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Dolan SB, Burstein R, Shearer JC, Bulula N, Lyons H, Carnahan E, Beylerian E, Thompson J, Puttkammer N, Lober WB, Liu S, Gilbert SS, Werner L, Ryman TK. Changes in on-time vaccination following the introduction of an electronic immunization registry, Tanzania 2016-2018: interrupted time-series analysis. BMC Health Serv Res 2022; 22:1175. [PMID: 36127683 PMCID: PMC9485799 DOI: 10.1186/s12913-022-08504-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 08/25/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Digital health interventions (DHI) have the potential to improve the management and utilization of health information to optimize health care worker performance and provision of care. Despite the proliferation of DHI projects in low-and middle-income countries, few have been evaluated in an effort to understand their impact on health systems and health-related outcomes. Although more evidence is needed on their impact and effectiveness, the use of DHIs among immunization programs has become more widespread and shows promise for improving vaccination uptake and adherence to immunization schedules. METHODS Our aim was to assess the impact of an electronic immunization registry (EIR) using an interrupted time-series analysis to analyze the effect on proportion of on-time vaccinations following introduction of an EIR in Tanzania. We hypothesized that the introduction of the EIR would lead to statistically significant changes in vaccination timeliness at 3, 6, and > 6 months post-introduction. RESULTS For our primary analysis, we observed a decrease in the proportion of on-time vaccinations following EIR introduction. In contrast, our sensitivity analysis estimated improvements in timeliness among those children with complete vaccination records. However, we must emphasize caution interpreting these findings as they are likely affected by implementation challenges. CONCLUSIONS This study highlights the complexities of using digitized individual-level routine health information system data for evaluation and research purposes. EIRs have the potential to improve vaccination timeliness, but analyses using EIR data can be complicated by data quality issues and inconsistent data entry leading to difficulties interpreting findings.
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Affiliation(s)
- Samantha B Dolan
- Dolan Consulting LLC, PATH, Seattle, USA. .,Department of Global Health, University of Washington, Seattle, USA. .,Present Address: Bill and Melinda Gates Foundation, Seattle, 98109, USA.
| | | | | | - Ngwegwe Bulula
- Immunisation and Vaccine Development Program, Ministry of Health, Community Development, Gender, Elderly and Children, Government of Tanzania, University of Dodoma, Dodoma, Tanzania
| | - Hil Lyons
- Institute for Disease Modeling, Bellevue, USA
| | | | | | | | - Nancy Puttkammer
- Department of Global Health, University of Washington, Seattle, USA
| | - William B Lober
- Department of Global Health, University of Washington, Seattle, USA.,Biobehavioral Nursing and Health Informatics, University of Washington, Seattle, WA, USA
| | - Shan Liu
- Department of Industrial and Systems Engineering, University of Washington, Seattle, WA, USA
| | | | | | - Tove K Ryman
- Present Address: Bill and Melinda Gates Foundation, Seattle, 98109, USA
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