JSI RESOURCES: Journal article

Contribution of health information system to child immunization services in Ethiopia: baseline study of 33 woredas

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Monitoring progress using appropriate data, with a functional health information system (HIS), is believed to be very crucial for the success of an immunization program. This baseline study was conducted to assess, immunization service coverage, HIS performance status, and their relationships. The research team concurrently conducted a linked facility and population-based survey from September 21 to October 15, 2020, reaching a total of 3,016 households in the 33 woredas; eighty-one health posts; 71 health centers; and 15 hospitals. The study used modified Performance of Routine Information System Management (PRISM) tools for the facility survey and a structured questionnaire for the household survey. Using STATA 14.0 software, mixed effect modeling was employed to control the effect of clustering and potential confounders.

The proportion of fully immunized children was 58%. Coverages of measles (at least one dose) and penta3 immunization (received all 3 doses of DPT-HepB-Hib vaccine) were 86%, and 85% respectively. About 27% of mothers had missed their child immunization card mainly due to misplacing or lost. Except 'source document completeness' (85%) and 'use of data for planning and target setting' (84%), other data quality and use indicators like 'data accuracy' (63%), 'data use for performance review and evidence-based decision making' (50%), and 'data use to produce analytical reports' (31%) show low performance.

While child immunization coverages are promising, the current HIS performance is suboptimal. Both service user and HIS-related factors are important for immunization service uptake. Documenting required information and advising mothers to keep immunization cards by health workers, and working to have functional HIS are recommended.

Authors: Abebaw Worku, Hibret Alemu, Hiwot Belay, Afrah Mohammedsanni, Wubshet Denboba, Frehiwot Mulugeta, Shemsedin Omer, Biruk Abate, Mesoud Mohammed, Mohammed Ahmed, Yakob Wondarad, Meskerem Abebaw

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