BLN Webinar on “Cultivating a Data Use Culture: Lessons Learned from the BID Initiative” Speakers: Masaina Bwakya, Change Management Lead, PATH Daines Mgidange, Change Management Officer, PATH 22 August 2019

The bid learning network 1 22 August 2019

The BID Learning Network Platform for information exchange, technical resource sharing, peer-to-peer interaction & exchange of promising practices e & technical Conduit of Learning and Experience Exchange Connects innovations coming out of implementation activities to country managers and professionals Brings like minds together to brainstorm matters of mutual interest that contribute to better health outcomes 22 August 2019

CULTIVATING A DATA USE CULTURE: LESSONS LEARNED FROM THE BID INITIATIVE 2 22 August 2019

What you will learn How the BID Initiative developed a suite of interventions for data collection and availability at different levels of health system in Tanzania and Zambia Which specific Interventions were used by the Initiative to complement the Electronic lmmunization Registries to strengthen data use practices Experiences and key lessons learned by the BID Initiative during implementation of data use interventions 22 August 2019

Data Management Specialists Audience This webinar should be of interest (but not limited) to: Policy Makers Funders EPI Managers Health Care Workers HMIS Specialist Data Management Specialists 22 August 2019

introducing the SPEAKERS 3 22 August 2019

Introducing our Speakers: Daines Mgidange Has more than 8 years experience working with local and international NGOs–Health, Natural Resources and Education sectors Has been with PATH Tanzania since 2014 serving as Change Management Officer for the BID Initiative Has been coordinating change management interventions under BID Initiative She holds a MA in Environmental Science and Policy from Clark University, USA.  22 August 2019

Introducing our Speakers: Masaina Bwakya Has worked with PATH since 2014 Change Management Lead for the BID Initiative in Zambia Spearheads all Change Management and Quality Improvement efforts of the Initiative in Southern Province of Zambia Areas of interest in immunization: Data Visualization which helps top show trends and tell stories about data generated for health workers to make better decisions for better health outcomes Academic credential: HND in Information Systems; BA in Development Studies and MSc. In Project Management. 22 August 2019

Please note All mics to be on mute until end of presentation Speakers will respond to questions at the end of the presentation While presentation is on-going, audience may type questions in the chat box Webinar is being recorded 22 August 2019

Cultivating a Data Use Culture: Lessons Learned from the BID Initiative Daines Mgidange and Masaina Bwakya PATH 22 August 2019

The BID Initiative There are strong challenges related to data quality around immunizations in Africa, yet few can identify which problems matter most and where. Lack of reliable, accessible, actionable data on the barriers impeding immunizations coupled with trained and empowered data users at all levels. The Challenge Empower countries to enhance immunization and overall health service delivery through improved data collection, quality, and use. The Vision Partner with demonstration countries Tanzania and Zambia to: Identify the most pressing routine immunization service delivery problems. Develop, perfect, and scale solutions with the users on the ground throughout the health system. Facilitate peer learning with other sub-Saharan African countries in design, testing, and applying interventions. The Approach The BID Initiative reflects a new type of cross-cutting investment and partnership process that we are making with governments to shore up the information system products that can more efficiently collect data, alter the policies and practices that govern routine data collection and analysis, and support the people who need to use information. Now this data is not structured to help us at the global level, but rather to support the data heroes in the field. Help them: decide where to send health workers tomorrow to give the follow up dose of PCV, ensure there is enough stock of DTP3 to manage tomorrow’s immunization day in the clinic, and put the power of routine information quickly and efficiently in the hands of those on the front line so they can do their jobs more effectively Our vision is to empower countries to enhance immunization and overall health service delivery through improved data collection, quality, and use. And to share, through a peer learning network, the interventions, best practices, and tools across the region for greater impact. If we’re successful, a true tipping point will occur—one in which countries can access, analyze, and act upon accurate immunization data anytime, anywhere—resulting in improved immunization outcomes and healthier families and communities. 22 August 2019

10/13/2019 The fifth child Without reliable health data, coupled with trained and empowered data users, health workers are not able to identify, treat, and take action to provide targeted care. Globally, one in five children does not receive their full course of immunizations, leaving them at risk of vaccine-preventable diseases. Successful immunization programs require effective supply chains, efficient service delivery, a motivated and committed health workforce, demand generation, and financial resources. Data is critical to closing the immunization gap. Without reliable, easily accessed, and actionable data on the barriers impeding health, coupled with trained and empowered data users at all levels, those interested in improving health coverage don’t have the needed data and tools to make the best decisions. 22 August 2019

10/13/2019 It used to be hard for Lucy to plan for immunization clinics.  Incomplete, inaccurate, and untimely immunization data meant children missed life-saving vaccines. In order to promote and empower health workers such as Lucy to use quality data and help address such challenges, the BID Initiative partnered with the Ministry of Health. She had to sift through paper records, tally numbers, and count stock. 14

10/13/2019 The BID Initiative is working in Tanzania and Zambia to enhance immunization and health service delivery through improved data collection, quality, and use. BID empowers countries to enhance immunization and overall health service delivery through improved data collection, quality, and use. 22 August 2019

Data Use Experience Experience shows that data has been easily captured and submitted to higher levels but using that data to improve immunization services is still a challenge to most of the health workers. We have learned that health workers need support on how to use their own data at their level and they can be supported through a mentorship process. Change management strategies were used to help health workers appreciate the benefits of using the data that they had collected. Change management helps individuals make successful personal transitions resulting in the adoption and realization of change. Information system product alone can only take us so far, it needs a combination of right change management interventions to 22 August 2019

Kotter’s Change Management steps in influencing positive change 10/13/2019 Kotter’s Change Management steps in influencing positive change and data use

Interventions for Data Use Data Use Discussions at Health Facility and District levels Peer Networking (WhatsApp Groups) Peer Learning Data Use Mentorship Targeted Supportive Supervision Data-Use Guide Electronic Immunization Registries (TiMR and ZEIR) Change Readiness Assessments 22 August 2019

Encouraging Data Use by Addressing Potential Change Management Issues To help encourage data use, it is important to note: Who the “Change Agents” are; Who can manage and perform tasks to bring about change; Set up an environment to encourage change to happen; Influence others to create the positive change; We can all be “Change Agents” in different environments e.g. District staff can be agents of data use culture to health care workers. But staff must understand the benefits of a data use culture to avoid resistance to change It is not satisfactory to only say “ Using data is beneficial to the health staff”. Benefits need to be well explained and tie into personal objectives to help respond to the “so what” for data use culture to be appreciated. e.g data review can help them plan to avoid stock out of vaccines and identify defaulters, making their work easier. 22 August 2019

Benefits of Data Use 22 August 2019

Decision Making: helps review trends in service- delivery in real-time Data Quality: prompts ensure all appropriate data is collected and validated Data Visualization: EIRs provide visual graphs allowing nurses to analyze larger amounts of data to identify gaps and design solutions Complimentary supportive supervision: more targeted action by a glance in the key immunisation indicators Peer Learning: HCWs can tell stories and share best practices with others Data use champions Defaulter tracing: Alerts help to notify staff of defaulters for follow-up through sharing reports with village leaders and asking clients to remind their neighbors to bring back children for vaccination. Dashboards: Districts can view the aggregate number of children vaccinated at facilities to improve performance for better service delivery Automated reports and graphs that helps HCWs to identify trends, check performance, identify gaps and make follow up. WhatsApp group have helped HCWs to share their best practices, performance trend and challenges 22 August 2019

Lessons Learned Involvement of User Advisory Group helped the design and adoption of data use interventions Selecting the right solution requires time and a deeper understanding of the technology involved District involvement is key in promoting data use in health facilities. Change management interventions is also very important for health workers to consistently use systems and data. Adoption of TimR is good so far, as Government of Tanzania are now facilitating and coordinating intervention scale up from 4 to 9 regions, They provide technical support, logistics and supervision and have reviewed and improved some of the interventions that was introduced at the beginning . 22 August 2019

Lessons Learned Flexible On-site training strategies help train maximum number of staff Data use discussions encouraged staff to identify ways to improve their service delivery processes Acknowledgment, prior appointments and feedback on health facility performance helped motivate staff Patience is key to encourage health workers who may not use data initially Constant support and demand of data from the district supervisors can be a motivator to use the data consistently Brainstorming helped HCWs reorganise their clinical workflow In Tanzania under GAVI support MoH, have implemented BID intervention to 6 regions and all coordination, logistics, support and follow up are conducted by government itself. PATH is just providing technical support. MOH has taken a different implementation approach by improving on lessons learned from pilot regions. e.g forming National TOT team, procuring more advanced devices, new training approaches, engaging more stakeholders (JSI, UNICEF, and AMREF) and using zonal health colleges to coordinate logistics. The MOH through IVD are advocating for improvement of data quality and data use through insisting the use of electronic system.. The well-trained teams from the national, regional, and district councils will take more frontline role in supporting and sustaining the implementation of the data quality and use interventions developed under BID initiative. 22 August 2019

Importance of feedback from Data Users Feedback from data users and policy-makers is important to improve data use. Sharing information is also essential for decision-making and contributes to creating an “information culture” However Systems that generate accurate, timely, and complete data is not the solution by itself. Data use is an on-going process HCWs need to continuously review the data they are collecting to make better decisions The impact of “Better Data, Better Decisions for Better Health” will not come until data and tools are continuously used to generate quality data to make decisions to improve service delivery. 22 August 2019

Thank you! 22 August 2019

To learn more, visit bidinitiative.org. 10/13/2019 To learn more, visit bidinitiative.org. 26 22 August 2019

Thank you & connect with us! 22 August 2019