Routine reporting: A private provider in Madagascar weighs in
It can be challenging for private clinical facilities to submit service data to the national health management information system on a monthly basis—even after staff receive training and coaching. Private providers are often busy with the day-to-day management of their practices, and incentives to report are not enough to offset the time, effort, and cost of routine reporting. Yet, despite the challenges, some private providers have prioritized reporting. SHOPS Plus talked to one such provider to better understand his motives and perspective.
Dr. Gabriel Razafimahatratra founded TSOTRA Medical Center in 2010 in a low resource neighborhood of Antananarivo, the capital of Madagascar. The facility, whose name is short for “everyone treated here shall be healed” in Malagasy, offers primary care and delivery services. Dr. Gabriel began reporting in 2019 using the Ministry of Health’s standard paper-based reporting form, but found it challenging. “Sending photocopies of the [form] to the district office was difficult and cumbersome, and it took us a lot of time.” Then Dr. Gabriel heard about the new Excel-based reporting form that SHOPS Plus developed and attended a training session to learn how to use it.
“I think that if we didn’t have the Excel-based form we would have already stopped reporting. [The form] is simpler; no photocopies, no printing,” said Dr. Gabriel. “Now it only takes us about a week to prepare and submit our [form].” Dr. Gabriel has since reported consistently and well ahead of the deadline each month. The switch to an electronic reporting format also enabled his medical center to continue reporting during the COVID-19 lockdown, when movement was restricted.
An incentive for Dr. Gabriel to report has been the possibility of receiving free family planning and vaccination commodities from the Ministry of Health. Dr. Gabriel has been looking to expand the products and services that he can offer his clients. This win-win partnership increases the channels through which the Ministry of Health can distribute essential health products while at the same time creating a revenue stream for the TSOTRA Medical Center, and value for Dr. Gabriel’s patients.
Dr. Gabriel recognizes that monthly reporting supports decision-making at many levels of the Ministry of Health and that it is important that his health services are counted. However, he emphasized that private providers need training, timely feedback and updates, and technical and material support to sustainably report. He advises other private facilities that the Excel form could be a useful tool to monitor the performance of their facilities over time. He also notes that participation in the national health management information system may help providers get insight into the activities at the district and national level. Those insights could help in planning for services and products.
“The [form] is an obligation for private facilities, so we must do it. But it is also a good tool to monitor the activities of private facilities, the district, and even the country, to support the planning of health activities, services and products,” according to Dr. Gabriel.