Abstract
BACKGROUND: The District Health Information System (DHIS2) is a modular, cloud-based data management system designed for use in integrated health information systems. In Nigeria, it serves as the repository for routine health data, including measles. A first dose of measles is given routinely in most countries, however, for a country to include a second dose of measles in the routine immunization schedule, it must meet certain criteria set by the World Health Organization (WHO). Unfortunately, Nigeria falls into the category of countries that haven’t met the criteria. Despite this, MCV2 data can be seen on the DHIS2 platform. Data from DHIS2 also shows that Gombe State has the highest number of health facilities that reported MCV2 data at least once from 2015 to 2017.
 
 The aim of the study was to determine the reasons for the MCV2 reporting on DHIS2 platform for Gombe State. 
 
 METHOD: We conducted a cross-sectional study among health workers in selected health facilities and LGA RI Officers at the LGA level in Gombe State. Health facility registers were reviewed, and data consistency was ascertained. We reviewed and conducted secondary data analysis of MCV2 data for Gombe State from January 2015 to December 2017.
 
 RESULTS: Of the 22 health facilities assessed, 14 health facilities (12 public and 2 private) reported offering MCV2 during the health facility-level interviews. At the LGA level, 5 LGAs out of the 11 LGAs reported during the LGA-level interviews that a second dose of measles is part of the RI schedule in their respective LGAs. For the 6 LGAs that reported not offering a second dose of measles as part of the RI schedule, 3 LGAs identified data entry error as the possible reason for having MCV2 data in the DHSI2 platform while the remaining 3 LGAs reported that the MCV2 data in the DHIS2 platform can be attributed to recording children who didn’t receive a first dose of measles at 9 months but received at 18–23 months as second dose of measles.
 
 CONCLUSION: Data entry error and knowledge gap on how to record measles data were identified factors responsible for MCV2 data on the DHIS2 platform. There is a need for targeted interventions towards improving the quality of RI data in Nigeria.
Highlights
One-third of children in many African countries get infected with measles within the first 2 years of life (Ibrahim, Usman, Muhammed, & Okunromade, 2017)
For the 6 Local Government Area (LGA) that reported not offering a second dose of measles as part of the Routine Immunization (RI) schedule, 3 LGAs identified data entry error as the possible reason for having MCV2 data in the DHSI2 platform while the remaining 3 LGAs reported that the MCV2 data in the District Health Management Information System version 2 (DHIS2) platform can be attributed to recording children who didn’t receive a first dose of measles at 9 months but received at 18–23 months as second dose of measles
These meetings should include data validation sessions where health facility workers are expected to come with the data tools to the LGA secretariat for data validation and verification), the sub-optimal quality of immunization data noticed in the LGAs, health facilities and DHIS2 suggest that little or no data validation and review is conducted
Summary
One-third of children in many African countries get infected with measles within the first 2 years of life (Ibrahim, Usman, Muhammed, & Okunromade, 2017). In Africa, measles remains one of the leading causes of morbidity and mortality These high case-fatality rates can be linked to infection at a young age, poor shelter and overcrowding, underlying immune deficiency disorders due to malnutrition, vitamin A deficiency, and lack of access to medical care (Ibrahim et al, 2017). While Measles Containing Vaccine first dose (MCV1) has been given routinely in most countries at 9–12 months of age, WHO recommends that Measles Containing Vaccine second dose (MCV2) be included in the routine immunization schedule of countries that have attained ≥ 80% coverage of MCV1 nationally for at least 3 years (WHO, 2009). A first dose of measles is given routinely in most countries, for a country to include a second dose of measles in the routine immunization schedule, it must meet certain criteria set by the World Health Organization (WHO). Data from DHIS2 shows that Gombe State has the highest number of health facilities that reported MCV2 data at least once from 2015 to 2017
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