Tuesday, 27 June 2017
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Hello all,

I have a query regarding the reporting of antigens given beyond 1 year of age in various countries. 

Some antigens can be given only in the first year of life, these will be included as part of "full immunization coverage". However, some other antigens like DPT- doses 1,2,3 can also be given after the first year of life- such doses will not be included as part of FIC.  So, in the Health Management Information Systems across various countries, are there two separate columns to capture data for these antigens?

 

Kindly share if you have any idea about this reporting.

Thank you

Almas 

 

Dear Almas,

indeed, in most of the systems I have direct recent knowledge (around 10 or so in Sub-Saharan Africa) and for what I know from other sources, THERE ARE different spaces to record vaccination given from 0 to 11 months of age and those given from 12 to 23 months of age. This usually applies to tally sheets, registers and reports. I think I remember that some countries may not even have the 12 to 23 months, but most do.

You can check as well, for your reference, standard vaccination monitoring practices within WHO.

I hope this helps.

Xavier Bosch-Capblanch

6 years ago
·
#4681

Dear Almas,

A good opportunity to share line items listed in the revised HMIS (Common version of the country) with the viewers / policy makers.

Series 9 deals with immunization data from 9.1 to 9.11 with sub items.

9.3.1 / 9.3.2 provides opportunity to report vaccination data of 1st dose of either Measles monovalent or Mesles and Rubella depending upon the district and the state to report vaccine administered beyond first birth day similarly 9.3.3 for JE 1st dose administered after 12 months.

However no line items to report if DPT 1st/2nd/3rd dose is administered beyond 12 months, this usually happens among migrant children from Bangladesh, Jharkhand, Bihar, UP, Assam etc working in tea / coffee / rubber plantations in Kodagu district. A few other districts may also face the same situation.

With these lapses, all those who are administered Measles 1st dose / MR first dose (depending on the district and the state) will be erroneously reported as FIC below one year against the line item - 9.2.4 (9.24a and 9.2.4b). It is assumed that all receive one dose of BCG / 3 doses of DPT or Pentavalent and 3 doses of OPV before 9 months). 

These need to be addressed.

HMIS Form for this portion is attached for reference and suggestion by the viewers for needful.

There are several lapses in the proper understanding / usage and linkage of data from the private sector mailny because the government assumes that private practioiners are vaccinating as per National Immun ization Schedule (NIS) but it is not so. The vaccination schedule is whimsical in the private sector and it never matches with that of NIS including that of Private pioneer medical colleges. Hence the vaccination data is not compatible for updating in the HMIS.

This is just a small part of the several problems with HMIS form of India. I wish to share in detail so that the policy makers may be able to find some solution or accept some of the solutions we (KVG Team) have. 

 

 

 

 

 

Dear all, WHO is preparing some updated guidance on monitoring routine coverage data. The draft "handbook" was shared with WHO's Immunization Practices Advisory Committee (IPAC) see: http://www.who.int/immunization/programmes_systems/policies_strategies/ipac/en/ (reports on the right). In this handbook teh recomendation will be to have at least two separate columns, one for >12 months and the other for 12 months plus, but countries can add more as per their needs. Many countries use more columns to not only get a better sense on vaccines recommended during the second year of life (measles-rubella second dose, seasonal influenza, DTP4/booster, and in some places OPV4), but also to better understand the proportion of children who are being vaccinated late.

With the introduction of more an more vaccines, the concept of fully-immunized (FIC) may become difficult to monitor in paper. It is important to find the balance between what "would be nice" vs what is practical for the front worker filling-in the forms along with many other forms for many programs. With that said, in my experience in Latin America, many countries were able to monitor delayed vaccination and do something about it, thanks to not only collecting the data by age group, but more importantly, thanks to using it!  

In the attached figure, you can see that in this particular country, DTP3 by 1 year (1 ano) for children born in 2008 (cohorte 2008) was 84.4% but if you look at late vaccination, close to an additional 10% were being vaccinated after 12 months of age (8.6% in the second year of life). This led this country to work with its provinces to promote timely vaccination and not to postpone Pentavalent in favor of pneumococcal vaccine (which upon further exploration they detected was happening in same places where nurses were reluctant to give multiple injections in the same visit). If you have more columns, it is extremely important to ensure that the vaccination is entered in the correct column, based on the age at vaccination (and not based on when the child should have been vaccinated), and to promote that health workers do not deny late vaccination, particularly for measles-containing vaccines. 

 

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