{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T04:20:06Z","timestamp":1772166006214,"version":"3.50.1"},"reference-count":33,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,1,6]],"date-time":"2021-01-06T00:00:00Z","timestamp":1609891200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,1,6]],"date-time":"2021-01-06T00:00:00Z","timestamp":1609891200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007843","name":"Direktoratet for Utviklingssamarbeid","doi-asserted-by":"publisher","award":["QZA-0484"],"award-info":[{"award-number":["QZA-0484"]}],"id":[{"id":"10.13039\/100007843","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Med Inform Decis Mak"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The ability to report complete, accurate and timely data by HIV care providers and other entities is a key aspect in monitoring trends in HIV prevention, treatment and care, hence contributing to its eradication. In many low-middle-income-countries (LMICs), aggregate HIV data reporting is done through the District Health Information Software 2 (DHIS2). Nevertheless, despite a long-standing requirement to report HIV-indicator data to DHIS2 in LMICs, few rigorous evaluations exist to evaluate adequacy of health facility reporting at meeting completeness and timeliness requirements over time. The aim of this study is to conduct a comprehensive assessment of the reporting status for HIV-indicators, from the time of DHIS2 implementation, using Kenya as a case study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective observational study was conducted to assess reporting performance of health facilities providing any of the HIV services in all 47 counties in Kenya between 2011 and 2018. Using data extracted from DHIS2, K-means clustering algorithm was used to identify homogeneous groups of health facilities based on their performance in meeting timeliness and completeness facility reporting requirements for each of the six programmatic areas. Average silhouette coefficient was used in measuring the quality of the selected clusters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Based on percentage average facility reporting completeness and timeliness, four homogeneous groups of facilities were identified namely: best performers, average performers, poor performers and outlier performers. Apart from blood safety reports, a distinct pattern was observed in five of the remaining reports, with the proportion of best performing facilities increasing and the proportion of poor performing facilities decreasing over time. However, between 2016 and 2018, the proportion of best performers declined in some of the programmatic areas. Over the study period, no distinct pattern or trend in proportion changes was observed among facilities in the average and outlier groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The identified clusters revealed general improvements in reporting performance in the various reporting areas over time, but with noticeable decrease in some areas between 2016 and 2018. This signifies the need for continuous performance monitoring with possible integration of machine learning and visualization approaches into national HIV reporting systems.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12911-020-01367-9","type":"journal-article","created":{"date-parts":[[2021,1,6]],"date-time":"2021-01-06T16:03:31Z","timestamp":1609949011000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Evaluating performance of health care facilities at meeting HIV-indicator reporting requirements in Kenya: an application of K-means clustering algorithm"],"prefix":"10.1186","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7340-5346","authenticated-orcid":false,"given":"Milka Bochere","family":"Gesicho","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin Chieng","family":"Were","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ankica","family":"Babic","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,1,6]]},"reference":[{"key":"1367_CR1","unstructured":"Global HIV and AIDS statistics\u20142020 fact sheet | UNAIDS. https:\/\/www.unaids.org\/en\/resources\/fact-sheet. Accessed 14 July 2020."},{"key":"1367_CR2","unstructured":"UNAIDS. Towards universal access. In: UNAIDS Annual Report. 2009. http:\/\/www.unaids.org\/en\/KnowledgeCentre\/Resources\/Publications\/default.asp. Accessed 14 July 2020."},{"key":"1367_CR3","doi-asserted-by":"publisher","first-page":"1","DOI":"10.11604\/pamj.2013.14.129.2581","volume":"14","author":"M Mbondo","year":"2013","unstructured":"Mbondo M, Scherer J, Aluoch GO, Sundsmo A, Mwaura N. Organizational HIV monitoring and evaluation capacity rapid needs assessment: the case of Kenya. Pan Afr Med J. 2013;14:1\u20137.","journal-title":"Pan Afr Med J"},{"key":"1367_CR4","doi-asserted-by":"publisher","first-page":"S120","DOI":"10.1097\/QAI.0b013e31825cf345","volume":"60","author":"LE Porter","year":"2012","unstructured":"Porter LE, Bouey PD, Curtis S, Hochgesang M, Idele P, Jefferson B, et al. Beyond indicators. JAIDS J Acquir Immune Defic Syndr. 2012;60:S120\u20136.","journal-title":"JAIDS J Acquir Immune Defic Syndr"},{"key":"1367_CR5","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1097\/COH.0b013e3283479316","volume":"6","author":"DK Ekouevi","year":"2011","unstructured":"Ekouevi DK, Karcher S, Coffie PA. Strengthening health systems through HIV monitoring and evaluation in Sub-Saharan Africa. Curr Opin HIV AIDS. 2011;6:245\u201350.","journal-title":"Curr Opin HIV AIDS"},{"key":"1367_CR6","doi-asserted-by":"publisher","first-page":"S129","DOI":"10.1097\/QAD.0000000000000713","volume":"29","author":"S Saito","year":"2015","unstructured":"Saito S, Howard AA, Chege D, Ellman TM, Ahoua L, Elul B, et al. Monitoring quality at scale: implementing quality assurance in a diverse, multicountry HIV program. AIDS. 2015;29:S129\u201336.","journal-title":"AIDS"},{"key":"1367_CR7","first-page":"62","volume":"48","author":"R Dehnavieh","year":"2019","unstructured":"Dehnavieh R, Haghdoost AA, Khosravi A, Hoseinabadi F, Rahimi H, Poursheikhali A, et al. The District Health Information System (DHIS2): a literature review and meta-synthesis of its strengths and operational challenges based on the experiences of 11 countries. Health Inf Manag. 2019;48:62\u201375.","journal-title":"Health Inf Manag"},{"key":"1367_CR8","first-page":"114","volume":"10","author":"A Manya","year":"2016","unstructured":"Manya A, Nielsen P. Reporting practices and data quality in health information systems in developing countries: an exploratory case study in Kenya. J Health Inform Dev Ctries. 2016;10:114\u201326.","journal-title":"J Health Inform Dev Ctries"},{"key":"1367_CR9","unstructured":"WHO. Data Quality Review (DQR) Toolkit. WHO. In :World Health Organization; 2019. http:\/\/who.int\/healthinfo\/tools_data_analysis\/en\/. Accessed 5 Mar 2020."},{"key":"1367_CR10","doi-asserted-by":"publisher","first-page":"e0211265","DOI":"10.1371\/journal.pone.0211265","volume":"14","author":"AA Bhattacharya","year":"2019","unstructured":"Bhattacharya AA, Umar N, Audu A, Allen E, Schellenberg JRM, Marchant T. Quality of routine facility data for monitoring priority maternal and newborn indicators in DHIS2: a case study from Gombe State, Nigeria. PLoS ONE J. 2019;14:e0211265.","journal-title":"PLoS ONE J"},{"key":"1367_CR11","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12936-016-1650-6","volume":"16","author":"S Githinji","year":"2017","unstructured":"Githinji S, Oyando R, Malinga J, Ejersa W, Soti D, Rono J, et al. Completeness of malaria indicator data reporting via the District Health Information Software 2 in Kenya, 2011\u20132015. BMC Malar J. 2017;16:1\u201311.","journal-title":"BMC Malar J"},{"key":"1367_CR12","doi-asserted-by":"publisher","first-page":"3","DOI":"10.4314\/gmj.v50i1.1","volume":"50","author":"MN Adokiya","year":"2016","unstructured":"Adokiya MN, Awoonor-Williams JK, Beiersmann C, M\u00fcller O. Evaluation of the reporting completeness and timeliness of the integrated disease surveillance and response system in northern Ghana. Ghana Med J. 2016;50:3\u20138.","journal-title":"Ghana Med J"},{"key":"1367_CR13","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1186\/1472-6947-14-40","volume":"14","author":"VM Kiberu","year":"2014","unstructured":"Kiberu VM, Matovu JK, Makumbi F, Kyozira C, Mukooyo E, Wanyenze RK. Strengthening district-based health reporting through the district health management information software system: the Ugandan experience. BMC Med Inform Decis Mak. 2014;14:40.","journal-title":"BMC Med Inform Decis Mak"},{"key":"1367_CR14","doi-asserted-by":"publisher","first-page":"25829","DOI":"10.3402\/gha.v7.25829","volume":"7","author":"MP Nisingizwe","year":"2014","unstructured":"Nisingizwe MP, Iyer HS, Gashayija M, Hirschhorn LR, Amoroso C, Wilson R, et al. Toward utilization of data for program management and evaluation: quality assessment of five years of health management information system data in Rwanda. Glob Health Action. 2014;7:25829.","journal-title":"Glob Health Action"},{"key":"1367_CR15","unstructured":"Muga R, Kizito P, Mbayah MM, Gakuruh T. Overview of the health system in Kenya. In: Kenya Service provision assessment survey 2004; 1999, p. 13\u201324."},{"key":"1367_CR16","first-page":"1","volume":"2012","author":"A Manya","year":"2012","unstructured":"Manya A, Braa J, \u00d8verland L, Titlestad O, Mumo J, Nzioka C. National roll out of District Health Information Software (DHIS 2) in Kenya, 2011\u2013central server and cloud based infrastructure. IST-Africa. 2012;2012:1\u20139.","journal-title":"IST-Africa"},{"key":"1367_CR17","first-page":"38","volume":"8","author":"J Karuri","year":"2014","unstructured":"Karuri J, Waiganjo P, Orwa D, Manya A. DHIS2: the tool to improve health data demand and use in Kenya. J Health Inform Dev Ctries. 2014;8:38\u201360.","journal-title":"J Health Inform Dev Ctries"},{"key":"1367_CR18","unstructured":"DHIS2: DHIS2 overview. https:\/\/www.dhis2.org\/overview. Accessed 28 Sep 2020."},{"key":"1367_CR19","unstructured":"DHIS2: SDHIS2 in action. https:\/\/www.dhis2.org\/in-action. Accessed 28 Sep 2020."},{"key":"1367_CR20","doi-asserted-by":"publisher","first-page":"293","DOI":"10.1186\/s12911-020-01315-7","volume":"20","author":"MB Gesicho","year":"2020","unstructured":"Gesicho MB, Were MC, Babic A. Data cleaning process for HIV-indicator data extracted from DHIS2 national reporting system: a case study of Kenya. BMC Med Inform Decis Mak. 2020;20:293.","journal-title":"BMC Med Inform Decis Mak"},{"key":"1367_CR21","doi-asserted-by":"publisher","first-page":"651","DOI":"10.1016\/j.patrec.2009.09.011","volume":"31","author":"AK Jain","year":"2010","unstructured":"Jain AK. Data clustering: 50 years beyond K-means. Pattern Recognit Lett. 2010;31:651\u201366.","journal-title":"Pattern Recognit Lett"},{"key":"1367_CR22","doi-asserted-by":"publisher","DOI":"10.1002\/9780470977811","volume-title":"Cluster analysis","author":"BS Everitt","year":"2011","unstructured":"Everitt BS, Landau S, Leese M, Stahl D. Cluster analysis. 5th ed. Chichester: Wiley; 2011.","edition":"5"},{"key":"1367_CR23","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1016\/0377-0427(87)90125-7","volume":"20","author":"PJ Rousseeuw","year":"1987","unstructured":"Rousseeuw PJ. Silhouettes: a graphical aid to the interpretation and validation of cluster analysis. J Comput Appl Math. 1987;20:53\u201365.","journal-title":"J Comput Appl Math"},{"key":"1367_CR24","doi-asserted-by":"crossref","DOI":"10.1002\/9780470316801","volume-title":"Finding groups in data, an introduction to cluster analysis","author":"L Kaufman","year":"1990","unstructured":"Kaufman L, Rousseeuw PJ. Finding groups in data, an introduction to cluster analysis. Hoboken: Wiley; 1990."},{"key":"1367_CR25","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1243\/095440605X8298","volume":"219","author":"DT Pham","year":"2005","unstructured":"Pham DT, Dimov SS, Nguyen CD. Selection of K in K-means clustering. Proc Inst Mech Eng Part C J Mech Eng Sci. 2005;219:103\u201319.","journal-title":"Proc Inst Mech Eng Part C J Mech Eng Sci"},{"key":"1367_CR26","doi-asserted-by":"crossref","unstructured":"Thinsungnoen T, Kaoungku N, Durongdumronchai P, Kerdprasop K, Kerdprasop N. The clustering validity with silhouette and sum of squared errors. In: International conference on industrial application engineering; 2015, p. 44\u201351.","DOI":"10.12792\/iciae2015.012"},{"key":"1367_CR27","first-page":"528","volume-title":"Tableau your data!: fast and easy visual analysis with tableau software","author":"D Murray","year":"2013","unstructured":"Murray D, Chabot C. Tableau your data!: fast and easy visual analysis with tableau software. Hoboken: Wiley; 2013. p. 528."},{"key":"1367_CR28","volume-title":"IBM SPSS statistics for windows version 25","author":"IBM Corp","year":"2017","unstructured":"Corp IBM. IBM SPSS statistics for windows version 25. Armonk: IBM Corp; 2017."},{"key":"1367_CR29","doi-asserted-by":"publisher","first-page":"e188","DOI":"10.5210\/ojphi.v8i2.6722","volume":"8","author":"JM Kariuki","year":"2016","unstructured":"Kariuki JM, Manders E-J, Richards J, Oluoch T, Kimanga D, Wanyee S, et al. Automating indicator data reporting from health facility EMR to a national aggregate data system in Kenya: an interoperability field-test using OpenMRS and DHIS2. Online J Public Health Inform. 2016;8:e188.","journal-title":"Online J Public Health Inform"},{"key":"1367_CR30","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1093\/heapol\/czp010","volume":"24","author":"A Aqil","year":"2009","unstructured":"Aqil A, Lippeveld T, Hozumi D. PRISM framework: a paradigm shift for designing, strengthening and evaluating routine health information systems. Health Policy Plan. 2009;24:217\u201328.","journal-title":"Health Policy Plan"},{"key":"1367_CR31","doi-asserted-by":"publisher","first-page":"1136","DOI":"10.1136\/bmjgh-2018-001136","volume":"3","author":"G Irimu","year":"2018","unstructured":"Irimu G, Ogero M, Mbevi G, Kariuki C, Gathara D, Akech S, et al. Tackling health professionals\u2019 strikes: an essential part of health system strengthening in Kenya. BMJ Global Health. 2018;3:1136.","journal-title":"BMJ Global Health"},{"key":"1367_CR32","doi-asserted-by":"publisher","first-page":"e0200858","DOI":"10.1371\/journal.pone.0200858","volume":"13","author":"T-S Joseph Wu","year":"2018","unstructured":"Joseph Wu T-S, Kagoli M, Kaasb\u00f8ll JJ, Bjune GA. Integrated Disease Surveillance and Response (IDSR) in Malawi: implementation gaps and challenges for timely alert. PLoS ONE. 2018;13:e0200858.","journal-title":"PLoS ONE"},{"key":"1367_CR33","doi-asserted-by":"publisher","first-page":"e195","DOI":"10.5210\/ojphi.v8i3.7100","volume":"8","author":"O Ola","year":"2016","unstructured":"Ola O, Sedig K. Beyond simple charts: design of visualizations for big health data. Online J Public Health Inform. 2016;8:e195.","journal-title":"Online J Public Health Inform"}],"container-title":["BMC Medical Informatics and Decision Making"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12911-020-01367-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s12911-020-01367-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12911-020-01367-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,16]],"date-time":"2023-10-16T23:02:02Z","timestamp":1697497322000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcmedinformdecismak.biomedcentral.com\/articles\/10.1186\/s12911-020-01367-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1,6]]},"references-count":33,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["1367"],"URL":"https:\/\/doi.org\/10.1186\/s12911-020-01367-9","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-54718\/v4","asserted-by":"object"},{"id-type":"doi","id":"10.21203\/rs.3.rs-54718\/v2","asserted-by":"object"},{"id-type":"doi","id":"10.21203\/rs.3.rs-54718\/v3","asserted-by":"object"},{"id-type":"doi","id":"10.21203\/rs.3.rs-54718\/v1","asserted-by":"object"}]},"ISSN":["1472-6947"],"issn-type":[{"value":"1472-6947","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,1,6]]},"assertion":[{"value":"5 August 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 December 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 January 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Ethical approval for this study was obtained from the Institutional Review and Ethics Committee (IREC) Moi University\/Moi Teaching and Referral Hospital (Reference: IREC\/2019\/78).","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"The findings and conclusions in this report are those of the authors and do not represent the official position of the Ministry of Health in Kenya.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclaimer"}}],"article-number":"6"}}