Assessing the performance of the family folder system for collecting community-based health information in Tigray Region, North Ethiopia: a capture-recapture study.

OBJECTIVES:To assess completeness and accuracy of the family folder in terms of capturing community-level health data. STUDY DESIGN:A capture-recapture method was applied in six randomly selected districts of Tigray Region, Ethiopia. PARTICIPANTS:Child health data, abstracted from randomly selected 24 073 family folders from 99 health posts, were compared with similar data recaptured through household survey and routine health information made by these health posts. PRIMARY AND SECONDARY OUTCOME MEASURES:Completeness and accuracy of the family folder data; and coverage selected child health indicators, respectively. RESULTS:Demographic data captured by the family folders and household survey were highly concordant, concordance correlation for total population, women 15-49 years age and under 5-year child were 0.97 (95% CI 0.94 to 0.99, p<0.001), 0.73 (95% CI 0.67 to 0.88) and 0.91 (95% CI 0.85 to 0.96), respectively. However, the live births, child health service indicators and child health events were more erratically reported in the three data sources. The concordance correlation among the three sources, for live births and neonatal deaths was 0.094 (95% CI -0.232 to 0.420) and 0.092 (95% CI -0.230 to 0.423) respectively, and for the other parameters were close to 0. CONCLUSION:The family folder system comprises a promising development. However, operational issues concerning the seamless capture and recording of events and merging community and facility data at the health centre level need improvement.