Monitoring and evaluation surveillance system Quality

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Monitoring and evaluation (surveillance)
systemQuality ENRS
E G Y P T
Dr. Essam Elmoghazy NTP Manager Egypt
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ENRS in Egypt

• It is easy now for all levels to make reporting
  and recording of all data required for monitoring
  the progress of managing TB activities.
• It is also easy to check , recheck data and
  recall it to make all needed reports in
  appropriate time

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What is the ENRS ?

• It is a (package) of the Electronic version of
  the three Nominal (Lab, District, and suspects)
  TB Registers..
• The main file is the E-TB register. It contains
  all the information of the patient including
  drugs consumption calculation.

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ENRS-Database structure

• This sheet was modified to be user friendly,
  comments of Arabic for all titles were
  introduced, drop lists in English and Arabic, if
  conditions for translation to English for the
  medical expressions, division to quarters, and
  have been previously tested and feed back to be
  simply used was done

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ENRS-Database structure
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ENRS - Data and Information flow process
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Implementation of ENRS

• 2004, Two pilot governorates Cairo and Giza
• 2005 NTP started the first stage of expansion it
  was planed to work on 4 governorates, Ismaelia,
  Qaliubia, Port Saied.
• 2006 full expansion after distribution of about
  66 computers.
• 2 (Two) e-registers were introduced (district and
  lab).

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ENRS-Cost and resources

• The cost of developing the system was part of the
  staff salary, and the technical assistance from
  WHO was part of the training component through
  JPRM
• The main cost items in implementation were
• the hardware (60000 USD)
• the communication (5000 USD)
• the training (25000 USD)
• the supervision (3000 USD)
• Egypt example for full implementation covering
  153 chest clinics and 26 provinces plus 20 HI
  centers

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Implementation duration

• Total duration 2 years for full expansion (153
  BMU/district, 26 G, HIO 20)
• 6 months for pilot
• 3 months for expansion

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Quality Tables

• ENRS as a new system implements parameters of
  quality to ensure accuracy, completeness,
  consistency and timeliness.
• All these are done through electronic sheets
  which make it easy to fulfill all these
  parameters.

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Completeness Tables
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Completeness Tables
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Completeness Tables
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Completeness Tables
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Completeness Tables
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Completeness Tables
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Accuracy Tables
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Accuracy Tables
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Accuracy Tables
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Consistency Tables

• Some items revised for Consistency
• The patient with the chest clinic
• Registration date with Start of treatment
• Age group with sputum examination at diagnosis
• Patient diagnosis with Diagnosis Category
• Patient Category with treatment regimen
• Patient Category with Sputum examination at
  diagnosis

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Consistency Tables
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Consistency Tables
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Timeliness Tables
The GCT or the focal person in the information
centre receives the data from each clinic in an
assigned date, date is recorded in the electronic
sheets and a chart is drawn to notify the
timeliness of the process and the progress of
quality.
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ENRS-Evaluationeasy to prepare reports
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ENRS-EvaluationImproved data analysis
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ENRS-In Summary
Data entry in the same BMU/diagnostic
centre Data cleaning filtering and quality
verification Transfer to higher level (nominal
monthly and reports quarterly) Quality
verification at both governorate and central
level with feed back to the local level monthly.
On job training Supervision, progress and
evaluation meetings Data analysis Develop
routine reports WITH the needed data analysis
including measuring indicators. Data backup is
done routinely in separate folders, and on flash
memories.
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ENRS-Lessons Learned

• Improve accuracy, completeness consistency and
  timeliness of reporting and indicators
  calculation in NTP at all levels. (high quality)
• Save time for analysis, and facilitate feedback.
• Facilitate supervision and increase its
  efficiency
• Facilitate locating the patients as per their
  residency not only their place of diagnosis,
  which will give more accurate information about
  disease distribution, and access to services
  using GIS.
• Produce comprehensive NTP database to be used in
  
• GIS for planning of treatment supporters (DOT)
  network.
• Operational research
• Evidence based planning and budgeting.

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Thank You