Data from healthcare facilities across Africa are often transcribed from paper records to electronic data collection software by entry officers, who are not directly involved with the work, and may not be healthcare personnel. It has been suggested that this has implications for accuracy and data integrity.

Recently, on a project, the importance of facility staff oversight of data collection officers’ work became apparent. A data collection entry staff had wrongly imputed ‘negative’ on the software tool for tests that were not done. Before it was caught by the facility staff running the tests, 157 erroneous entries had been uploaded into the software.

A quick check of the research on this subject shows that it is a fairly common challenge for laboratory-based results not directly reported by the Medical Laboratory Scientist running the test. Apart from transcription errors by data entry officers, who may not fully understand the medical laboratory lingo, there is also the issue of incorrect values, which may skew the data. In the instance, I referred to earlier, if the error had not been caught on time, it would report a much lower prevalence of the condition being tested for in the research study, which may cause the stoppage of treatment interventions and funding support for at-risk patients.

In the laboratory, a familiar aphorism is that “work not documented is work not done.” However, it appears this understanding is not universal or a template for data collection officers. Some, may not ask and would rather report any missing data as negative or zero. According to Rijal et al (2019), data omissions accounted for 2/3rds of the errors in the study they conducted to explore this challenge.

They advocated for laboratory software that does not allow blank results. This however was the challenge the data entry staff faced in 2022 that made him select Negative for all the tests that were reported as not done in the paper-based entries.
This error has grave negative implications for community and global health.

It is suggested that data collection software should also include options for tests not done and other invalid results, which should not be counted as negative, to avoid low prevalence reporting as more facilities globally switch to electronic data collection.

Another suggestion is that the health worker facility staff have direct oversight of the data entry work either as an endpoint oversight that allows them to see a summary of the data uploaded and thus compare it with their own records. In addition, save and upload functions on data collection software should be reversible such that edits and deletions can be done when facility healthcare staff discover errors​.

In conclusion, oversight of data entry officers by health workers ​is needed in order to ensure accuracy of data at all levels.
Onaoluwa Abimbola is a Health Equity and Gender Equality Advocate who is committed to working for the best outcomes in every community. She is a 2019 Generation Africa Fellow and 2022 YMLSF Ambassador and the Founder of Mohealth Ace Limited (A social enterprise) and Volunteer Medical Laboratory Scientists Forum.