Administrative data linkage and its usefulness in public health: the case of Ecuador

The objective of this article is to describe the characteristics of addressing the linkage of administrative databases and the uses of such linkages in public health research, and also to discuss the opportunities and challenges for implementation in Ecuador. The linkage of databases makes it possible to integrate a person's data that may be scattered across different subsectors such as health, education, justice, immigration, and social programs. It also facilitates research that can inform more efficient management of social and health programs and policies. The main advantages of using linked databases are: diversity of data, population coverage, stability over time, and lower cost in comparison to primary data collection. Despite the availability of tools to process, link, and analyze large data sets, there has been minimal use of this approach in Latin American countries. Ecuador is well positioned to implement this approach, due to compulsory use of a unique ID in health services delivery, which permits linkages with other national information systems. However, the country faces several cultural, technical, ethical, legal, and political challenges. To take advantage of its potential, Ecuador needs to develop a data governance strategy that includes standards for data access and data use, as well as mechanisms for data control and quality, greater investment in professional training in data use both within and beyond the health sector, and collaborations between government entities, universities, and civil society organizations.