The BID
Learning
Network

Oct 3, 2019

Three waves of data use among health workers: The experience of the Better Immunization Data Initiative in Tanzania and Zambia

Global Health: Science and Practice

Subjects: People, Policies, Practices, Products
Countries: Tanzania, Zambia

The governments of Tanzania and Zambia identified key data-related challenges affecting immunization service delivery including identifying children due for vaccines, time-consuming data entry processes, and inadequate resources. To address these challenges, since 2014, the countries have partnered with PATH’s Better Immunization Data (BID) Initiative to design and deploy a suite of data quality and use interventions. Two key aspects of the interventions were an electronic immunization registry and tools and practices to strengthen a culture of data use. As both countries deployed the interventions, three distinct changes in data use emerged organically. This article provides a detailed summary of these three phases or waves, based mostly on qualitative data or observation: (1) strengthening data collection using new data collection tools and processes and increasing efficiency of health workers; (2) improving data quality regarding accuracy and completeness; and (3) increasing use of data to take action to strengthen their work and for programmatic decision making. These waves clearly demonstrated the growing ability of health workers to move from data collectors to data analyzers who began to focus on the data quality and then the value of using the data in their day-to-day activities. For the full article, visit Global Health: Science and Practice.

Download File

Aug 8, 2019

Electronic immunization registries in Tanzania and Zambia: Shaping a minimum viable product for scaled solutions

Frontiers in Public Health

Subjects: eHealth, Immunization Registry, People, Policies, Products
Countries: Tanzania, Zambia

As part of the work the BID Initiative undertook starting in 2013 to improve countries’ collection, quality, and use of immunization data, PATH partnered with countries to identify the critical requirements for an electronic immunization registry (EIR). An EIR became the core intervention to address the data challenges that countries faced but also presented complexities during the development process to ensure that it met the core needs of the users. The work began with collecting common system requirements from 10 sub-Saharan African countries; these requirements represented the countries’ vision of an ideal system to track individual child vaccination schedules and elements of supply chain. Through iterative development processes in both Tanzania and Zambia, the common requirements were modified and adapted to better fit the country contexts and users’ needs, as well as to be developed with the technology available at the time. This process happened across four different software platforms. The BID Initiative recently published a paper to Frontiers in Public Health that outlines the process undertaken and analyzes similarities and differences across the iterations of the EIR in both countries, culminating in the development of a registry in Zambia that includes the most critical aspects required for initially deploying the registry and embodies what could be considered the minimum viable product for an EIR. Read the full article in Frontiers in Public Heath.

Download File

Feb 26, 2019

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

Vaccine

Subjects: People, Policies, Practices, Products
Countries: Tanzania, Zambia

Vaccine coverage is routinely used as a performance indicator for immunization programs both at local and global levels. For many national immunization programs, there are challenges with accurately estimating vaccination coverage based on available data sources, however an increasing number of low- and middle-income countries (LMICs) have begun implementing electronic immunization registries to replace health facilities’ paper-based tools and aggregate reporting systems. These systems allow for more efficient capture and use of routinely reported individual-level data that can be used to calculate dose-specific and cohort vaccination coverage, replacing the commonly used aggregate routine health information system data. With these individual-level data immunization programs have the opportunity to redefine performance measures to enhance programmatic decision-making at all levels of the health system. In this commentary, we discuss how measures for assessing vaccination status and program performance can be redefined and recalculated using these data when generated at the health facility level and the implications of the use and availability of electronic individual-level data. Read the full article in Vaccine.

Download File

Feb 20, 2019

BID Initiative briefs: Recommendations and lessons learned

PATH

Subjects: Packaging, People, Policies, Practices, Products

The BID Initiative is committed to sharing its learnings with others interested in improving immunization data quality and use. The following series of briefs summarizes our work alongside the governments of Tanzania and Zambia and our lessons and recommendations spanning seven key subject areas.

Read More

Jan 9, 2019

Mott MacDonald evaluation of the BID Initiative: Final evaluation report for Zambia and Tanzania

Mott MacDonald

Subjects: Monitoring & Evaluation, Policies, Practices
Countries: Tanzania, Zambia

Mott MacDonald conducted an independent evaluation of the BID Initiative with the aim of verifying and explaining results and identifying lessons learnt. This report presents a synthesis of findings from successive milestone evaluations. Full reports for each of these evaluation exercises are included as annexes. This report also includes findings from a special study in Dodoma Region to assess the effectiveness of an alternative rollout strategy.

Download File

Jan 9, 2019

Mott MacDonald evaluation of the BID Initiative: Final evaluation presentation for Zambia and Tanzania

Mott MacDonald

Subjects: Monitoring & Evaluation, Policies, Practices
Countries: Tanzania, Zambia

Mott MacDonald conducted an independent evaluation of the BID Initiative with the aim of verifying and explaining results and identifying lessons learnt. This presentation is a synthesis of key findings from successive milestone evaluations, including a special study from Dodoma Region.

Download File

Dec 21, 2018

MMS Bulletin #148: The challenges of implementing a data use culture

MMS Bulletin

Subjects: People, Policies, Practices, Products
Countries: Global

To increase coverage and equity of routine immunization services, the government of Tanzania is strengthening the data use culture through the implementation of a package of data quality and use interventions, including an electronic immunization registry, for immunization service delivery. Three key phases for achieving scale as a government-owned model emerged during the implementation: user-centered design and testing, PATH-led implementation, and government-led implementation with scale-up. A combination of factors contributed to achieving a government-owned model of implementation and ultimately showed significant time and cost savings, as well as greater ownership and ability to sustain and scale the interventions.

Read More

Dec 21, 2018

MMS Bulletin #148: Marrying engineering with health policy to bring digital health to scale

MMS Bulletin

Subjects: People, Policies, Practices, Products
Countries: Global

Just as medical doctors take the Hippocratic Oath as they graduate into their profession, so do many engineers solemnly promise to carry out work to the highest quality, recognizing that any errors may put lives at stake. Given this sharing of fundamental values, engineering is a profession that could be leveraged even further towards public health information systems to address opportunities created by the fusion of the early and relatively informal eHealth and mHealth paradigms into the more mature and complex one that is Digital Health. Recently, the World Health Assembly (WHA) adopted a key resolution on Digital Health, urging member states to assess and prioritise the scale-up of the implementation of digital technologies towards the “universal access to health for all” (WHA 71.1, 2018).

Read More

Jul 6, 2018

BID Initiative lessons learned encyclopedia

PATH

Subjects: Applications, Barcodes, eHealth, Hardware, Immunization Registry, Packaging, People, Policies, Products, Stock Management, Supportive Supervision, Tools, Training
Countries: Tanzania, Zambia

The BID Initiative took a holistic approach to address immunization data challenges by packaging together information system products, data management policies, and evidence-based practices with people who are empowered to improve decision-making. This document captures the various lessons learned throughout BID, from the design and testing phase through implementation, noting if the lesson was learned in the Tanzania or Zambia implementation (or both). Read the full BID Initiative Lessons Learned Encyclopedia.

Download File