Assessment of VaxTrac electronic immunization registry in an urban district in Sierra Leone: Implications for data quality, defaulter tracking, and policy.

Autor: Jalloh MF; Immunization Systems Branch, Global Immunization Division, U.S. Centers for Disease Control and Prevention, Atlanta, United States. Electronic address: yum8@cdc.gov., Namageyo-Funa A; Strategic Information and Workforce Development Branch, Global Immunization Division, U.S. Centers for Disease Control and Prevention, Atlanta, United States., Gleason B; Sierra Leone Country Office, Division of Global Health Protection, U.S. Centers for Disease Control and Prevention, Freetown, Sierra Leone., Wallace AS; Immunization Systems Branch, Global Immunization Division, U.S. Centers for Disease Control and Prevention, Atlanta, United States., Friedman M; Sierra Leone Country Office, Division of Global Health Protection, U.S. Centers for Disease Control and Prevention, Freetown, Sierra Leone., Sesay T; Sierra Leone Ministry of Health and Sanitation, Freetown, Sierra Leone., Ocansey D; Health Africa, Freetown, Sierra Leone., Jalloh MS; Health Africa, Freetown, Sierra Leone., Feldstein LR; Immunization Systems Branch, Global Immunization Division, U.S. Centers for Disease Control and Prevention, Atlanta, United States., Conklin L; Immunization Systems Branch, Global Immunization Division, U.S. Centers for Disease Control and Prevention, Atlanta, United States., Hersey S; Sierra Leone Country Office, Division of Global Health Protection, U.S. Centers for Disease Control and Prevention, Freetown, Sierra Leone., Singh T; Sierra Leone Country Office, Division of Global Health Protection, U.S. Centers for Disease Control and Prevention, Freetown, Sierra Leone., Kaiser R; Sierra Leone Country Office, Division of Global Health Protection, U.S. Centers for Disease Control and Prevention, Freetown, Sierra Leone.
Jazyk: angličtina
Zdroj: Vaccine [Vaccine] 2020 Sep 03; Vol. 38 (39), pp. 6103-6111. Date of Electronic Publication: 2020 Aug 01.
DOI: 10.1016/j.vaccine.2020.07.031
Abstrakt: Background: In 2016, the Sierra Leone Ministry of Health and Sanitation (MoHS) piloted VaxTrac, an electronic immunization registry (EIR), in an urban district to improve management of vaccination records and tracking of children who missed scheduled doses. We aimed to document lessons learned to inform decision-making on VaxTrac and similar EIRs' future use.
Methods: Ten out of 50 urban health facilities that implemented VaxTrac were purposively selected for inclusion in a rapid mixed-method assessment from November to December 2017. For a one-month period, records of six scheduled vaccine doses among children < 2 years old in VaxTrac were abstracted and compared to three paper-based records (register of under-two children, daily tally sheet, and monthly summary form). We used the under-two register as the reference gold standard for comparison purposes. We interviewed and observed 10 heath workers, one from each selected facility, who were using VaxTrac.
Results: Overall, VaxTrac captured < 65% of the vaccine doses reported in the paper-based sources, but in the largest health facility VaxTrac captured the highest number of doses. Two additional notable patterns emerged: 1) the aggregated data sources reported higher doses administered compared to the under-two register and VaxTrac; 2) data sources that need real-time data capture during the vaccination session reported fewer doses administered compared to the monthly HF2 summary form. Health workers expressed that the EIR helped them to shorten the time to manage, summarize, and report vaccination records. Workflows for data entry in VaxTrac were inconsistent among facilities and rarely integrated into existing processes. Data sharing restrictions contributed to duplicate records.
Conclusion: Although VaxTrac helped to shorten the time to manage, summarize, and report vaccination records, data sharing restrictions coupled with inconsistent and inefficient workflows were major implementation challenges. Readiness-to-introduce and sustainability should be carefully considered before implementing an EIR.
Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Published by Elsevier Ltd.)
Databáze: MEDLINE
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