BACKGROUND Routine health information systems can provide near real-time data for malaria programme management, monitoring and evaluation, and surveillance. There are widespread concerns about the quality of the malaria data generated through routine information systems in many low-income countries. However, there has been little careful examination of micro-level practices of data collection which are central to the production of routine malaria data. METHODS Drawing on fieldwork conducted in two malaria endemic sub-counties in Kenya, this study examined the processes and practices that shape routine malaria data generation at frontline health facilities. The study employed ethnographic methods-including observations, records review, and interviews-over 18-months in four frontline health facilities and two sub-county health records offices. Data were analysed using a thematic analysis approach. RESULTS Malaria data generation was influenced by a range of factors including human resource shortages, tool design, and stock-out of data collection tools. Most of the challenges encountered by health workers in routine malaria data generation had their roots in wider system issues and at the national level where the framing of indicators and development of data collection tools takes place. In response to these challenges, health workers adopted various coping mechanisms such as informal task shifting and use of improvised tools. While these initiatives sustained the data collection process, they also had considerable implications for the data recorded and led to discrepancies in data that were recorded in primary registers. These discrepancies were concealed in aggregated monthly reports that were subsequently entered into the District Health Information Software 2. CONCLUSION Challenges to routine malaria data generation at frontline health facilities are not malaria or health information systems specific; they reflect wider health system weaknesses. Any interventions seeking to improve routine malaria data generation must look beyond just malaria or health information system initiatives and include consideration of the broader contextual factors that shape malaria data generation.

中文翻译：

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产生常规疟疾数据：探索肯尼亚一线医疗机构中影响常规疟疾数据质量的微观实践和过程。

背景技术常规健康信息系统可以提供用于疟疾计划管理，监测和评估以及监视的近实时数据。在许多低收入国家，人们对通过常规信息系统生成的疟疾数据的质量存在广泛的担忧。但是，很少仔细检查数据收集的微观实践，这些实践对于产生常规疟疾数据至关重要。方法利用在肯尼亚两个疟疾流行亚县进行的野外调查，本研究考察了影响一线医疗机构常规疟疾数据生成的过程和实践。该研究在四个前线医疗机构和两个县以下医疗记录办公室中采用了人种学方法，包括观察，记录审查和访谈，为期18个月。使用主题分析方法分析数据。结果疟疾数据的产生受到多种因素的影响，包括人力资源短缺，工具设计和数据收集工具的存货不足。卫生工作者在常规疟疾数据生成中遇到的大多数挑战都源于更广泛的系统问题以及国家层面的指标框架和数据收集工具的开发。为应对这些挑战，卫生工作者采用了各种应对机制，例如非正式任务转移和使用简易工具。这些举措虽然维持了数据收集过程，但它们对记录的数据也有相当大的影响，并导致原始寄存器中记录的数据存在差异。这些差异被隐藏在汇总的每月报告中，这些报告随后被输入到地区卫生信息软件2中。结论前线卫生机构常规疟疾数据生成所面临的挑战并非针对疟疾或特定于卫生信息系统；它们反映了更广泛的卫生系统弱点。寻求改善常规疟疾数据生成的任何干预措施都不仅应包括疟疾或健康信息系统计划，还应考虑影响疟疾数据生成的更广泛的背景因素。