Accuracy and quality of immunization information systems in forty-one low income countries
Accuracy and quality of immunization information systems in forty-one low income countries
复制标题
DOI：
10.1111/j.1365-3156.2008.02181.x
复制
发表时间：
2009-01-01
影响因子：
3.3
通讯作者：
Bchir, Abdallah
中科院分区：
文献类型：
--
作者：
Bosch-Capblanch, Xavier;Ronveaux, Olivier;Bchir, Abdallah
在一系列有资格接受免疫联盟支助的低收入国家衡量免疫信息系统的准确性和质量，数据质量审计采用世卫组织经过验证的标准方法，将从卫生单位（HU）的免疫记录收集的数据与中央一级的免疫报告进行比较，并收集报告系统的质量指标。核查系数（VF）是衡量准确性的一个指标，表示在国家一级报告的免疫接种中可以追溯到HU的比例。自愿捐款达到或超过80%的国家将获得更多的免疫联盟财政支助。质量指标是指在国家、地区和卫生单位一级的质量分数。本报告所列的DQA是在2002年至2005年期间在41个国家进行的，涵盖了188个随机选择的地区的1082个初级卫生保健单位。几乎一半的国家获得的VF低于80%，只有9个国家的VF和QS得分始终较高。信息系统中最常见的弱点是用于估计覆盖率的数据不一致、缺乏指导方针（例如关于迟报的指导方针）、对疫苗浪费的估计不正确以及缺乏关于免疫接种业绩的反馈。在第一次DQA失败并进行了第二次DQA的所有六个国家中，VF和所有QS都有所改善，但并非所有这些都具有统计学意义DQA是一种诊断工具，可以揭示影响卫生系统各级免疫数据质量的一些关键问题。它确定了HU和地区级别的良好绩效，可用作最佳实践的示例。DQA方法将数据质量问题置于议程的首位，以改善对免疫覆盖率的监测。
To measure the accuracy and quality of immunization information systems in a range of low-income countries eligible to receive GAVI support.The Data Quality Audit (DQA) uses a WHO validated, standard methodology to compare data collected from health unit (HU) records of immunizations administered with reports of immunizations at central level and to collect quality indicators of the reporting system. The verification factor (VF), as a measure of accuracy, expresses the proportion of immunizations reported at national level that can be tracked down to the HU. A VF of 80% or above entitles countries to receive additional GAVI financial support. Quality indicators are assigned points which were summed to obtain quality scores (QS) at national, district and HU levels. DQAs included here were conducted between 2002 and 2005 in 41 countries, encompassing 1082 primary healthcare units in 188 randomly selected districts.Almost half of countries obtained a VF below 80% and only nine showed consistently high VF and QS scores. The most frequent weaknesses in the information systems were inconsistency of denominators used to estimate coverage, poor availability of guidelines (e.g. for late reporting), incorrect estimations of vaccine wastage and lack of feedback on immunization performance. In all six countries that failed a first DQA and undertook a second DQA, the VF and all QSs improved, not all of them statistically significantly.The DQA is a diagnostic tool to reveal a number of crucial problems that affect the quality of immunization data in all tiers of the health system. It identifies good performance at HU and district levels which can be used as examples of best practices. The DQA methodology brings data quality issues to the top of the agenda to improve the monitoring of immunization coverage.