TY - JOUR T1 - Early Lessons From Ethiopia in Establishing a Data Triangulation Process to Analyze Immunization Program and Supply Data for Decision Making JF - Global Health: Science and Practice JO - GLOB HEALTH SCI PRACT DO - 10.9745/GHSP-D-21-00719 VL - 10 IS - 3 SP - e2100719 AU - Adriana Almiñana AU - Amare Bayeh AU - Daniel Girma AU - Natasha Kanagat AU - Lisa Oot AU - Wendy Prosser AU - Belayneh Dagnew AU - Disha Ali Y1 - 2022/06/29 UR - http://www.ghspjournal.org/content/10/3/e2100719.abstract N2 - Key FindingsHealth 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 ImplicationsMore 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.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. ER -