number of questions in the question flows over time. For the management of severe acute malnutrition program this produces incomplete data, which could lead to poor mismanagement or less than acceptable patient outcomes. By triangulating the complete data, it is possible to identify both strong and poor performance allowing coordination staff to target quickly supportive supervision to where it is needed and improve the quality of services.