Electronic capture and transmission of routine immunization data using open data kit (ODK): A pilot study in selected PHCs in Enugu, Nigeria

Background: Despite the efforts invested in generating quality data for routine immunization (RI) in Nigeria, significant improvement is yet to be reported, largely due to the multiple reporting, summation, and data transfer processes associated with the current paper-based reporting system. Aim: This study piloted the use of electronic capture and transmission of RI data using Open Data Kit (ODK) in selected health facilities in Enugu State to determine its effect on internal consistency, completeness, timeliness, and validity on RI data. Materials and Methods: An intervention study adopting the implementation research approach was conducted in 12 local government areas (LGAs) in Enugu State, Nigeria: six intervention LGAs and six control LGAs. Four RI data sets were built into two ODK data collection tools and deployed in Android phones for RI data capture and transmission in 60 randomly selected primary health care centers (PHCs) from six intervention LGAs (10 PHC per LGA) for three months. A second set of 60 health facilities was randomly selected from another six different LGAs as a control. A total of 10,663 RI data captured within this period were processed and analyzed using Microsoft Excel and SPSS version 25. Results: Only 49 (81.7%) of the 60 intervention PHCs transmitted RI data using the ODK, and the majority of the PHCs (81, 74.3%) were also from rural areas. RI data captured and transmitted using ODK had internal consistency in more health facilities where intervention had taken place (46, 93.9%) than in health facilities where the paper-based method was used (33, 55.0%), representing a 70.1% marginal increase in internal consistency. Internal consistency was significantly associated with intervention status (intervention and non-intervention sites) and location (urban/rural) at P value = 0.001 and 0.044, respectively. Data transmitted electronically using ODK were also 2.9 times more likely to have internal consistency than those captured and transmitted with the paper-based method (P = 0.001). Data from urban areas were also 1.5 times more likely to have internal consistency than those from rural areas (P = 0.011). Conclusion: Despite its challenges, such as poor power supply, poor network coverage, and device specification and the capacity of health workers, electronic capture and transmission of RI data using ODK is effective in improving RI data internal consistency, completeness, and validity.