Three Waves of Data Use Among Health Workers: The Experience of the Better Immunization Data Initiative in Tanzania and Zambia.

Laurie Werner,Dawn Seymour,Chilunga Puta,Skye Gilbert

doi:10.9745/ghsp-d-19-00024

Abstract

The governments of Tanzania and Zambia identified key data-related challenges affecting immunization service delivery including identifying children due for vaccines, time-consuming data entry processes, and inadequate resources. To address these challenges, since 2014, the countries have partnered with PATH's Better Immunization Data Initiative to design and deploy a suite of data quality and use interventions. Two key aspects of the interventions were an electronic immunization registry and tools and practices to strengthen a culture of data use. As both countries deployed the interventions, 3 distinct changes in data use emerged organically. This article provides a detailed summary of these 3 phases or waves, based mostly on qualitative data or observation: (1) strengthening data collection using new data collection tools and processes and increasing efficiency of health workers; (2) improving data quality regarding accuracy and completeness; and (3) increasing use of data to take action to strengthen their work and for programmatic decision making. These waves clearly demonstrated the growing ability of health workers to move from data collectors to data analyzers who began to focus on the data quality and then the value of using the data in their day-to-day activities.

Highlights

Global Health: Science and Practice 2019 | Volume 7 | Number 3 better data plus better decisions will lead to better health outcomes.Both Tanzania and Zambia have seen their national coverage rates increase, but continue to face challenges with regions having low coverage.[3]
When the Better Immunization Data (BID) Initiative work began in 2014, Tanzania and Zambia government stakeholders identified several challenges with data use in their health systems that contributed to these inequities[4]:
When tools for health service delivery are redesigned or new, it is important to consider how the tools can impact data quality and use and how the impact unfolds over time or, as seen with BID, progresses across multiple waves

Summary

INTRODUCTION

Global Health: Science and Practice 2019 | Volume 7 | Number 3 better data plus better decisions will lead to better health outcomes. Experience of the Better Immunization Data Initiative www.ghspjournal.org reports for the district level) consumes time, especially when 1 or 2 health workers vaccinate hundreds of children. The BID Initiative, building on periodic literature reviews, a dynamically updated theory of change, and frequent consultations with user advisory groups in Tanzania and Zambia, developed a suite of data quality and use interventions to address these challenges and to begin to build a data use culture to “support and encourage the use of evidence, including facts, figures, and statistics, to inform their decision making” (Figure 1).[5,6,7,8,9,10,11,12] The user advisory groups included immunization health workers from all levels of the health system. The interventions were tested in facilities and districts and developed iteratively before a final suite of complementary

Electronic immunizaƟon record

Increasing use of data for programmatic decision making

Findings

CONCLUSION