Health data in Libya……… Inadequate and misleading



Health data in Libya……… Inadequate and  misleading

By Dr Nagi Giumma Barakat.

A data base is vital for the effective operation of  the Libyan health system (Photo:Libya Herald).

London, 2 February 2013:

The former health minister says that major investment into data  collection has to be made into the health service to make it work properly and  that it is a golden opportunity for information service  companies.

Any leader who has a vision to develop a sector or organisation, whatever it  is, needs data so he or she can put forward a strategic plan to improve or move  the sector forward. Without accurate data, it is very difficult to develop  anything. Unfortunately, Libya lacks such data — and that is true in all  ministries.

Nowhere is that more so than in the Libyan health service. Data is  insufficient, at best patchy, and it is vital to make plans in health services.  Under the old regime, there was no systematic collection of data or accurate  analysis. What existed is not very accurate. It always collected in a hurry and  to please ministers or Qaddafi himself. The managers and administrators were  terrified when asked to do survey and found multiple problems or indicators  showing incompetence. So they went and forged the data and kept the decisions  makers blind. There was a systematic policy to cover up any mistakes, whether it  was data collection, decision-making or implementing certain measures to improve  any services in Libya.

Since the success of 17th February revolution, and new governments  in Libya, no attention has been paid to this issue, yet it is vital and  important in helping ministers achieve their strategic goals. Is it because of  inexperience? Or lack of expertise? Or instability or is it a case that there  are other priorities? I think information collection is very important for  crisis management — and it was not done by Libyan governments before and since  the revolution.

Both in the past and now, the health ministry has faced major obstacles in  collecting data due to the following reasons:

  1. No funds allocated to fund data collection at the level of the Ministry of  Health or local health authorities;
  2. No funds allocated for collecting data or analysing it due to the  inexperience of people who now running the data collection centre at the  Ministry of Health;
  3. There is no money to train hospital and primary healthcare staff to collect  data, so the staff continue to provide inaccurate data due to their ignorance  and poor experience in this field;
  4. Doctors often make up data, either because they do not care or have no  experience in collecting and analysing it due to lack of training in this field  at medical schools and when they start practicing medicine.
  5. Doctors tend to protect their image by providing excessive numbers of  patients they have treated, but not the numbers who died or who were infected or  suffered other consequences because of their malpractices;
  6. The managers and administrator lack the experience and training in  understanding the value of collecting data; this lead them to focus their  efforts on other activities and to ignore their role as data collectors;
  7. Many managers and administrators deliberately hide significant data so they  will not exposed to criticism and only provide data that may generate incentives  for them rather than helping to improve quality of services and care to  public;
  8. Many systems are too poorly managed across all sectors, and worse at the  level of ministry of health to allow the managers and administrators to exercise  more control over what information they release;
  9. Doctors do not value data collection, nor pay attention to it;
  10. Hospital management does not support data collection because it could  demonstrate their inability to run the hospital efficiently.

The Health Information Centre in Libya is the prime source of information for  the sector in Libya but it lacks of leadership, money and plans. Measures need  to be taken to improve the centre in order to achieve the Health Ministry’s  strategic plans. Without implementing such measures, it will be very difficult  to build a quality health care system in Libya. Data gathering and propers  analysis will help the Health Ministry convince the Planning Minister to agree  to strategic plan put by it to develop health services in Libya.

These measures needing to be taken include:

  1. A central department for health information with annual statistical reports  from other centres feeding information regularly to this centre;
  2. Staff trained on how to gather and use data for decision-making related to  public healthcare and for achieving goals drawn up by a strategic committee at  the chaired by the Minister of Health;
  3. A culture of keeping medical records (patients’ notes, activities of  inpatient and outpatient care, primary health care activities, medicine, staff,  appraisal, mortality and morbidity, and so forth;
  4. Managers, doctors and administrators encouraged to use statistical  approaches to evaluate their work and measure their achievement through policies  and standards;
  5. Build up expertise within the health information centres that develops  statistical documentation and analyses data effectively and accurately;
  6. Provide information technology for collecting, storing and analysing  data;
  7. Health surveys, a central data base and library are very important  departments in gathering information as well as providing proper statistical  information;
  8. As a result of data collection and analysis, the dissemination of  information about disease in Libya and surrounding areas so as to enable the  Heath Ministry to make plans for control and eradication;
  9. Should introduce and encourage studies in health statistics to learn  methodologies in different areas;
  10. Promote epidemiological studies and coordinate work between different  centres to enable the Heath Ministry to plan and impact on all people across  Libya;
  11. Periodic evaluation of the health information centre (audit, commissioning  and appraisal)

There is an excellent opportunity here for investors to come forward with a  proposal to help Libyan government tackle the data collection issue. Expertise  in this field are scarce. The new Libyan government should not be ashamed to ask  for help ; data collection is a vital tool for all decision makers.

Information in regards to the health sector is absent in Libya and it is one  of reasons so much money been spent on building, importing different drugs,  equipment and hiring foreign employees. This all done without clear data  available to enable decision-makers to know what is needed in next five to ten  years.

The lack of data is a massive impediment. For example, no one knows how many  people were injured during the liberation or even how many were killed or went  missing during the struggle. The numbers are inaccurate because there have been  no systematic collection of data. I myself instructed the director of the  information centre at Health Ministry to set up ten committee to collect data  from all over Libya as to the war wounded, martyrs and missing persons. This was  to enable us to know how to provide adequate health care for this group and was  to be a priority. Unfortunately, nothing was done before I left office and till  today nothing still has been done.  Whether this is due to inability or  obstruction or something else remains to be seen.

It is now a major priority for Libya to create information centres for  everything and each minister should be planning his own centre, setting forth  measures, as above, to make it effective. If this does not happen, Libya will  keep spending money as if pouring water down a hole. Strategic planning needs  accurate data and without data Libya will take decades to stand on its feet.

Dr Nagi Giumma Barakat Former Minister of Health,  NTC Consultant paediatric neurologist

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