Assessment of the Integrity of the Routine Mental Health Reporting System in the Shai-Osudoku District in the Greater Accra Region of Ghana

Abstract

Background: Globally, Routine Health Information Systems exist but many health care systems do not focus on mental health. Few countries routinely collect data on mental health as part of their national Health Information Systems. In 2018, Ghana added mental health reporting to DHIMS-2 (the national portal for routine reporting of service delivery data). Objective: This study sought to understand the context-specific routine mental health reporting system, by estimating the accuracy ratio of new mental health cases (outpatient) and further determining the use of Standard Operating Procedures for mental health information, and identifying challenges associated with the work and data flow of mental health services Methodology: A landscape analysis was employed using a mixed method (both quantitative and qualitative) to assess the integrity of the routine mental health reporting system in the Shai-Osudoku District. All three (3) facilities which rendered mental health services in the district were part of the study. The data abstraction form was used to extract data from primary sources, reporting forms and DHIMS-2. Service providers were interviewed to solicit information on existing primary data collection tools, Standard Operating Procedures and challenges with the data/workflow processes. Microsoft Office Excel version 2016 was used for the analysis. Findings: The accuracy of new mental health cases (outpatient) data in the Shai-Osudoku District was 5.5% over-reported. Meanwhile, other individual facility data depict that there was 9.1% over-reported data at Agomeda Health Centre and a 100% accuracy rate at Osudoku Health Centre. For DHMIS-2 reported data, all facilities reported a 100% accuracy ratio except Osudoku Health Centre which under-reported its data by approximately 44%. The participants used improvised notebooks to collect primary data of their clients in the communities and recorded them into their registers at the health facilities after their daily or weekly community visits. The flow of data was found to be done by reporting data to the Health Information Officer at the district who then input the data into the District Health Information Management System 2 (DHIMS-2). Some of the challenges that affect accurate mental health data collection were inadequate standard recording books and infrastructure. Conclusion: The study observed some over-reported facility data in two health facilities and under-reported DHIMS-2 data in one facility. Primary data of clients were mostly collected using improvised books at the communities. There were SOPs in some of the facilities which were used with varied frequencies and on various occasions. Mental health data reporting starts at the facility after which the data is given to the Health Information Officer at the district level for data entry in DHIMS-2. The institutional care directorate of the mental health unit of the Ghana Health Service should provide standard registers and enough SOPs to mental health units of the various health facilities in the Shai-Osudoku District and other mental health service providing facilities. This will help improve easy data capture and standard reporting in all levels of health care delivery.