ACCURACY AND QUALITY OF ROUTINE IMMUNISATION DATA MONITORING SYSTEM IN OGBARU AND ONITSHA NORTH LOCAL GOVERNMENT AREAS, ANAMBRA STATE, NIGERIA

Abstract

Routine Immunization (RI) is a cost-effective public health intervention to reduce child morbidity and mortality. Immunization programme managers often depend on immunization coverage obtained from RI data monitoring system to guide planning for intervention programmes. However, few studies have been carried out to determine the accuracy and quality of RI information system at the Health Facility (HF) and Local Government Area (LGA) levels in Nigeria. This study was therefore designed to assess the quality and accuracy of RI data monitoring system in Ogbaru and Onitsha North (ON) LGAs of Anambra State, Nigeria. All the 48 HFs in the two LGAs (Ogbaru=28; ON= 20) and each of the LGAs Immunization Units (IUs) were selected for the study. The World Health Organization standard methodology relating to immunization data quality audit was used. This involved the review of the immunization session tally sheets, monthly summary sheets and monthly LGA reports. A checklist containing 120-item Quality Score (QS) was used to assess the quality of the date monitoring system. A QS<90 indicated poor quality while a QS≥90 was taken as good quality. Records of the third dose of diphtheria-pertussis-tetanus vaccination at the HFs from January to December 2009 were recounted and compared with the data at the LGA IUs for the same period. An Accuracy Ratio (AR) which expresses the number of immunization recounted at the HFs to that report to the LGAs IUs was obtained. An AR within the range of 0.95 and 1.05 indicates data consistency. Immunization Focal Persons (IFPs) in the HFs were interviewed using a questionnaire that contained a 70-point knowledge scale. Knowledge scores <50 indicated poor knowledge, while scores of ≥50 were taken as good knowledge. Data were analyzed using descriptive statistics, t-test, Chi-square test, Spearman rho correlation and logistic regression. The proportion of HFs with consistent data in Ogbaru and ON were 28.6% and 70.0% (p<0.05) respectively. The AR was 0.83 in Ogbaru and 0.99 in ON. The mean QS for HFs in Ogbaru and ON were 74.5±18.0 and 73.6±13.2 (p>0.05) respectively, implying low quality of the data monitoring system. There was a moderate correlation between the QS and AR obtained from the HFs in the two LGAs. Mean age of IFPs was 39.1±9.1 years in Ogbaru and 40.0± 6.9 years in ON. Highest levels of education of IFPs were university degree (20.0%); Higher National Diploma (38.0%) and Community Health Officers certificate (42.0%). The mean knowledge score among IFPs was 44.0±8.0 in Ogbaru and 46.2±6.9 in ON with no significant difference. The proportion of IFPs with good knowledge in Ogbaru and ON were 54.5% and 45.5% respectively, with no significant difference. Data consistency was not associated with age of IFPs (OR=0.8, 95% CI=0.3-2.7), LGA location (OR=O.7, 95% CI=0.2-1.7), level of education (OR=0.6, 95% CI=0.2-2.2) and years of experience (OR=1.2, 95% CI=0.5-50). There were inconsistent and low quality data reporting system in the two Local Government Areas. On-the-job training is needed to promote data accuracy and improve quality of data reporting system.