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FIELD ACTION REPORT
Open Access

Early Lessons From Ethiopia in Establishing a Data Triangulation Process to Analyze Immunization Program and Supply Data for Decision Making

Adriana Almiñana, Amare Bayeh, Daniel Girma, Natasha Kanagat, Lisa Oot, Wendy Prosser, Belayneh Dagnew and Disha Ali
Global Health: Science and Practice June 2022, 10(3):e2100719; https://doi.org/10.9745/GHSP-D-21-00719
Adriana Almiñana
aJSI Research & Training Institute, Inc., Arlington, VA, USA.
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  • For correspondence: adriana_alminana@jsi.com
Amare Bayeh
bJSI Research & Training Institute, Inc., Addis Ababa, Ethiopia.
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Daniel Girma
bJSI Research & Training Institute, Inc., Addis Ababa, Ethiopia.
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Natasha Kanagat
aJSI Research & Training Institute, Inc., Arlington, VA, USA.
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Lisa Oot
aJSI Research & Training Institute, Inc., Arlington, VA, USA.
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Wendy Prosser
aJSI Research & Training Institute, Inc., Arlington, VA, USA.
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Belayneh Dagnew
bJSI Research & Training Institute, Inc., Addis Ababa, Ethiopia.
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Disha Ali
aJSI Research & Training Institute, Inc., Arlington, VA, USA.
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Key Findings

  • Health managers who reviewed data by using the data triangulation tool reported clear benefits, including more accessible and synthesized data. This prompted decision making and meaningful actions to improve immunization services, such as expanding the number of immunization sites.

  • Additional effort was required initially to improve the availability of vaccine supply data to fully leverage triangulated data. Over time, health managers could operate the tool on their own and lead the meeting and data review process.

Key Implications

  • More research and documentation are needed to further understand what regular, practical data triangulation processes can look like for Expanded Programmes on Immunization (EPIs) and how data triangulation processes contribute to better programmatic decision making and better data quality.

  • EPI managers interested in incorporating data triangulation analyses into their current data review systems will need to determine practical, feasible means to operationalize regular use of triangulated data at the subnational level. When doing so, the process should be designed through a collaborative process with users, including an initial training followed by iterative support on a routine basis, embedding of implementation research, and a collaborative process to work with users to address barriers or challenges.

ABSTRACT

Strengthening data use and quality is critical to achieving high, equitable immunization coverage. One approach that is being increasingly recognized as effective in improving data use and quality is data triangulation, which can provide more information for decision making in public health programs.

In Ethiopia, immunization program data has had ongoing quality challenges, including timeliness, completeness, and accuracy. Some data are reported through different systems to different departments, and coordination between departments is limited.

JSI, through the Universal Immunization through Improving Family Health Services (UI-FHS) project, introduced a data review process and an Excel tool for triangulating immunization program data and vaccine supply data to improve data quality and programmatic decision making. The user-friendly Immunization Data Triangulation Tool (IDTT) provides decision-support information—such as scoring of districts based on performance—and suggests follow-up actions. It also highlights gaps between vaccines supplied and consumed and helps managers determine the next steps to address programmatic, supply, or data quality issues.

The data review process and IDTT were rolled out in 2 regions in Ethiopia. UI-FHS documented learning to understand the feasibility of the IDTT's application as a decision-making tool by conducting key informant interviews and observing how the IDTT was used at monthly data review meetings.

Health managers who used the tool reported ease of use and clear benefits, including more accessible and synthesized data, which prompted decision making and actions to improve services and supply, such as expanding the number of immunization sites. Challenges with the availability of vaccine supply data hindered managers' ability to leverage triangulated data fully, but the data triangulation process prompted cross-departmental collaboration to address this gap.

These early findings show promise in the ability of immunization programs to successfully use triangulated data to address challenges and provide lessons for introducing new tools or processes into health systems.

  • Received: October 21, 2021.
  • Accepted: April 12, 2022.
  • Published: June 29, 2022.
  • © Almiñana et al.

This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly cited. To view a copy of the license, visit https://creativecommons.org/licenses/by/4.0/. When linking to this article, please use the following permanent link: https://doi.org/10.9745/GHSP-D-21-00719

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Global Health: Science and Practice: 10 (3)
Global Health: Science and Practice
Vol. 10, No. 3
June 29, 2022
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Early Lessons From Ethiopia in Establishing a Data Triangulation Process to Analyze Immunization Program and Supply Data for Decision Making
Adriana Almiñana, Amare Bayeh, Daniel Girma, Natasha Kanagat, Lisa Oot, Wendy Prosser, Belayneh Dagnew, Disha Ali
Global Health: Science and Practice Jun 2022, 10 (3) e2100719; DOI: 10.9745/GHSP-D-21-00719

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Early Lessons From Ethiopia in Establishing a Data Triangulation Process to Analyze Immunization Program and Supply Data for Decision Making
Adriana Almiñana, Amare Bayeh, Daniel Girma, Natasha Kanagat, Lisa Oot, Wendy Prosser, Belayneh Dagnew, Disha Ali
Global Health: Science and Practice Jun 2022, 10 (3) e2100719; DOI: 10.9745/GHSP-D-21-00719
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    • ABSTRACT
    • BACKGROUND
    • DEVELOPMENT OF DATA TRIANGULATION TOOL AND DATA REVIEW PROCESS
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    • FINDINGS
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