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Challenges in data quality: the influence of data quality assessments on data availability and completeness in a voluntary medical male circumcision programme in Zimbabwe
  1. Y Xiao1,2,
  2. A F Bochner2,
  3. B Makunike3,
  4. M Holec2,
  5. S Xaba4,
  6. M Tshimanga5,
  7. V Chitimbire6,
  8. S Barnhart2,7,8,
  9. C Feldacker2,8
  1. 1Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China
  2. 2International Training and Education Center for Health (I-TECH), Seattle, Washington, USA
  3. 3International Training and Education Center for Health (I-TECH), Harare, Zimbabwe
  4. 4Ministry of Health and Childcare, Harare, Zimbabwe
  5. 5Zimbabwe Community Health Intervention Project (ZICHIRE), Harare, Zimbabwe
  6. 6Zimbabwe Association of Church-related Hospitals (ZACH), Harare, Zimbabwe
  7. 7Department of Medicine, University of Washington, Seattle, Washington, USA
  8. 8Department of Global Health, University of Washington, Seattle, Washington, USA
  1. Correspondence to Dr Caryl Feldacker; cfeld{at}


Objectives To assess availability and completeness of data collected before and after a data quality audit (DQA) in voluntary medical male circumcision (VMMC) sites in Zimbabwe to determine the effect of this process on data quality.

Setting 4 of 10 VMMC sites in Zimbabwe that received a DQA in February, 2015 selected by convenience sampling.

Participants Retrospective reviews of all client intake forms (CIFs) from November, 2014 and May, 2015. A total of 1400 CIFs were included from those 2 months across four sites.

Primary and secondary outcomes Data availability was measured as the percentage of VMMC clients whose CIF was on file at each site. A data evaluation tool measured the completeness of 34 key CIF variables. A comparison of pre-DQA and post-DQA results was conducted using χ2 and t-tests.

Results After the DQA, high record availability of over 98% was maintained by sites 3 and 4. For sites 1 and 2, record availability increased by 8.0% (p=0.001) and 9.7% (p=0.02), respectively. After the DQA, sites 1, 2 and 3 improved significantly in data completeness across 34 key indicators, increasing by 8.6% (p<0.001), 2.7% (p=0.003) and 3.8% (p<0.001), respectively. For site 4, CIF data completeness decreased by 1.7% (p<0.01) after the DQA.

Conclusions Our findings suggest that CIF data availability and completeness generally improved after the DQA. However, gaps in documentation of vital signs and adverse events signal areas for improvement. Additional emphasis on data completeness would help support high-quality programme implementation and availability of reliable data for decision-making.

  • Data quality
  • Zimbabwe
  • Monitoring and Evaluation
  • voluntary medical male circumcision
  • operations research

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:

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  • Contributors YX conducted data collection and review. AFB, CF and YX drafted the paper. BM, MH, MT, VC and SB direct and manage VMMC programme implementation. XY and AB analysed programme data. SX collaborated on the VMMC programme implementation for the MOHCC. CF advised on the project. All authors contributed to the drafting of the paper, reviewed drafts and approved the final manuscript.

  • Funding This study was supported by the US President's Emergency Plan for AIDS Relief (PEPFAR) through a cooperative agreement, ‘Scaling Up Voluntary Male Medical Circumcision to Prevent HIV Transmission in Zimbabwe’, 1U2GGH000972, from the US Centers for Disease Control and Prevention (CDC), Division of Global HIV/AIDS (DGHA).

  • Competing interests None declared.

  • Ethics approval The Medical Research Council of Zimbabwe, the US Centers for Disease Control and Prevention (CDC) and University of Washington's Internal Review Board provided non-research determination for this routine programme evaluation activity. All patient-level data were de-identified. MRFs and CIFs are the property of the MOHCC and are stored by implementing partners in accordance with MOHCC standards for the routine care of data.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The de-identified Stata data file used for analysis is available for sharing.

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