RT Journal Article SR Electronic T1 Three Waves of Data Use Among Health Workers: The Experience of the Better Immunization Data Initiative in Tanzania and Zambia JF Global Health: Science and Practice JO GLOB HEALTH SCI PRACT FD Johns Hopkins University- Global Health. Bloomberg School of Public Health, Center for Communication Programs SP 447 OP 456 DO 10.9745/GHSP-D-19-00024 VO 7 IS 3 A1 Werner, Laurie A1 Seymour, Dawn A1 Puta, Chilunga A1 Gilbert, Skye YR 2019 UL http://www.ghspjournal.org/content/7/3/447.abstract AB Data quality and use rollout in Tanzania's and Zambia's immunization programs progressed along 3 phases—from strengthening data collection, to improving data quality, to increasing data use for programmatic decision making cultivating a culture of data use.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 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, 3 distinct changes in data use emerged organically. This article provides a detailed summary of these 3 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.