Monitoring evaluation for routine immunization data for action
This presentation is the property of its rightful owner.
Sponsored Links
1 / 29

Monitoring & Evaluation for Routine Immunization: Data For Action PowerPoint PPT Presentation


  • 55 Views
  • Uploaded on
  • Presentation posted in: General

Monitoring & Evaluation for Routine Immunization: Data For Action. Using information to improve routine immunization services. Presentation 2 Objectives. Be familiar with the role of information in routine immunization

Download Presentation

Monitoring & Evaluation for Routine Immunization: Data For Action

An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -

Presentation Transcript


Monitoring evaluation for routine immunization data for action

Monitoring & Evaluation for Routine Immunization: Data For Action

Using information to improve routine immunization services


Presentation 2 objectives

Presentation 2 Objectives

  • Be familiar with the role of information in routine immunization

  • Be able to use, modify or develop tools for monitoring or improving data quality and use at health facility / district level

  • Be aware of resources available for vaccination information in routine immunization


Overview of m e framework for ri

Overview of M&E framework for RI

Goals

* WHO / UNICEF Global Immunization Vision and Strategy

** Millennium Development Goal 4


How monitoring works for ri

How monitoring works for RI

  • RI staff at all levels routinely monitor system performance and use this information to drive decision-making

  • Monitoring indicators include

    • Doses administered, coverage, dropout

  • Monitoring tools include

    • Monitoring charts, tables, monthly summary forms

  • Internal monitoring activities include

    • Supervision visits

    • Rapid community assessments


How evaluation works for ri

How evaluation works for RI

  • Internal evaluation activities include

    • Annual reporting of ~40 EPI indicators to WHO/UNICEF including doses administered and immunization coverage

    • Data quality self-assessments

    • Lot quality assurance surveys

  • External evaluation activities include

    • External immunization coverage surveys

    • Data quality audits


How data for action works for epi

How Data for Action works for EPI

  • RI staff are expected to monitor their system AND use this information for action

  • Use of RI information to improve coverage is often the weakest part of RI

  • Supervisors (& you) should observe and ask staff if they know how to both calculate and use monitoring indicators, tools and activities


Common ri indicators

Common RI Indicators

  • Service performance

    • Defined as number of children receiving one of the later vaccines

      • Coverage with DTP3 (DTP = DPT = DTC)

      • Coverage with measles

      • Percentage of children never reached

  • Access

    • Defined as availability/start of services (number of children who received one of the earliest vaccines)

      • Coverage with BCG or DTP1

  • Utilization

    • Defined as continued use of services

      • “Dropout rate” e.g. the number of children who received an early vaccination (DTP1) compared to the number of children who received a later vaccination (DTP3)


How to calculate coverage

How to calculate coverage

  • Coverage formula

    ________number of doses given_______ X 100

    estimated number of age-eligible children

    in catchment area

  • Sources of error for coverage

    • Number of doses given

    • Estimated number of age-eligible children in the catchment area


How to calculate dropout

How to calculate dropout

Dropout definition: Child begins but does not complete immunization schedule

Drop-out rate formula

[ ( # Beginning – # Ending ) / # Beginning ] X 100

  • Usually, series begins with DTP1 or BCG

    and ends with DTP3 or measles

    = [( DTP1 – measles ) / DTP1] X 100

    = [( DTP1 – DTP3 ) / DTP1] X 100

    = [( BCG – measles ) / BCG] X 100

    = [( BCG – DTP3 ) / BCG] X 100


Visualization of never reached versus drop outs

Visualization of Never-reached versus Drop-outs

Never-reached

Never-reached

Drop-outs

Drop-outs


Practice calculate coverage and dropout

Practice: Calculate Coverage and Dropout


Tool 1 monitoring chart

Tool 1: Monitoring chart

  • Used at multiple levels to visually track monthly performance

  • Charts include:

    • Number of doses administered per month

    • Cumulative number of doses administered in year

    • Coverage rate

    • Difference in number of doses administered between 2 vaccines (dropout)

    • Monthly target and cumulative target population

  • Good charts are:

    • Up to date

    • Properly filled


Completing an immunization monitoring chart

Completing an Immunization Monitoring Chart

  • Enter monthly objectives on the y-axis (target population ÷ 12)

  • Diagonal line represents regular progress over a 12 month period ending with 100% coverage

  • Every month

    • Enter the antigen total for the month

    • Calculate the cumulative total for the antigen

    • Mark the cumulative total on the chart with a dot

    • Calculate the cumulative number of drop outs

    • Calculate the cumulative drop out rate


Practice how to fill in a monitoring chart

Practice: How to fill in a monitoring chart

  • Zorgho, 2003

  • Target population < 1 = 12,897


Monitoring evaluation for routine immunization data for action

Zorgho

2003

12897

1075

12897

11822

10748

9673

8598

7523

6449

5374

4299

3224

2150

1075

0


Monitoring evaluation for routine immunization data for action

Zorgho

2003

12897

1075

12897

11822

10748

9673

8598

7523

6449

5374

4299

3224

2150

1075

0

836

836

909

1745

818

2563

525

525

631

1156

539

1695


Monitoring evaluation for routine immunization data for action

Zorgho

2003

12897

11822

10748

9673

8598

7523

6449

5374

4299

3224

DTP1

2150

1075

DTP3

0

836

836

909

1745

818

2563

525

525

631

1156

539

1695

311

589

868

37

34

34


Tool immunization summary form

Tool: Immunization summary form

  • Facility summary form

    • Summary of doses administered at facility

    • Data summarized from session tally sheets

  • District summary form

    • Summary of doses administered across all facilities in district

    • Data summarized from facility summary sheets

  • Sent monthly by each level

  • Used nationally as source of information on number of doses administered


Illustrative flow of immunization summary information

Illustrative flow of immunization summary information

National

Department of

Epidemiology

EPI program

Consolidated monthly

Surveillance report

Weekly reports

Consolidated monthly

reports, vaccination

Case reports

District

Monthly reports

Case reports

Weekly reports

Health Center

consolidates

Tally sheets

Patient registers

Case reports

Health Center

Health posts

Outreach sites


Liberia immunization summary form

Liberia Immunization Summary Form


Tool defaulter tracking system

Tool: Defaulter Tracking System

  • Method to identify children who did not return for vaccination (drop outs)

  • Multiple tools used as “tracking system”

    • Ledger of children’s names who dropped out

    • Tickler box or blanket

      • Copy of vaccination card is kept with the month when child is expected to return

      • At end of month, remaining cards used to identify and then find children who did not return


Defaulter ledger example

Defaulter ledger example


Monitoring evaluation for routine immunization data for action

Tool: Prioritize your locations by severity of problems (I)

What proportion of the children have ACCESS to immunization services? (what is DTP1 coverage?)

HIGH coverage with DTP1 (>80%)

Low coverage with DTP1 (<80%)

What proportion of children COMPLETE the immunization schedule (what are the DTP1 - DTP3 drop-out rates?)

Drop-out rate <10%

Drop-out rate >10%

Drop-out rate <10%

Drop-out rate >10%

Categorize the problem

  • Dropout rates are low = good utilization

  • Coverage is high = good access

  • Category 1 (no problem)

  • Dropout rates are high = poor utilization

  • Coverage is low= poor access

  • Problem Category 4

  • Dropout rates are high= poor utilization

  • Coverage is high = good access

  • Problem Category 2

  • Dropout rates are low = good utilization

  • Coverage is low= good access

  • Problem Category 3

Source: Increasing immunization coverage at the health facility level, WHO 2001


Tool prioritize your locations by severity of problems ii

Tool: Prioritize your locations by severity of problems (II)


Tool rapid community assessment

Tool: Rapid community assessment

  • Monitoring tool used by supervisors to rapidly understand whether vaccination services are reaching the community and identify barriers to vaccination

  • Not a survey and does not generate coverage rates

  • Useful to use in places where administrative vaccination coverage is reportedly high

    • A rapid assessment should not find many unvaccinated children

  • General method

    • Select ~20 households and assess vaccination status and reasons for no vaccination

    • Should be conducted in parts of a catchment area where low coverage is expected


Thanks

Thanks

Questions?


  • Login