Utilization of immunization data in district health planning in the context of health sector reforms

Abstract

Background: The importance of data utilization in health planning at the district level cannot be over emphasized. The demand for and utilization of health information currently is influenced by the health sector reforms which focus on decentralized system. That is to say health systems are managed more closely at the level of service delivery by the people in their respective localities. This shift in function between the central (national) and peripheral (regions and districts) levels generates new information needs and calls for an in-depth restructuring of information systems, with changing data collection, processing, analysis, and dissemination requirements. Objective: The study aimed at exploring the utilization of Immunization data in health planning by district health planning teams and the barriers they face in using health information. Methods: The study was conducted in Iringa District, Tanzania using qualitative research method whereby interview guides for in-depth interview and Observation Checklist were used to obtain information from respondents. The interview involved: informants of the Council Health Planning Team (CHPT) and Regional Health Management Team (RHMT). The respondents were purposively selected and a total of 18 informants were enrolled in the study. Results: Immunization data with doubtful accuracy were found to be used in the preparation of CCHP. From the observation checklist it was noted that immunization data used in CCHP did not match with those found in Annual Health reports. In addition, inconsistency of immunization data within the same CCHP and a problem of “copy and paste” of immunization performance indicators were noted. Participants highlighted that there was no involvement of planning team members in the analysis of immunization data. The role of data analysis seemed to be left to those who deal directly with immunization data. In that case, the District Cold chain Coordinators (DCCO). The targeted population was derived from the 2002 National Census vii were found to be not realistic. It was also reported that despite the fact that Expanded Program on Immunization (EPI) data management tool covers wide information about immunization services compared to HMIS tool. The CCHP utilizes immunization data obtained from the HMIS tool. Importantly, potential barriers identified were unrealistic target population, inadequate analytic knowledge among the team members, poor quality of immunization data generated and increased workload due to the burden of paperwork to health providers. Conclusion and Recommendations: The use of immunization data and consequently information about immunization services in preparation of CCHP must be seen in a broader perspective not focusing only on presence of immunization data in the tables of CCHP but also on the ability of planners to analyse such data and the quality of data being used. The study strongly recommends the following: (1) reduction of paper work should be done at facility level (2) the districts should be empowered to use locally generated health data (3) the existing result based bonus should be strengthened (4) the Council Health planning teams ought to be capacitated in order to be equipped with knowledge on analysis of data and planning.