The role of recorded and verbal information in health information systems: A case study of the Expanded Program on Immunization in Mozambique
Background: There is ongoing interest in strengthening the informational component of the EPI as a mean to enhance the efficacy of service delivery. As developing country governments make significant investments in strengthening health information systems, benefits obtained from these initiatives tend to be below their potential. To improve this, it is argued that such systems need to take into account both formal (documented) and informal forms of information. Objective: This study measures the accuracy of people-based information with information recorded in the \"Road to Health Card\". Methods: 840 mothers were screened in a cross sectional study. Information about measles immunization status as documented in the Road to Health card was compared to mothers\' verbal information. The pattern of these answers among mothers presenting the card was compared with those among mothers without the card. Results: Measles vaccine information was 95.7% sensitive and 80.0% specific. Measles vaccination positive answer was 10.0% higher among mothers without the card. In the sample of mothers without the vaccination card, only 2.0% never received a card, 53.0% had forgotten to bring it, and the remaining 44.0% had lost it. Conclusion: A key implication of these findings is the need to develop a mother-specific information system that is based at the facility, and an integration of the verbal and tacit information sources while designing the information system. Further recommendation concerns the need to have more targeted information and education programs about the importance of the Road to Health Cards, especially focused for less educated mothers.
The Ethiopian Journal of Health Development Vol. 21 (2) 2007: pp. 136-142