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Immunization Data Quality Improvement in Karamoja

A team from the Ministry of Health, EPI partners and AFENET worked, with district data improvement teams (DITs) from Karamoja region to conduct a regional training, field deployment and support supervision activity for Moroto Region districts of Abim, Kotido, Kaabong, Karenga, Nabilatuk, Amudat, Nakapiripirit, Moroto, and Napak.

The DIT Strategy is a data quality improvement initiative developed to address major gaps in the quality of EPI data at national and subnational levels. The strategy has an overall objective of strengthening the quality of immunization data at all levels of the health system in Uganda, for improved planning, monitoring and evaluation of the national EPI program to ultimately improve access and utilization of immunization services and reduce morbidity and mortality due to vaccine preventable diseases (VPDs).

 AFENET- DIT team visited Amudat district, part of Karamoja Sub Region to supervise and conduct mentorship for immunization data quality. Deployed teams used standard immunization district and health facility-level immunization data quality assessment tools.  Amudat is situated in north Eastern region of Uganda, with a population of 129,400.  The district is bordered by Moroto District in the north, the republic of Kenya in the east, Bukwo District and Kween District in the south and Nakapiripirit District in the west.

The AFENET DIT team led by Dr Kevin Mugenyi – Epidemiologist, AFENET interacted with facility staff on data quality assessment and conducting on-job mentorship on areas where data quality gaps were found, such as analysis and use of immunization data, data recording and reporting practices, data archiving practices among others. The health workers were highly receptive to mentorship and learning new skills in immunization data quality improvement, and were found to be using standard MoH data recording and reporting tools which were generally in good supply.

Alex Nimasiya – Health Information Officer – Amudat Health Center IV explained that the district has 8 health centers which are to serve the entire population. According to the Uganda Bureau of Statistics (UBOS), majority of the population live in the rural areas which makes 88.9% of the entire population. Amudat Health Center IV, one of the most equipped, mostly serves the urban population of 14,400 leaving out the rest.

He further explains that there is a poor health seeking behavior aided with a limited male involvement. Mothers walk long distances to access health facilities, and in some cases have to cross over to the nearby Kacheliba Hospital in Kenya.   Mothers do not easily access Information on immunization mobilization and outreaches due to poor infrastructure. There is need for a concerted effort to ensure that the critical roads leading to health facilities are worked upon.

Phase 1 of the DIT strategy was implemented from 2014-16, with periodic stakeholder review on progress of implementation, and all 116 districts and 90% of all immunizing health facilities in Uganda were assessed by DITs where EPI DQI mentorship was conducted.

Phase 2 of the strategy began in April 2017, and is on-going, scheduled to cover all 17 regions and 122 districts of the country. The recently concluded Gulu Region Immunization Data Quality Improvement Teams (DIT) regional training, deployment and national support supervision activities were scheduled DIT project activities that were agreed upon by the Ministry of Health (Immunization Programme and Division for Health Information) EPI partners including the US Centers for Disease Control and Prevention (CDC), WHO, GAVI, and UNICEF.