{
  "abstract": "Introduction Digital clinical decision support tools are increasingly used in primary-level health facilities to improve maternal and child healthcare. These tools guide health workers to input patient records digitally, providing a critical opportunity to strengthen routine health information systems with real-time data and improve quality of care. However, often, these service-level data are not always effectively integrated into existing data systems, reducing their downstream impact on data quality and data-driven decision-making. Our study evaluated the impact of a digital job aid tool (Registre Electronique de Consultations-Maternite, REC-Maternity tool), used by healthcare workers in rural primary healthcare facilities in Burkina Faso, on routine data quality at the district level.Methods First, we conducted an analysis comparing REC-Maternity data (n=79 895 visits) with District Health Information System 2 (DHIS2) data from 34 facilities to assess agreement in service delivery records. Next, in a quasi-experimental study design, we used DHIS2 data in Toma intervention and Gourcy comparison districts to conduct a difference-in-difference analysis with 13 months preintervention and postintervention time horizon. We assessed the impact of the intervention on three DHIS2 data quality outcomes: completeness, timeliness and internal consistency.Results The validation analysis revealed limited data agreement between REC-Maternity and DHIS2, particularly for postnatal care (ratio: 1.56) and family planning (ratio: 3.05). These discrepancies suggest parallel data flows from paper-based and electronic forms, indicating limited integration of the digital tool into routine reporting. The results also suggested the potential for digital records to help distinguish true zero-reporting from missing values in DHIS2. The difference-in-difference analysis indicated a significant decrease in timely reporting in the intervention district compared with the comparison district (−66.5% of facilities (95% CI −73.0% to −60.1%)).Discussion While digital tools offer a potential data revolution in resource-limited settings, they should not be presumed to be more efficient and replace paper-based data collection without continuous monitoring and quality improvement strategies.",
  "authors": [
    {
      "affiliations": [
        "Department of Maternal and Child Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA",
        "Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA"
      ],
      "name": "Arisa Shichijo"
    },
    {
      "affiliations": [
        "Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA",
        "Center for Global Digital Health Innovation, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA"
      ],
      "name": "Lena Kan"
    },
    {
      "affiliations": [
        "Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA"
      ],
      "name": "Abdoulaye Maïga"
    },
    {
      "affiliations": [
        "Institut Supérieur des Sciences de la Population, Université Joseph Ki-Zerbo, Ouagadougou, Burkina Faso"
      ],
      "name": "Douba Nabié"
    },
    {
      "affiliations": [
        "Institut Supérieur des Sciences de la Population, Université Joseph Ki-Zerbo, Ouagadougou, Burkina Faso"
      ],
      "name": "Bruno Lankoande"
    },
    {
      "affiliations": [
        "Ministry of Health and Public Hygiene, Ouagadougou, Burkina Faso"
      ],
      "name": "Youssouf Zon"
    },
    {
      "affiliations": [
        "Terre des hommes, Ouagadougou, Burkina Faso"
      ],
      "name": "Ferdinand Kaboré"
    },
    {
      "affiliations": [
        "Terre des hommes, Ouagadougou, Burkina Faso"
      ],
      "name": "Mamoudou Diallo"
    },
    {
      "affiliations": [
        "Terre des hommes, Ouagadougou, Burkina Faso"
      ],
      "name": "Seydou Toguiyeni"
    },
    {
      "affiliations": [
        "Terre des hommes, Ouagadougou, Burkina Faso"
      ],
      "name": "Assetou Zongo"
    },
    {
      "affiliations": [
        "Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA",
        "Center for Global Digital Health Innovation, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA"
      ],
      "name": "Smisha Agarwal"
    }
  ],
  "title": "Assessing the impact of a facility-based digital intervention on district-level data quality in rural Burkina Faso",
  "uid": "9b5798c8-091b-5af4-b66c-706dc763ed24"
}