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

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.

FIGURE 1

Data Quality and Use Interventions Developed Under the Better Immunization Data Initiative Work

FIGURE 2

Illustrative Depiction of Health Workers Progressing Through 3 Waves of Data Use

Paul Urioh, a health worker at Mareu Health Center in Tanzania, reviews patient data in Tanzania's electronic immunization registry. © 2015 Trevor Snapp/PATH

FIGURE 3

Perceptions of Data Quality Among Facility In-Charges and Immunization Nurses in Tanga Region, Tanzania

Nurses in Arusha, Tanzania scan child health cards. © 2015 Riccardo Gangale/Bill & Melinda Gates Foundation

FIGURE 4

Ability to Identify Low DPT3 Coverage Areas, Defaulters, and Vaccine Stock Levels Among Facility Health Care Workers, Baseline Versus Midline, Southern Province, Zambia Abbreviations: DPT3, third dose of diphtheria, pertussis, and tetanus vaccine.