Implementing the routine immunisation data module and dashboard of DHIS2 in Nigeria, 2014-2019

Abstract

In 2010, Nigeria adopted the use of web-based software District Health Information System, V.2 (DHIS2) as the platform for the National Health Management Information System. The platform supports real-time data reporting and promotes government ownership and accountability. To strengthen its routine immunisation (RI) component, the US Centers for Disease Control and Prevention (CDC) through its implementing partner, the African Field Epidemiology Network-National Stop Transmission of Polio, in collaboration with the Government of Nigeria, developed the RI module and dashboard and piloted it in Kano state in 2014. The module was scaled up nationally over the next 4 years with funding from the Bill & Melinda Gates Foundation and CDC. One implementation officer was deployed per state for 2 years to support operations. Over 60 000 RI healthcare workers were trained on data collection, entry and interpretation and each local immunisation officer in the 774 local government areas (LGAs) received a laptop and stock of RI paper data tools. Templates for national-level and state-level RI bulletins and LGA quarterly performance tools were developed to promote real-time data use for feedback and decision making, and enhance the performance of RI services. By December 2017, the DHIS2 RI module had been rolled out in all 36 states and the Federal Capital Territory, and all states now report their RI data through the RI Module. All states identified at least one government DHIS2 focal person for oversight of the system's reporting and management operations. Government officials routinely collect RI data and use them to improve RI vaccination coverage. This article describes the implementation process-including planning and implementation activities, achievements, lessons learnt, challenges and innovative solutions-and reports the achievements in improving timeliness and completeness rates.

Keywords: vaccines.

Figure 1

Visualisation of four AFRIN indicators on the DHIS2 RI dashboard (September 2019). AFRIN, Accountability Framework for RI in Nigeria; DHIS2, District Health Information System, V.2; LGAs, Local Government Areas; RI, routine immunisation.

Figure 2

Implementation phases of the DHIS2 RI module and dashboard in each state over a 2-year period. DHIS2, District Health Information System, V.2; RI, routine immunisation.

Figure 3

Completeness rate of the monthly reporting for the four sources of RI data in Nigeria, from the launch of the DHIS2 RI module project in November 2014 to July 2019*. *The data do not represent the 774 LGAs at one time. Rather, information from the LGAs was added as each state moved into the active phase. The graph reports information on all LGAs starting in December 2017. DHIS2, District Health Information System, V.2; HF, health facility; LGAs, local government areas; NHMIS, National Health Management Information System; RI, routine immunisation.

Figure 4

Example of RI data quality improvement on the RI module. Three has been a steady reduction in the number of data entry errors* since January 2019. *There should be no data entry for antigens hepatitis B, doses 1 and 2 because they are not included in the Nigerian immunisation schedule. RI, routine immunisation.