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Published in: BMC Health Services Research 1/2019

Open Access 01-12-2019 | Vaccination | Research article

Accuracy and quality of immunization data in Iran: findings from data quality self-assessment survey in 2017

Authors: Manoochehr Karami, Salman Khazaei, Abbas Babaei, Fatemeh Abdoli Yaghini, Mohammad Mehdi Gouya, Seyed Mohsen Zahraei

Published in: BMC Health Services Research | Issue 1/2019

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Abstract

Background

The aim of this study was to assess the accuracy and quality of immunization data on the pentavalent (diphtheria, pertussis, tetanus, hepatitis B and Haemophilus influenzae type B (Hib)) and MMR vaccines as the administrative data of the expanded program on immunization (EPI) in Iran.

Methods

We conducted a Data Quality Self-assessment (DQS) survey from October to December 2017. Standardized DQS tools were used to assess the accuracy of reported immunizations data and quality of the immunization monitoring system at the provincial level of the healthcare system including health houses, health posts, rural and urban health centers and district health centers. Multistage cluster random sampling with proportional to size (PPS) weights was used to select target provinces and related health units. Accuracy ratio, quality index (QI), completeness and relevant quality indices of first dose of MMR (MMR1) and third dose of pentavalent vaccines were reported. Corresponding period of the survey was limited to reported administrative immunization data during the first 6 months of 2016.

Results

In relation to accuracy ratio, there was some evidence of under reporting of pentavalent (3rd dose) and MMR1 vaccines in health house units which were 100.94 and 101.1%, respectively. Completeness of reporting for both vaccines at different provincial levels was near 100%. However, the corresponding value for pentavalent (3rd dose) and MMR1 vaccines at the level of urban health centers was 96.67 and 94.17% respectively.
Among the five components of a monitoring system data usage and core output had the lowest QI scores in either rural or urban as well as district healthcare centers.

Conclusions

Findings from our DQS survey reveals that administrative reporting of the immunization data was adequate at provincial and district levels of the healthcare centers. Although, addressing the existing concerns regarding timelines of the reporting by health authorities and staffs of EPI is warranted.
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Literature
1.
go back to reference Hinman AR, Orenstein WA, Schuchat A. Control CfD, prevention. Vaccine-preventable diseases, immunizations, and MMWR: 1961-2011. MMWR Surveill Summ. 2011;60(Suppl 4):49–57. Hinman AR, Orenstein WA, Schuchat A. Control CfD, prevention. Vaccine-preventable diseases, immunizations, and MMWR: 1961-2011. MMWR Surveill Summ. 2011;60(Suppl 4):49–57.
2.
go back to reference National immunization committee. Ministry of Health and Medical Education. Schedule and guideline of immunization 8 th ed. Tehran: Zarak; 2015. National immunization committee. Ministry of Health and Medical Education. Schedule and guideline of immunization 8 th ed. Tehran: Zarak; 2015.
3.
go back to reference Klaucke DN, Buehler JW, Thacker SB, Parrish RG, Trowbridge FL, Berkelman RL. Guidelines for evaluating surveillance systems. MMWR Morb Mortal Wkly Rep. 1988;37(Suppl 5):1–18. Klaucke DN, Buehler JW, Thacker SB, Parrish RG, Trowbridge FL, Berkelman RL. Guidelines for evaluating surveillance systems. MMWR Morb Mortal Wkly Rep. 1988;37(Suppl 5):1–18.
4.
go back to reference Zahraei SM, Eshrati B, Gouya MM. Is there still an immunity gap in high-level national immunization coverage, Iran? Archives of Iranian medicine. 2014;17(10):698.PubMed Zahraei SM, Eshrati B, Gouya MM. Is there still an immunity gap in high-level national immunization coverage, Iran? Archives of Iranian medicine. 2014;17(10):698.PubMed
5.
go back to reference Poorolajal J, Khazaei S, Kousehlou Z, Bathaei S, Zahiri A. Delayed vaccination and related predictors among infants. Iran J Public Health. 2012;41(10):65.PubMedPubMedCentral Poorolajal J, Khazaei S, Kousehlou Z, Bathaei S, Zahiri A. Delayed vaccination and related predictors among infants. Iran J Public Health. 2012;41(10):65.PubMedPubMedCentral
6.
go back to reference Bosch-Capblanch X, Ronveaux O, Doyle V, Remedios V, Bchir A. Accuracy and quality of immunization information systems in forty-one low income countries. Tropical Med Int Health. 2009;14(1):2–10.CrossRef Bosch-Capblanch X, Ronveaux O, Doyle V, Remedios V, Bchir A. Accuracy and quality of immunization information systems in forty-one low income countries. Tropical Med Int Health. 2009;14(1):2–10.CrossRef
9.
go back to reference Khazaei S, Ayubi E, Mansori K. High immunization coverage in children as one of the major achievements for the health system in Iran. International Journal of Pediatrics. 2016;4(7):2167–9. Khazaei S, Ayubi E, Mansori K. High immunization coverage in children as one of the major achievements for the health system in Iran. International Journal of Pediatrics. 2016;4(7):2167–9.
10.
go back to reference Izadi S, Zahraie S-M, Sartipi M. An investigation into a measles outbreak in Southeast Iran. Jpn J Infect Dis. 2012;65(1):45–51.PubMed Izadi S, Zahraie S-M, Sartipi M. An investigation into a measles outbreak in Southeast Iran. Jpn J Infect Dis. 2012;65(1):45–51.PubMed
11.
go back to reference Moghadam M, Afsarkazerooni P, Ebrahimi M, Soltani M, Razmpoor A, Pirasteh E, et al. Measles outbreak in south of Iran, where vaccine coverage was high: a case-series study. Iran J Public Health. 2014;43(3):375.PubMedPubMedCentral Moghadam M, Afsarkazerooni P, Ebrahimi M, Soltani M, Razmpoor A, Pirasteh E, et al. Measles outbreak in south of Iran, where vaccine coverage was high: a case-series study. Iran J Public Health. 2014;43(3):375.PubMedPubMedCentral
12.
go back to reference Ronveaux O, Rickert D, Hadler S, Groom H, Lloyd J, Bchir A, et al. The immunization data quality audit: verifying the quality and consistency of immunization monitoring systems. Bull World Health Organ. 2005;83(7):503–10.PubMedPubMedCentral Ronveaux O, Rickert D, Hadler S, Groom H, Lloyd J, Bchir A, et al. The immunization data quality audit: verifying the quality and consistency of immunization monitoring systems. Bull World Health Organ. 2005;83(7):503–10.PubMedPubMedCentral
13.
go back to reference Ronveaux O, Rickert D, Hadler S, Groom H, Lloyd J, Bchir A, Birmingham M. The immunization data quality audit: verifying the quality and consistency of immunization monitoring systems. Bull World Health Organ. 2005;83:503–10. Ronveaux O, Rickert D, Hadler S, Groom H, Lloyd J, Bchir A, Birmingham M. The immunization data quality audit: verifying the quality and consistency of immunization monitoring systems. Bull World Health Organ. 2005;83:503–10.
15.
go back to reference Chahed MK, Bellali H, Alaya NB, Ali M, Mahmoudi B. Auditing the quality of immunization data in Tunisia. Asian Pacific journal of tropical disease. 2013;3(1):65–70.CrossRef Chahed MK, Bellali H, Alaya NB, Ali M, Mahmoudi B. Auditing the quality of immunization data in Tunisia. Asian Pacific journal of tropical disease. 2013;3(1):65–70.CrossRef
16.
go back to reference Ward K, Mugenyi K, Benke A, Luzze H, Kyozira C, Immaculate A, et al. Enhancing workforce capacity to improve vaccination data quality, Uganda. Emerg Infect Dis. 2017;23(Suppl 1):S85.PubMedCentral Ward K, Mugenyi K, Benke A, Luzze H, Kyozira C, Immaculate A, et al. Enhancing workforce capacity to improve vaccination data quality, Uganda. Emerg Infect Dis. 2017;23(Suppl 1):S85.PubMedCentral
17.
go back to reference Hu Y, Zhang X, Li Q, Chen Y. Auditing the immunization data quality from routine reports in Shangyu District, East China. Int J Environ Res Public Health. 2016;13(11):1158.CrossRef Hu Y, Zhang X, Li Q, Chen Y. Auditing the immunization data quality from routine reports in Shangyu District, East China. Int J Environ Res Public Health. 2016;13(11):1158.CrossRef
18.
go back to reference Onta S, Sabroe S, Hansen E. The quality of immunization data from routine primary health care reports: a case from Nepal. Health Policy Plan. 1998;13(2):131–9.CrossRef Onta S, Sabroe S, Hansen E. The quality of immunization data from routine primary health care reports: a case from Nepal. Health Policy Plan. 1998;13(2):131–9.CrossRef
19.
go back to reference Freund PJ, Kalumba K. Monitoring and evaluation of primary health care in rural Zambia: a comparative study. Scand J Soc Med. 1985;13(4):137–46.CrossRef Freund PJ, Kalumba K. Monitoring and evaluation of primary health care in rural Zambia: a comparative study. Scand J Soc Med. 1985;13(4):137–46.CrossRef
20.
go back to reference Dunkle SE, Wallace AS, MacNeil A, Mustafa M, Gasasira A, Ali D, et al. Limitations of using administratively reported immunization data for monitoring routine immunization system performance in Nigeria. J Infect Dis. 2014;210(suppl_1):S523–S30.CrossRef Dunkle SE, Wallace AS, MacNeil A, Mustafa M, Gasasira A, Ali D, et al. Limitations of using administratively reported immunization data for monitoring routine immunization system performance in Nigeria. J Infect Dis. 2014;210(suppl_1):S523–S30.CrossRef
Metadata
Title
Accuracy and quality of immunization data in Iran: findings from data quality self-assessment survey in 2017
Authors
Manoochehr Karami
Salman Khazaei
Abbas Babaei
Fatemeh Abdoli Yaghini
Mohammad Mehdi Gouya
Seyed Mohsen Zahraei
Publication date
01-12-2019
Publisher
BioMed Central
Keyword
Vaccination
Published in
BMC Health Services Research / Issue 1/2019
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-019-4188-9

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