TechNet-21 - Forum

This forum provides a place for members to ask questions, share experiences, coordinate activities, and discuss recent developments in immunization.
  1. Hemanthi
  2. Immunization information systems & coverage monitoring
  3. Tuesday, 10 October 2017

PAHO highlights four immunization data related activities - please see the Global Immunization News (GIN) - September 2017 (http://www.who.int/immunization/GIN_September_2017.pdf?ua=1) for full articles:

Training on monitoring vaccination coverage and preventive chemotherapy to eliminate lymphatic filariasis (GIN, Page 14)

Workshop on Immunization Data Quality in Nicaragua (GIN, Page 15)

Countries from Africa and the Americas share/exchange their experiences with the Electronic Immunization Registry (EIR) information system (GIN, Page 16)

Workshop on Electronic Immunization Registries (EIRs) in Argentina (GIN page 17)

References
  1. http://www.who.int/immunization/GIN_September_2017.pdf?ua=1
Dr Khalid Accepted Answer
EXTENT OF DATA FALSIFICATION FROM THE SOURCE(HFs) IN NIGERIA
 
Quality immunization data is one of the major challenge of immunization in Nigeria. Data as a tool used to monitor performance for action become difficult to analysed, difficult to make decisions, difficult to planning and difficult for utilization of scarce available resources. How quality is our data? How can we used the data for planning? how could the data generated translate into financial support derived from donors?  
Possible causes for data falsification 
1. Deliberate falsification of data. 
2. Genuine errors, incompleteness of data might be attributed to work overload 
3. Some other legitimate reason – transcription error etc.
 
Planned monitoring and evaluation activity through data quality survey (DQS) was adopted to explore data quality issues at different level of data collect process with emphases on the health facility level (Data source). It conducted in Bauchi state for three consecutive years (2015, 2016 and 2017 recently) which revealed real issues with regard to data inconsistency and other issues of quality of monitoring system like recording, archiving and use of data for action. Recent the state conducted REW microplan exercised using GIS to estimated target population for each HF catchment area with involvement of community members to validate the information, as denominator posed challenge leading outrageous coverage and high administrative data as part of the DQS finding and recommendation. 
 
Attitude of health personnel toward generating false data become persistent with recent experienced of falsification in immunization register in other to reach desired coverages. Community survey during supportive supervision was utilized which became eye opener toward revealing evidence of data falsification in the health facility register. 
Child health cards were retrieved from caregivers and the records on the immunization cards were compared with the available records in the health facility register.  
Some issues identified include discrepancies in date vaccination given, register record not coincide with cards records among others, this clearly revealed deliberate data falsification by RI service provider.
Some other possible reason could be due work overload contribute toward data inconsistencies in some situations, but the nature of falsification is quite worrisome. Health workers really need to buy into the vision for high quality data for better health care service delivery.
 
Solutions
- Embarked on zero tolerance to data falsification with strong accountability framework
- Grant amnesty to all providers for past atrocities and imposed positive behavioral change. 
- Supervisory plan designed focused on tracking and monitoring RI sessions (Both fixed and outreach)
- Capacity building of the supervisors through refresher training on supportive supervision 
- Simple data quality check template to be attached with the current supportive supervisory checklist
- Feedback of data quality on monthly basis during monthly meeting with the providers
 
Recommendations: - 
- Change management activities so that health workers really do buy into the vision for high quality data for better health care service delivery through behavioral change strategy (Attitudinal change)
- Effective accountability framework strategy clearly highlights the need for quality data
 
CONCLUSION
Health workers at health facility level need to have an appreciation of the value of health data particularly for efficient and effective programming and by extension better health services and healthier populations, a key factor in national development. 
 
Dr khalid A Isah
Cluster consultant,
World Health Organisation (WHO)
No. 20 Ahmed Abdulkadir Bank Road,
WHO/Unicef Shared Premises Bauchi Nigeria.
Contact:- +2348038675855
E-mail; shamlid448@gmail.com                              
 


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