Redefining vaccination coverage and timeliness measures using electronic immunization registry data in low- and middle-income countries

Dolan, Samantha B.; Carnahan, Emily; Shearer, Jessica; Beylerian, Emily; Thompson, Jenny; Gilbert, Skye S.; Werner, Laurie; Ryman, Tove K.

doi:10.1016/j.vaccine.2019.02.017

Cited by 45 publications

(45 citation statements)

References 28 publications

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“…First, as shown with the data from the 14 countries, there are major data quality problems that need to be addressed in the coming years, including improvement of estimation of target populations. Several studies have described the problems and implemented ways to improve the quality of routine data with varying success, including training of health workers, strengthening of feedback, introduction of case-based electronic management systems, data verification surveys and other interventions 5 14 30–32…”

Section: Resultsmentioning

confidence: 99%

Generating statistics from health facility data: the state of routine health information systems in Eastern and Southern Africa

et al. 2019

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Health facility data are a critical source of local and continuous health statistics. Countries have introduced web-based information systems that facilitate data management, analysis, use and visualisation of health facility data. Working with teams of Ministry of Health and country public health institutions analysts from 14 countries in Eastern and Southern Africa, we explored data quality using national-level and subnational-level (mostly district) data for the period 2013–2017. The focus was on endline analysis where reported health facility and other data are compiled, assessed and adjusted for data quality, primarily to inform planning and assessments of progress and performance. The analyses showed that although completeness of reporting was generally high, there were persistent data quality issues that were common across the 14 countries, especially at the subnational level. These included the presence of extreme outliers, lack of consistency of the reported data over time and between indicators (such as vaccination and antenatal care), and challenges related to projected target populations, which are used as denominators in the computation of coverage statistics. Continuous efforts to improve recording and reporting of events by health facilities, systematic examination and reporting of data quality issues, feedback and communication mechanisms between programme managers, care providers and data officers, and transparent corrections and adjustments will be critical to improve the quality of health statistics generated from health facility data.

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Section: Resultsmentioning

confidence: 99%

Generating statistics from health facility data: the state of routine health information systems in Eastern and Southern Africa

et al. 2019

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“…The EIR was rolled-out in the remaining 2 districts on March 01, 2020, and July 03, 2020, therefore their targets have not been taken into account. Under-registration in EIRs has been identified as a significant challenge for data utilization [61] . Another limitation is the lack of exact slum area mapping.…”

Section: Discussionmentioning

confidence: 99%

Impact of COVID-19 pandemic response on uptake of routine immunizations in Sindh, Pakistan: An analysis of provincial electronic immunization registry data

Chandir

Siddiqi²,

Mehmood

et al. 2020

Vaccine

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Highlights One out of two children missed routine immunizations during COVID-19 lockdown in Sindh. COVID-19 lockdown disproportionately affected coverage rates across the districts. Drop in the number of immunizations was higher in rural areas followed by urban slums. Expanding pool of un-immunized children is bringing down herd immunity and raising the risk of vaccine-preventable disease outbreaks.

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“…Completion and timeliness of routine vaccination as recommended by the World Health Organization (WHO) are very crucial for maximum protection of children against specific infections [8]. To effectively control vaccine preventable diseases (VPDs), high immunization coverage is required with a targeted coverage level of 90% recommended by the WHO.…”

Section: Introductionmentioning

confidence: 99%

Timely completion of vaccination and its determinants among children in northwest, Ethiopia: a multilevel analysis

et al. 2020

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Background: Timely vaccination is key to prevent unnecessary childhood mortality from vaccine-preventable diseases. Despite the substantial efforts to improve vaccination completeness, the effort towards timeliness of vaccination is limited with non-attendance and delays to vaccination appointments remaining a big challenge in developing countries. There is also a limited evidence on timeliness of vaccination. Therefore, this study aimed to determine the magnitude and associated factors for timely completion of vaccination among children in Gondar city administration, northwest , Ethiopia. Method: This study employed a community-based cross sectional study design. A sample size of 821 children aged 12 to 23 months were considered. Two stages random sampling technique was used to select study subjects. To account the effect of clustering, bivariable and multivariable multilevel logistic regression analysis were applied. The measures of association estimates were expressed as adjusted odds ratio (AOR) with their 95% confidence intervals (CIs). Results: Of the 774 children included for analysis, 498 (64.3%) were fully vaccinated while 247 (31.9%) were fully vaccinated on-time. Caregivers who had secondary education and above (AOR = 2.391; 95% CI: 1.317-4.343), from richest households (AOR = 2.381; 95% CI: 1.502-3.773), children whose mother attended four or more ante natal care visits (AOR = 2.844; 95% CI: 1.310-6.174) and whose mother had two or more post natal care visits (AOR = 2.054; 95%CI:1.377-3.063) were positively associated with on-time full vaccination. In contrary, caregivers aged above 35 years (AOR = 0.469; 95 % CI: 0.253-0.869], being vaccinated at health post (AOR = 0.144; 95%CI: 0.048-0.428) and travelling more than 30 min to the vaccination site (AOR = 0.158; 95%CI: 0.033-0.739) were negatively associated with on-time full vaccination. The random effects indicated that 26% of the variability in on-time full vaccination was attributable to differences between communities. Conclusion: In this study, untimely vaccination was found to be high. Different individual and contextual factors were found to be associated with on-time full vaccination. Therefore, tailored strategies have to be designed and implemented to address people and the communities where they live. Moreover, timeliness of vaccination should be considered as important indicator of the immunization program performance in Ethiopia.

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Redefining vaccination coverage and timeliness measures using electronic immunization registry data in low- and middle-income countries

Cited by 45 publications

References 28 publications

Generating statistics from health facility data: the state of routine health information systems in Eastern and Southern Africa

Generating statistics from health facility data: the state of routine health information systems in Eastern and Southern Africa

Impact of COVID-19 pandemic response on uptake of routine immunizations in Sindh, Pakistan: An analysis of provincial electronic immunization registry data

Timely completion of vaccination and its determinants among children in northwest, Ethiopia: a multilevel analysis

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