Omoleke Semeeh Akinwale, Tadesse Menberu Getachew
World Health Organisation, Office of Country Representative, Abuja, Nigeria.
Pan Afr Med J. 2017 Aug 2;27:239. doi: 10.11604/pamj.2017.27.239.11875. eCollection 2017.
As a result of poor quality administrative data for routine immunisation (RI) in Nigeria, the real coverage of RI remains unknown, constituting a setback in curtailing vaccine preventable diseases (VPDs). Consequently, the purpose of this pilot study is to identify source(s) and evaluate the magnitude of poor data quality as well as propose recommendations to address the problem.
The authors conducted a cross-sectional study in which 5 out of the 22 health facilities providing routine immunization services in Bunza Local Government Area (LGA), Kebbi State, Nigeria, were selected for data quality assessment. The reported coverage of RI in August and September, 2016 was the primary element of evaluation in the selected Health Facilities (HFs). Administered questionnaires were adapted from WHO Data Quality Assurance and RI monitoring tools to generate data from the HFs, as well as standardised community survey tool for household surveys.
Data inconsistency was detected in 100% of the selected HFs. Maximum difference between HF monthly summary and RI registration book for penta 3 data quality report analysis was 820% and 767% in MCH Bunza and PHC Balu respectively. However, a minimum difference of 3% was observed at Loko Dispensary. Maximum difference between HF summary and RI registration for measles was 614% at MCH Bunza and 43% minimum difference at Loko. In contrast to the administrative coverage, 60-80% of the children sampled from households were either not immunised or partially immunised. Further, the main sources of poor data quality include heavy workload on RI providers, over-reliance on administrative coverage report, and lack of understanding of the significance of high data quality by RI providers.
Substantial data discrepancies were observed in RI reports from all the Health Facilities which is indicative of poor data quality at the LGA level. Community surveys also revealed an over-reporting from administrative coverage data. Consequently, efforts should be geared towards achieving good data quality by immunisation stakeholders as it has implication on disease prevention and control efforts.
由于尼日利亚常规免疫(RI)行政数据质量较差,RI的实际覆盖率仍然未知,这对控制疫苗可预防疾病(VPDs)构成了挫折。因此,本试点研究的目的是确定数据质量差的来源并评估其严重程度,并提出解决该问题的建议。
作者进行了一项横断面研究,在尼日利亚凯比州邦扎地方政府辖区(LGA)提供常规免疫服务的22个卫生设施中,选择了5个进行数据质量评估。2016年8月和9月报告的RI覆盖率是所选卫生设施(HFs)评估的主要内容。所发放的问卷改编自世界卫生组织的数据质量保证和RI监测工具,以从HFs收集数据,以及用于家庭调查的标准化社区调查工具。
在所有选定的HFs中均检测到数据不一致。在邦扎妇幼保健中心(MCH Bunza)和巴卢初级卫生保健中心(PHC Balu),五价疫苗3数据质量报告分析中,HF月度总结与RI登记册之间的最大差异分别为820%和767%。然而,在洛科药房观察到的最小差异为3%。邦扎妇幼保健中心麻疹HF总结与RI登记之间的最大差异为614%,洛科的最小差异为43%。与行政覆盖率相比,从家庭中抽取的儿童中有60 - 80%未接种疫苗或部分接种疫苗。此外,数据质量差的主要原因包括RI提供者工作量大、过度依赖行政覆盖率报告以及RI提供者对高数据质量的重要性缺乏理解。
在所有卫生设施的RI报告中均观察到大量数据差异,这表明LGA层面的数据质量较差。社区调查还显示行政覆盖率数据存在报告过度的情况。因此,免疫利益相关者应努力实现良好的数据质量,因为这对疾病预防和控制工作具有重要意义。