Root causes of COVID-19 data backlogs: a mixed methods analysis in four African countries
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With the unprecedented scale and scope of the COVID-19 vaccination response, many countries used digital systems to capture vaccine administration data. Data backlogs, a build-up of information captured via paper forms not yet entered into digital systems, were common across countries.
Together with USAID’s MOMENTUM Routine Immunization Transformation and Equity and as part of a two-year collaborative effort on a special supplement for Oxford Open Digital Health, Digital Square led a study aimed to identify the root causes of COVID-19 vaccination data backlogs in the Democratic Republic of the Congo, Kenya, Senegal and Tanzania. The study was based on primary (interviews and observations at vaccine delivery sites) and secondary data.
The study found that root causes of data backlogs were related to technology (system slowdowns, insufficient devices and limited system functionality), infrastructure (lack of reliable internet and data bundles), processes (incongruence between paper and digital tools, separate data collection and entry, lack of integration with routine immunization and lack of standard operating procedures) and people (staff shortages, large workloads and non-payment of staff).
Recommendations to inform digital and data systems include:
Use a country-led, coordinated, iterative approach for system design and introduction.
Start with a minimum viable product.
Proactively address the needs of the health workforce. As the COVID-19 global emergency ends, these findings can help inform broader health system strengthening efforts to improve effectiveness, resilience and pandemic preparedness.