TechNet-21 - Forum

This forum provides a place for members to ask questions, share experiences, coordinate activities, and discuss recent developments in immunization.
  1. Narayana Holla
  2. Immunization information systems & coverage monitoring
  3. Sunday, July 02 2017, 03:06 PM

 Dear viewers, 

Vaccination Data management is a long standing universal problem, often discussed in this forum. We (KVG Team) wish to share the attached with the viewers as many of the viewers are in the autorized post and the policy makers for the countries and can solve most of the issues through learning by doing and working together approach. We have comeout with some solutions to share with the country if they wish to.

Recently RCH Officer of Dakshinakannada District, Karnataka State, invited the stakeholders for half a day orientation on how to use properly the revised HMIS form received from the centre.

In India, HMIS is facility based / service based - i.e. service provider has to report services provided by the person / institution (HSC / Planning unit / Nursing Home / College Hospital) in the HMIS. It cannot provide denominators and numerators and hence indicators cannot be derived. One or more line-items are not applicable to reporting units [HSC/PHC/DH/Medical College/Private Hospital]. It provides a common “wholesome” reporting form.

Hoping to be useful to the country

Narayana Holla V 

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Narayana Holla Accepted Answer

Dear viewers

We the KVG team thought of sharing the true illustrations 

RI performances in India are often reviewed using HMIS generated indicators. Inspite of very high vaccination coverage, ANMs of RHTC Sampaje used to get depressed in every monthly review meeting as the HMIS based indicators could not reflect the true coverage.

We wish to share the illustration with the viewers for additional opinion and do these happen in other countries too.

As expressed earlier, we have come out with some solutions and wish to collaborate with the policy makers, development partners, RI players.

With best wishes

Holla

Attachments (1)
Narayana Holla Accepted Answer

Thanks for responding and sharing the experiences.

Stakeholders including service providers from the private sector are regularly invited to attend the meetings and training workshops at all levels with a request to contribute constructive suggestions. This provides an opportunity to update the operational knowledge in the private sector, e.g. in the recent meeting, private practiotiners expressed that they are administering 3 doses of TT in the first pregnancy and one dose in the subsequent pregnancy within 5 years; administering 0.1mL BCG to the newborns instead of 0.05mL. NIS recommends 2 doses in the 1st pregnancy and booster dose in the 2nd pregnancy within 3 years; 0.05mL BCG to the newborns within 30 days.

Vaccination schedule practiced by the private sector colosally differs not only from the NIS but differs from one provider to another and among the pediatricians of the same institution. There is no standard updated uniform schedule and hence the data finds no corresponding cells in the HMIS.

Even in the govt sector, as HMIS has no denominator / qualifying numerator; reviewing the performance with the spurious indicators greatly depresses the grass-root level workers. 

 

For addressing this, we 'discovered' a few operable solutions but no "TAKERS". We are looking for a reponsible implementer to share our innovations. 

Promoting and nurturing local innovations is extremely important for suatenance as narrated by WHO / National Health Mission. 

We - the KVG team will hope that authorized people from the Govt / development agencies will officially cross visit for bridging the gaps between the private and the Govt sector for collecting qualifying useable data for meanigful interpretation to obtain required information for appropriate action; giving an opportunity to share our innovations to strengthen the programme & serve the country. 

with best of hopes from the KVG Team

Thank you for sharing. 

In Latin America, we had the opportunity to look a bit at this during DQS and surveys. From a particular DQS, it was stricking to find that hexavalent and other combination vaccines from the private sector were reported, but had not been added to the monthly reports. They were being recorded as "other" vaccines, rather than counting them as IPV, DTaP, Hib and HepB, for example. 

Surveys may provide an opportunity to get an estimate on the proportion of vaccines given in the private sector (to then triangulate with admin data, fr example). However, it may be a bit tricky, given that the question could be just "where do you most often vaccinate your child" or "where did you take your child for his/her latest vaccines" vs. more complicated attempts at trying to look at vaccine by vaccine. In El Salvador 2012 survey, they noted that vaccination in the private sector was more common for earlier doses. In Bolivia 2013, they found big differences in % of vaccination by private providers in large cities vs. the rest of the country. 

The issue of reporting from the private sector, it is certainly a big problem in some settings. Please keep us posted on the use of the new form.



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