Clinton Health Access Initiative Inc, PO Box 2664, Yaounde, Cameroon.
Institute for Global Health, University of Siena, Siena, 53100, Italy.
BMC Health Serv Res. 2023 Sep 27;23(1):1033. doi: 10.1186/s12913-023-09965-9.
One crucial obstacle to attaining universal immunization coverage in Sub-Saharan Africa is the paucity of timely and high-quality data. This challenge, in part, stems from the fact that many frontline immunization staff in this part of the world are commonly overburdened with multiple data-related responsibilities that often compete with their clinical tasks, which in turn could affect their data collection practices. This study assessed the data management practices of immunization staff and unveiled potential barriers impacting immunization data quality in Cameroon.
A descriptive cross-sectional study was conducted, involving health districts and health facilities in all 10 regions in Cameroon selected by a multi-stage sampling scheme. Structured questionnaires and observation checklists were used to collect data from Expanded Program of Immunization (EPI) staff, and data were analyzed using STATA VERSION 13.0 (StataCorp LP. 2015. College Station, TX).
A total of 265 facilities in 68 health districts were assessed. There was limited availability of some data recording tools like vaccination cards (43%), maintenance registers (8%), and stock cards (57%) in most health facilities. Core data collection tools were incompletely filled in a significant proportion of facilities (37% for registers and 81% for tally sheets). Almost every health facility (89%) did not adhere to the recommendation of filling tally sheets during vaccination; the filling was instead done either before (51% of facilities) or after (25% of facilities) vaccinating several children. Moreso, about 8% of facilities did not collect data on vaccine administration. About a third of facilities did not collect data on stock levels (35%), vaccine storage temperatures (21%), and vaccine wastage (39%).
Our findings unveil important gaps in data collection practices at the facility level that could adversely affect Cameroon's immunization data quality. It highlights the urgent need for systematic capacity building of frontline immunization staff on data management capacity, standardizing data management processes, and building systems that ensure constant availability of data recording tools at the facility level.
在撒哈拉以南非洲地区，实现全民免疫覆盖的一个关键障碍是缺乏及时和高质量的数据。这一挑战在一定程度上源于这样一个事实，即该地区的许多一线免疫工作人员通常承担着多项与数据相关的职责，这些职责常常与他们的临床任务相竞争，这反过来又可能影响他们的数据收集实践。本研究评估了免疫工作人员的数据管理实践，并揭示了影响喀麦隆免疫数据质量的潜在障碍。
采用描述性横断面研究方法，通过多阶段抽样方案在喀麦隆所有 10 个地区的卫生区和卫生机构中进行。使用结构化问卷和观察检查表从扩大免疫规划（EPI）工作人员那里收集数据，使用 STATA VERSION 13.0（StataCorp LP. 2015. College Station, TX）进行数据分析。
共评估了 68 个卫生区的 265 个设施。大多数卫生设施中，一些数据记录工具（如疫苗接种卡（43%）、维护登记簿（8%）和库存卡（57%））的供应有限。核心数据收集工具在很大比例的设施中填写不完整（登记簿占 37%，计数表占 81%）。几乎每个卫生机构（89%）都没有按照在接种疫苗期间填写计数表的建议进行操作；填写工作要么在接种多个儿童之前（51%的设施）进行，要么在接种之后（25%的设施）进行。此外，大约 8%的卫生机构没有收集疫苗接种管理数据。大约三分之一的卫生机构没有收集库存水平（35%）、疫苗储存温度（21%）和疫苗浪费（39%）的数据。
我们的研究结果揭示了设施层面数据收集实践中的重要差距，这可能会对喀麦隆的免疫数据质量产生不利影响。它突出表明，迫切需要对一线免疫工作人员进行数据管理能力的系统能力建设，规范数据管理流程，并建立系统，确保在设施层面始终提供数据记录工具。
