Data Triangulation: A New Tool for the Data Revolution in Ethiopia

With new technology, analytics, and a premium on evidence-based decisions, data are getting a lot of attention in global health. A strong data system—from collection to reporting to analysis—can improve health programming, planning, and monitoring. In Ethiopia, there has even been a call for a “data revolution” to support the Sustainable Development Agenda.

This global call for improved data quality and use applies to Ethiopia’s immunization program and extends from the national to the facility level. Health care workers use data to plan outreach efforts,  track children who have missed certain vaccines, and identify entire communities that may not have access to vaccines or the health care system. However, the quality of data from facilities can be poor; there are often discrepancies in the number of children who have been vaccinated. One way to overcome data quality concerns is through triangulation. Similar to map reading where compass bearings from three known points can estimate a position, data triangulation uses multiple data sources to get better reliability/accuracy. This can provide an additional layer of insight and understanding, turning various pieces of data into information that can be used to make better decisions.

Although many people are talking about and using triangulation, it hasn’t been easy to map the practical steps of the process. We’ve seen, through work at district and sub-national levels in Ethiopia, that defining a practical approach for data triangulation must be a collaborative effort.

The UI-FHS project in Ethiopia is in the midst of this process. The first step was getting the right people in the room to look at which data are available, which decisions need to be made, and which areas of the immunization program need to be improved. Last September, in Benshangul Gumuz Region, we met with the regional immunization program officer, the maternal and child health regional director, a regional pharmaceutical and supply expert, the regional planning and program director, and a logistician who determines quantities of vaccines to send to each district and facility. The group discussed how to make data triangulation a routine activity, and which indicators could be triangulated. Next, we’ll put selected indicators into an Excel-based tool that will simplify analysis and support decision-making during regular meetings with key staff from both immunization and supply chain programs. 

We are in the early stages of this process and recognize that data alone cannot improve immunization coverage. But it can strengthen understanding of the immunization program (particularly in places where data quality is weak), improve planning and coordination, and provide feedback that can enhance performance at lower levels. We are excited by regional health managers’ commitment to revolutionizing their data and improving the reach of immunization campaigns until all children are protected from vaccine-preventable diseases.

Written by Amare Bayeh and Wendy Prosser