The District Weighs in on Data Dashboards
By Jason Walton, Senior Program Officer, BID Initiative
Aug 26, 2015
During a recent trip to Tanzania, I observed firsthand the BID Initiative’s progress in health facilities in and around Arusha. The familiarity nurses had with the newly introduced tablets, their ability to navigate through the electronic immunization registry and the adaptation of their work flow to account for the new technologies, including paper tools, within their health facilities were all highly encouraging. I also heard about some of the existing and new challenges they are experiencing, such as the hesitation of some mothers to affix a barcode to their child’s health card.
While the BID Initiative currently serves as the immediate point of contact for many of these challenges, the central figure within Tanzania’s Immunization and Vaccine Development (IVD) program is the district or council immunization and vaccine officer (D/CIVO). Aside from providing direct oversight, the D/CIVO offers health facilities technical expertise and a communication channel to broader IVD and district-level objectives. They will remain the focal point going forward for the health facilities to raise challenges and work to identify and implement appropriate solutions.
Given their critical role in the BID Initiative and Tanzania’s health system, I always jump at an opportunity to sit down and talk with one of the CIVOs or DIVOs. During this trip, I had the fortunate opportunity to talk with Mr. Majid Luhida, Arusha City’s CIVO. Our engagement with Mr. Luhida has been extensive since he is a member of our User Advisory Group and helped design the interventions we are implementing. Our conversation highlighted the need to not only address his technical understanding of the BID Initiative objectives and how our activities are designed to support those outcomes, but also the need for us to ensure he stays abreast of our progress within the Arusha City Council (i.e. the 60 health facilities he oversees).
His fluency with our technical objectives and our up-to-date progress enables the BID Initiative to demonstrate how closely we are collaborating with the Ministry of Health and Social Welfare (MoHSW). Conversely, if health facilities raise questions or challenges to him and he is unable to respond, it provides fodder for them to think we are working independently.
So what changed based on this conversation? Our original intention was to have a dashboard designed to provide the CIVOs and DIVOs with the relevant health metrics for their respective councils and districts such as on-time vaccination rates, coverage rates and wastage rates. However, Mr. Luhida made me realize that we need to expand the dashboards to enable his team to understand our implementation progress. This will position Mr. Luhida and his colleagues to be much more informed about our current state of implementation. For instance, how many health facilities are live on the electronic immunization registry and how many of the paper-based health facilities are currently utilizing the redesigned paper tools.
Acknowledging the significant role the C/DIVO play in supporting facilities means that we need to not only assist them in fully understanding what activities are rolling out in their councils and districts, but also when and how well those activities are going. For that, we are now iterating from our initial dashboard to create a more robust information source for the districts, and subsequently, the same will be done for the regional immunization and vaccine officer and the broader regional health management team.