Chapter 1. Bottleneck Analysis App¶

1.1 Introduction to the BNA App¶

Bottleneck analysis is a structured analysis of the determinants of coverage for a wide range of interventions delivered through the health sector, useful to supporting targeted operational planning. It is a systematic, outcome-based approach to equitable health programming and real-time monitoring that strengthens the health system, complementing and building on what exists.

The BNA App is developed and maintained by the HISP Community (UiO, HISP-Tanzania and HISP Uganda) in collaboration with UNICEF. The BNA app is available in the DHIS 2 Play store for download. It is currently compatible with DHIS2 2.28 and above.

1.2 Advantages of the BNA App¶

The bottleneck analysis and planning approach contribute to existing national and sub-national planning and monitoring cycles by offering a strategic, rapid and systematic approach to analyzing key health systems barriers to reaching intervention coverage targets. This approach can help save time and increase the efficiency of resources available by identifying where the greatest pockets of unmet needs or poor service outcomes exist and, in those places, identifying key bottlenecks, prioritizing what should be addressed immediately, what should be deferred (prioritization of most effective actions) and ensuring that resources are programmed to tackle priority bottlenecks with evidence-informed solutions.

1.3 Rationale for the BNA App¶

Health managers have competing demands resulting in limited time, resources and training to conduct data analysis. Collecting data from multiple sources and preparing it for analysis themselves can be a barrier to effectively using data for planning. While the growing trend of building dashboards into DHIS2 is encouraging, too often the information displayed in dashboards is a collection of related (or sometimes unrelated) indicators rather than a well thought out process (or framework) of how a workflow or intervention actually works. The bottleneck analysis app helps address these issues by automating data gathering and presentation within DHIS2 and displaying it in a manner that facilitates systematic analysis for programming. Effective and timely use of DHIS2 data by stakeholders at all levels of the health system is critical for health service delivery. DHIS2 dashboards have the potential to enhance the use of data for decision making and planning by displaying information for managers in an accessible and actionable manner. This visualization is made possible by using the bottleneck analysis model integrated with the causality and tracking actions/solutions to effect interventions.