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Practice
Data for decision making: using a dashboard to strengthen routine immunisation in Nigeria
  1. Sulaiman Etamesor,
  2. Chibuzo Ottih,
  3. Ismail Ndalami Salihu,
  4. Arnold Ikedichi Okpani
  1. National Primary Health Care Development Agency, Abuja, Nigeria
  1. Correspondence to Arnold Ikedichi Okpani; dichimike{at}yahoo.com

Abstract

Availability of reliable data has for a long time been a challenge for health programmes in Nigeria. Routine immunisation (RI) data have always been characterised by conflicting coverage figures for the same vaccine across different routine data reporting platforms.

Following the adoption of District Health Information System version 2 (DHIS2) as a national electronic data management platform, the DHIS2 RI Dashboard Project was initiated to address the absence of some RI-specific indicators on DHIS2. The project was also intended to improve visibility and monitoring of RI indicators as well as strengthen the broader national health management information system by promoting the use of routine data for decision making at all governance levels. This paper documents the process, challenges and lessons learnt in implementing the project in Nigeria.

A multistakeholder technical working group developed an implementation framework with clear preimplementation; implementation and postimplementation activities. Beginning with a pilot in Kano state in 2014, the project has been scaled up countrywide.

Nearly 34 000 health workers at all administrative levels were trained on RI data tools and DHIS2 use. The project contributed to the improvement in completeness of reports on DHIS2 from 53 % in first quarter 2014 to 81 % in second quarter 2017.

The project faced challenges relating to primary healthcare governance structures at the subnational level, infrastructure and human resource capacity. Our experience highlights the need for early and sustained advocacy to stakeholders in a decentralised health system to promote ownership and sustainability of a centrally coordinated systems strengthening initiative.

  • health policy
  • health systems
  • immunisation
  • vaccines
  • public health

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjgh-2018-000807

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    Footnotes

    • Handling editor Seye Abimbola

    • Contributors CO and INS conceptualised the report. AIO and SE developed the format for the report. SE, CO and INS wrote the first draft. AIO edited the manuscript. All authors have read and approved the final version.

    • Funding Funding for the Nigeria DHIS2 Routine Immunisation Dashboard Project was received from the Bill and Melinda Gates Foundation; Centres for Disease Control and Prevention; and Government of Nigeria.The authors did not receive specific funding for this paper.

    • Competing interests None declared.

    • Patient consent Not required.

    • Provenance and peer review Not commissioned; internally peer reviewed.

    • Data sharing statement Data on Nigeria’s National Health Management Information System is available on request from the Department of Health Planning, Research and Statistics of the Federal Ministry of Health, Central Business District Abuja, Nigeria.