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ORCA

ORCA

We aim to improve the quality of routine health data in Ethiopia by supporting analysts at the Federal Ministry of Health, the Ethiopian Public Health Institute, and the Pharmaceutical Fund and Supply agency.

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About us

ORCA stands for Operational Research and Coaching for Analysts. Based in Ethiopia and the UK we work with our partners at the Ethiopian Federal Ministry of Health, the Public Health Institute, and the Pharmaceutical Fund and Supply Agency to improve the quality and use of routine data for decision-making.

Who we are

ORCA is led by the London School of Hygiene & Tropical Medicine, hosted by the Ethiopian Public Health Institute and works in close collaboration with the Ethiopian Federal Ministry of Health and the Pharmaceutical Fund and Supply Agency. The project is funded by the Bill & Melinda Gates Foundation.

About
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About ORCA
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The ORCA project supports Ethiopia’s Federal Ministry of Health, by strengthening technical knowledge to critically assess, interpret and accurately report the wealth of health information generated in the country. This work will improve the country’s Health Management Information System (HMIS) to solve challenges in reliable reporting, as well as leading to improved and more robust measurement of key health indicators such as immunisation coverage, maternal, newborn and child health and nutrition.

A gender-balanced group of 38 analysts from the Federal Ministry of Health, the Ethiopian Public Health Institute and the Pharmaceutical Fund and Supply Agency receive training, mentoring, and coaching through a series of workshops and applied skills-building activities, following the research process from problem formulation to reporting results, and their implications for policy.

The ORCA project will work closely with two other London School of Hygiene & Tropical Medicine led projects based in Ethiopia, the IDEAS and Dagu projects.

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ORCA team

ORCA is led by the London School of Hygiene & Tropical Medicine, hosted by the Ethiopian Public Health Institute and works in close collaboration with the Ethiopian Federal Ministry of Health. The project is funded by the Bill & Melinda Gates Foundation.

Partners

Ethiopian Federal Ministry of Health

Ethiopian Public Health Institute

Pharmaceutical Fund and Supply Agency

Meet the Team

LSHTM

Professor Lars Persson – Principal Investigator

Seblewengel Lemma Abreham – Research Fellow

John Ashmore - Research Fellow

Bilal Avan - Associate Professor 

Della Berhanu - Research Fellow 

Jennifer Brown – Assistant Project Manager

Joanna Busza - Associate Professor 

Carina Kallestal – Research Fellow

Tanya Marchant - Associate Professor 

Yemisrach Okwaraji - Research Fellow

Professor Joanna Schellenberg - Professor of Epidemeology & International Health

Noreen Seyerl - Communications Officer 

Suzanne Welsh – Project Manager

 

EPHI

Martha Zeweldemariam – Project Coordinator

Atkure Defar – Principal Investigator

Abebe Belayneh - Co-Principal Investigator

 

ORCA Analysts

Abera Dibabe

Abiy Kiflom

Abyot Adane

Addis Girma

Admasu Teketel

Binyam Kemal

Emiamrew Sisay Ayalew

Eshetu cherinet Teka

Etenesh Gebereyohannes

Freweini Gebrehiwot

Gulitat Tefera

Habtamu Alemay

Heven Semi Friew

Hilina Dejene Desalegne

Israel Ataro Otoro

Kalkidan Mekete

Kidist Woldesenbet

Kidist Zealiyas

Magdelawit Mengesha

Mamo Dereje

Mebrahtom Haile Zeweli

Meresha Worku Nega

Mesoud Mohammed

Miraf Tesfaye

Misrak Getnet Beyene

Mohammed Ormango

Netsanet Berhanu

Sorsa Faltamo Jama

Tefera Taddele

Tesfahun Bishaw Mengistie

Tesga  Hailu Desta

Tewabe Manaye Adege

Tsion Tsegaye

Yakob Wondarad

Yidnekachew Degefaw Mazengiya

Zemzem Mohammed Yusuf

Zenebech Gela

Zuriash Halefom

Events
Events ORCA

 

 

 

ORCA workshops

  • Mixed methods for second batch of participants at Yaya village hotel November 7-11, 2018
  • R-commander workshop for both batches at EPHI, December, 14-18 2018
  • National and regional data analysis and applied qualitative methods, March 20-22, 2019
  • Analysis workshop for first batch of participants, May 6-10 2019
  • Analysis workshop for the second batch of participants, May 20-24 2019
Methods workshop ORCA
Updates
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ORCA participants take a closer look at data quality and qualitative methods

With a special focus on comparing secondary data and the importance of quality routine data, a workshop took place at the Ethiopian Public Health Institute with all ORCA participants attending. To start the day participants presented their preliminary work on comparisons of secondary data on indicators of interest from different sources, including the Health Management Information System reports, the Ethiopian Demographic and Health Surveillance reports and various surveys.

A presentation by Antoinette Bhattacharya on the importance of quality of routine data opened up a new perspective for many of the participants. Ms Bhattacharya is a PhD student and member of the IDEAS project at the London School of Hygiene & Tropical Medicine who came to Ethiopia specifically to speak about her research on data quality of routine facility data for monitoring priority maternal and newborn indicators in Nigeria.

The second day Joanna Busza presented on qualitative approaches to health systems research. She described a case study and then took time for questions and answers from participants on their qualitative studies. A much-appreciated feedback session on each group's interview guides followed. After lunch the groups worked on criteria for rigor in qualitative research and mixed methods presentation of findings as well as on planning mixed methods analysis and reporting.

On the third day, participants further refined their work plans for the forthcoming months fulfilling their objectives on reporting assessments and analysis of the discrepancies between different data sources. They then presented and discussed these during the afternoon.

Overall, the workshop was well attended, and the evaluation statements from the participants showed that they appreciated the input given and that they were making good progress with their work.

2019-2020 PACF scholarships at LSHTM

Two highly competitive Positive Action for Children (PACF) Scholarships are available to applicants from sub-Saharan Africa intending to study at London School of Hygiene & Tropical Medicine on a one-year, full-time, London-based 2019-20 qualifying MSc programme. Deadline for application February 27, 2019.

Find out more 

ORCA Analysts learn the fundamentals of ‘R’

‘Simple’ and ‘practical’ – words not immediately associated with statistical software.  The ORCA analysts who recently attended a four-day workshop at EPHI, facilitated by Katarina Selling of Statistikakademin, however said just that following an intense two day get-together. The workshop was designed to introduce the analysts to the open-source statistical software ‘R’, using ‘R-commander’ (Rcmdr) – an interface similar to other menu-based statistical software with the added benefit that it enables users to access ‘R’ without having to learn and write code.

Participants after the 'R' workshop
All participants pose after completing the 'R' workshop. © ORCA 2018

During the workshop, the analysts covered the following themes:

  • Data management. Importing data into R-commander, sub-setting data, and the functions recode and compute.
  • Visualisation. To produce histograms, bar graphs, and scatterplots.
  • Descriptive statistics. To compute means, medians, standard deviations, proportions and the like in R-commander.
  • Basic statistical tests and their assumptions. To master certain statistical test (for example chi-square test, different t-tests, correlation test) and how to do it in R-commander.
  • Introduction to statistical models including their assumptions. To conduct and interpret output from simple and multiple linear regression, and One way- and Multi way Analysis of Variance (ANOVA) in R-commander.

The workshop was intensive with a packed agenda but the analysts remained engaged throughout the process and provided lots of positive feedback. Guililat, working as part of the immunization group, noted that the workshop ‘will help [them] to conduct the analysis part of the research’. Tsion, a member of the maternal health working group, was one of the participants remarking on the ease of using the Rcmdr software.

The skills gained through the workshop will prove to be beneficial when the participants analyse the data for their projects in the coming months.

Successful second workshop hosted at YaYa village
The TB working group

The group working on TB

The working group on immunisation

The immunisation group

The group working on malaria

The group working on malaria

A group picture of ORCA participants

The second batch of ORCA participants

The ORCA project participants are grouped in two batches, completing capacity building workshops to support them in their analytical roles at the Federal Ministry of Health and the Ethiopian Public Health Institute.

The second group of ORCA participants, who had come together for a first workshop in August met again from the 7th to the 11th of November for a methods workshop. With 15 participants attending the workshop was held at YaYa village outside Addis Ababa.

The five-day workshop included themes such as critical reading, ethical considerations for operational research, preparing questionnaires and conducting qualitative research. The focus on qualitative research methods was well received by participants. Emiamrew Sisay, who is a PMTCT Coordinator, mentioned rapid appraisal methods and the introduction to using focus group discussions as especially useful in also being able to choose the right tool for the job and appreciating the practical coaching elements during the workshop. In parallel, the participants worked on critically reading and presenting scientific articles and on their thematic group’s protocols. Participants, such as Mesoud Mohammad found the workshop helpful in improving his protocol, as well as learning from other thematic groups: “Almost all of our project proposals need some re-working”, he said: “based on the comments we received and the lecturers time spent in training us.” The thematic groups work on data quality of indicators for immunization, chronic diseases/tuberculosis and malaria.

Methods workshop

The first ORCA methods workshop was conducted July 29 to August 03, 2018 at Ya-Ya village in Sululta town. For the 21 participants, the same who had participated in an earlier planning workshop, the aim was to refine each thematic group’s study plan including the individual participants’ plans. The main focus was the selection of the right methodological approach for each group’s research questions.

Sessions during the workshop included:

  • critical reading
  • questionnaire design for quantitative interviews
  • qualitative approaches including rapid appraisal approaches
  • an introduction on analysis

Participants worked in their groups to refine the research questions, the choice of methods, the ethical considerations, and a work plan.

During the last day of the workshop, a representative from the Federal Ministry of Health joined the workshop. Participants presented posters with their refined plans and received feedback from the audience.

ORCA planning workshop

The ORCA team conducted a first planning workshop for a first batch of ORCA participants from June 26-30, 2018 at Nega Bonger Hotel, on the outskirts of Addis Ababa. The workshop established thematic groups each of the participants will contribute to, as well as a plan of activities for each of the groups and for each of the participants for the upcoming 12 months.

The 21 participants received introductions on the following subject areas:

  • Objectives of the ORCA project,
  • Research approaches for identifying errors in routine data
  • Problem formulation and the design of studies
  • Critical reading of research reports
  • Ethical issues in operational research
  • How to work and interact in a group
ORCA team

The workshop followed a participatory approach, encouraging participants to work in their respective groups and actively contribute. At the end of the workshop, participants had:

  • established specific areas of thematic work
  • formulated a preliminary research problem
  • suggested a potential approach and prepared plans for the next 12 months

During the last day of the workshop, a member of staff from the Ethiopian Public Health Institute (EPHI) – one of the partner institutions of the ORCA project, joined in the discussions following the thematic group presentations.

Methods workshop

The first ORCA methods workshop was conducted July 29 to August 03, 2018 at Ya-Ya village in Sululta town. For the 21 participants, the same who had participated in an earlier planning workshop, the aim was to refine each thematic group’s study plan including the individual participants’ plans. The main focus was the selection of the right methodological approach for each group’s research questions.

Sessions during the workshop included:

  • critical reading
  • questionnaire design for quantitative interviews
  • qualitative approaches including rapid appraisal approaches
  • an introduction on analysis
ORCA planning workshop

Participants worked in their groups to refine the research questions, the choice of methods, the ethical considerations, and a work plan.

During the last day of the workshop, a representative from the Federal Ministry of Health joined the workshop. Participants presented posters with their refined plans and received feedback from the audience.

Strengthening the measurement of key health indicators in Ethiopia

The London School of Hygiene & Tropical Medicine (LSHTM) has been awarded more than £1.8 million by the Bill & Melinda Gates Foundation to improve the collection and analysis of health data in Ethiopia.

Like many other African countries, Ethiopia has gaps in their Health Management Information System (HMIS), as well as insufficient mechanisms for data validation, which hinders informed decision making particularly at national policy level. For example, there are often errors and inconsistencies in recorded immunisation data which can impact on the delivery of vaccination programmes.

Through this new grant, researchers will be supporting Ethiopia’s Federal Ministry of Health (FMOH), strengthening technical knowledge to critically assess, interpret and accurately report the wealth of health information. This work will improve the country’s HMIS, as well as leading to improved and more robust measurement of key health indicators such as immunisation coverage, maternal, newborn and child health and nutrition.

Academic teams from LSHTM are already based at the Ethiopian Public Health Institute (EPHI) under two ongoing projects: the IDEAS project, which aims to improve the health and survival of Ethiopian mothers and babies by generating evidence to inform policy and practice, and Dagu, which is working to strengthen maternal, newborn and child health programmes in Ethiopia. Both projects are already contributing to national evaluation, research, and capacity-building activities.

The new grant will expand the existing LSHTM team and allow them to create the resources required to improve both the quality of government metrics and the analytical capacities of key ministry staff.

A gender-balanced group of 40 analysts from the Federal Ministry of Health and affiliated organisations will receive training, mentoring, and coaching through a series of workshops and applied skills-building activities, following the research process from problem formulation to reporting results, and their implications for policy.

In 2015, the FMOH published their Health Sector Transformation Plan. An Information Revolution was a key on the Ministry’s agenda, and outlined the need for timely, accurate and dependable information to allow effective decision-making. Improving quality issues in data, and training and capacity building for analysts were also highlighted as crucial. The Annual Review Meeting of the Ethiopian health sector in 2017 highlighted that inconsistencies in health data remain and need to be further addressed.

The research will be led by Lars Åke Persson, a Professor in Public Health Evaluation, who is based in Ethiopia. Professor Persson, said: “We are delighted to receive this funding from the Bill & Melinda Gates Foundation, to continue vital work in improving the quality and analysis of health data in Ethiopia.

“Ethiopia’s ability to plan and make evidence-based decisions to protect and improve health is impossible if their data have errors.

“This programme of work will allow our experienced analysts to partner with colleagues in Ethiopia to identify errors in health data collection and analysis, fixing them at the root. This will considerably increase the analytic capability at Ethiopia’s Ministry of Health.”

Welcoming the ORCA participants

Through the ORCA project researchers from the London School of Hygiene & Tropical Medicine are supporting Ethiopia’s Federal Ministry of Health to strengthen technical knowledge to critically assess, interpret and accurately report the wealth of health information generated in the country.

The analysts participating in the project were recruited in a competitive process, including a background screening, as well as written and oral examinations relevant to the field. 38 were finally admitted from the following three Ethiopian institutions:

  • Federal Ministry of Health (27)
  • Ethiopian Public Health Institute (6)
  • Pharmaceutical Supply and Fund Agency (5)

The selected participants already work at the ministry and institutions in roles related to data management and analysis, have basic knowhow and experience of the country’s health information system and were keen to contribute towards improved  quality of routine health information.

A total of 23 men and 15 women were selected, all between the ages of 20 to 49. A majority of the participants hold master degrees and have chosen careers in the fields they were initially trained in.