Making sense of key health program indicators is a critical step to driving the use of data for decision making. This, in turn, leads to improved services and better health outcomes for communities. In Ethiopia, the Universal Immunization through Improving Family Health Services (UI-FHS) project is enabling health workers to do this by using quality improvement methods and tools.
Recently, the project developed the Reaching Every District (RED) Categorization Tool to help woreda health office (WoHO) staff understand and act on their immunization data. Based on WHO’s system for classifying the access and utilization of immunization services, the Excel-based tool collects and analyzes core immunization performance indicators—coverage and dropout rates for Penta1, Penta3, and measles vaccines.
Managers and immunization staff at the woreda and primary health care unit levels input coverage data into the database and it automatically classifies the health facilities and WoHO into one of the categories below.
Once health facilities have been categorized, managers can analyze the results, identify the health facilities where extra support is needed, and determine follow-up actions. For a facility in Category 2, for example, managers could recommend the development of a system to register and track children who do not return for follow up doses. In the case of a facility in Category 3, for example, managers may recommend collaborating with local community members to review the catchment area map and ensure underserved communities are identified and linked to services.
Some of the other important features of the RED Categorization Tool include:
- It uses the routine data collected through the health management information system of each health facility. Health workers don’t need to collect additional data in order to conduct the analysis.
- It enables automatic calculation and graphic display of coverage, dropout rate, and the number of unimmunized children.
Since its introduction across the Southern Nations, Nationalities, and People’s Region (SNNPR), the RED Categorization Tool has been especially popular. Across the region, WoHO staff are actively analyzing the data collected and using it for decision making.
In Humbo woreda, the tool has been so critical such that during a six-month period when its computer was being repaired, the WoHO staff manually re-created the database categorization (see photo below). Despite the technical hitch, the staff wanted to continue regularly assessing the performance of each health facility.
Use of the RED Categorization Tool has also taken off in the Segen Area People’s Zone where UI-FHS supports Burji woreda. The zonal health department there has shown a strong interest in expanding the use of the tool to all other woredas in the zone. In a recent zonal review meeting, the department used the tool to display routine immunization status across the zone.
The RED Categorization Tool is also being adapted for use by other health programs beyond routine immunization.
The WoHO in Aroresa woreda appreciates using the RED Categorization Tool to display and analyze their data. They recently adapted the tool to track the progress of antenatal care visits and skilled delivery indicators.
By using this practical tool and adapting it to fit their needs, WoHO staff across SNNPR and beyond are taking ownership of their programs and working to achieve better health outcomes for all.