By Judith Grace Amoit
Efficient health monitoring and immunization coverage are the cornerstones of improved public health outcomes. In Uganda, achieving this relies on robust data systems that ensure accuracy and usability. Recognizing this need, Makerere University School of Public Health (MakSPH) has partnered with the Ministry of Health (MoH) under the Countdown to 2030 initiative and African Population and Health Research Center. This collaboration seeks to enhance health outcomes through evidence-based interventions, capacity building, and the institutionalization of data-driven decision-making.
Enhancing Data Quality for Immunization
Accurate immunization data is crucial in reducing inequities and ensuring that no child is left behind. The World Health Organization (WHO) emphasizes the importance of high-quality health data to achieve universal health coverage and meet immunization targets. However, Uganda faces significant challenges in this area. Population-based denominators used for coverage calculations often yield inconsistencies due to factors such as migration, refugee influxes, and urbanization.
“These discrepancies, which have led some districts to report coverage rates exceeding 100% with anomalies as high as 200%—highlight the urgent need for improved methods of data collection and analysis,” explained Mr. Besigye Albert, Monitoring and Evaluation Manager for the MoH immunization program.
This challenge is not unique to Uganda. Globally, progress toward universal health coverage (Sustainable Development Goal 3.8) has stalled since 2015. Compounding this issue is the rising proportion of people facing catastrophic health spending, further emphasizing the urgency for systemic improvements in health data management.
Capacity Building for Reliable Health Data
To address these challenges, MakSPH is supporting the MoH through the Countdown to 2030 initiative. This global effort, supported by partners like Johns Hopkins University, the African Population and Health Research Centre (APHRC), the Hospital for Sick Children in Canada, and the University of Manitoba Canada focuses on institutionalizing routine data use to track progress toward Sustainable Development Goals (SDGs).
Professor Peter Waiswa, Principal Investigator at MakSPH, highlighted the initiative’s goals: “Our objective is to establish routine data as a reliable source for health coverage estimates and institutionalize its use within the Ministry of Health.”
One of the initiative’s key activities has been the Health Facility Data Quality Assessment on Immunization Indicators, led by Dr. Rornald Kananura, a postdoctoral Research Scientist at African Population and Health Research Center. This assessment identified areas for improvement, such as addressing reporting completeness, consistency, and addressing outliers. By comparing routine data with surveys like the Uganda Demographic and Health Survey (UDHS), the team demonstrated how routine data when cleaned and validated, could complement survey data, reducing costs and improving timeliness.
“We’ve shown that routine data, can provide reliable immunization estimates,” Dr. Kananura explained. Moreover, the partnership also equips national and district teams with skills to replicate advanced analysis techniques, identify data gaps—especially for zero-dose children—and align administrative data with WHO-UNICEF estimates (WUENIC). “The alignment of administrative and WUENIC estimates reflects growing confidence in our data systems,” added Mr. Besigye.
Leveraging Regional Insights for Targeted Interventions
Analysis of routine data by MakSPH has uncovered significant regional disparities in immunization coverage and dropout rates. For instance, dropout rates between pentavalent 1 and pentavalent 3 vaccines were higher in some districts, indicating the need for localized strategies to retain children in immunization programs.
“These findings align with WHO’s emphasis on using disaggregated data to address health inequities and strengthen service delivery,” noted Dr. Kananura.
Sustainable improvements in health data systems require ongoing collaboration. Due to this collaboration, MoH has established subcommittees on data and service delivery to facilitate regular progress reviews, identification of emerging challenges, and share of best practices among partners such as UNICEF and WHO.
Driving Innovation with Data-Driven Policies
Dr. Paul Mbaka, the Ministry of Health’s Assistant Commissioner for Health Services and Health Information Management Division emphasized the importance of methodological rigor in data analysis to produce actionable insights. “We must continuously adjust to realities and deliver relevant, defensible data to guide our policies,” he said.
In addition to improving routine data quality, the collaboration is exploring mathematical modeling to set realistic immunization targets and address data discrepancies. This approach ensures a more accurate understanding of immunization coverage and informs effective interventions.
This partnership together with Countdown to 2030 and the APHRC represents a significant step toward strengthening Uganda’s health information systems. By leveraging routine health data and addressing challenges with immunization coverage estimates, this collaboration demonstrates how academic-government partnerships can drive progress toward equitable health outcomes.
Building a Healthier, More Equitable Future
The WHO has emphasized that achieving health equity requires data-driven policies and targeted interventions. With ongoing investments in capacity building, data quality improvement, and methodological innovation, Uganda is well-positioned to make significant strides in achieving its immunization and health coverage goals.
Guided by evidence and a shared vision, this collaboration is creating a healthier, more equitable future for all Ugandans. It also serves as a model for other nations striving to achieve universal health coverage, proving that strategic partnerships and data-driven solutions can drive transformative change.