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Success rolls out in Southern Province

By Mali Kambandu, Communications Officer, BID Initiative Zambia

Mar 29, 2018

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Photo: Bill & Melinda Gates Foundation/John Healey. Sarah Banda holds her baby after a vaccination service at the Mahatma Gandhi Clinic in Livingstone, Zambia. The Mahatma Gandhi Clinic was one of the first clinics to test data quality and use interventions under the BID Initiative.

When Fred Njobvu, Provincial Coordinator for the BID Initiative in Zambia, looks back on January 2017, he wasn’t sure how the team would manage to roll out data quality and use interventions to the remaining districts in Southern Province.

“We were running out of time in our grant,” remembers Fred, “and we needed to deliver interventions to the rest of the province.”

Today, he is pleased with how far the team has come, and the incredible potential for data quality and use interventions to improve immunization service delivery in Zambia and beyond.

“We employed different strategies and were able to appreciate what was working and what was not. This did not compromise quality of the visits in any way, as we were able to identify champions among facility users and district supervisors,” says Fred. “We achieved our objectives right on time, with very good outcomes, to the satisfaction of all our stakeholders.”

By mid-March 2018 the data quality and use interventions designed and developed by the BID Initiative and the Zambia Ministry of Health (MOH) had been rolled out to 299 health facilities in Southern Province. The interventions were implemented in 25 more facilities than initially planned because the government commissioned more health facilities throughout the province.

Rollout was conducted over seven months by a dedicated team of Implementation Specialists and District Health Officers from all 13 districts of Southern Province.

To date, 291 facilities are operating in a live environment – they’re able to enter data into the Zambia Electronic Immunisation Registry (ZEIR) in real time, or to sync with ZEIR when network connectivity allows.

Though there are eight facilities that are still not live, we expect to bring them online soon. These facilities, which were not part of the original rollout plan, are currently experiencing small technical issues, such as missing facility codes that have not yet been created in the Health Management Information System. Technical details will be corrected by the end of March.

By using ZEIR and the other data use interventions, health workers are now recording their immunisation data on dual systems. This is an increase in their workload, but it has generally been well-received because the facility staff look forward to the benefits of using the digital tool once ZEIR has several months of operational data.

The latest version of ZEIR allows health workers to automatically run their health information aggregation (HIA) Form Two reports and send them to their district health offices on a monthly basis, thus improving decision-making at various levels of the health system. In addition to using the digital tool, the data use guide has been helpful in uncovering where some services are not reported, allowing health workers to immediately make corrections and provide better service.

The data visualisations are one of the favourite features of the interventions. They have been incredibly helpful, as Gwembe District Health Information Officer Justina Kafunga said: “For some health workers, plotting graphs has been a challenge because of the size of the paper and the scale of information they have to put in. Using a digital tool, that also helps to calculate z-scores, is a tremendous help and increases accuracy of the reports.”

The BID team looks forward to planning for what’s next in Zambia, and is encouraged by the health workers’ positive reception to the data quality and use interventions that will contribute to improved health outcomes for Zambian children.

I can only describe the last 13 months of BID as like running a decathlon. But the race is not over yet. And we haven’t run this race alone. The Government, at every level, has both cheered and challenged us to carry on. We’re now working collaboratively to ensure that BID is not only sustained in Southern Province, but that it scales to the rest of the country. This will be our greatest success.

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