Improving routine immunization data quality using daily short message system reporting platform: An experience from Nasarawa state, Nigeria

PLoS One. 2021 Aug 19;16(8):e0255563. doi: 10.1371/journal.pone.0255563. eCollection 2021.


Routine immunization (RI) delivery was declared a public health concern in Nigeria in 2017 because of persistently low immunization coverage rates reported in independent surveys. However, administrative coverage rates remain high, suggesting serious data quality issues. We posit that a shorter timespan between service provision and data reporting can improve the monitoring of RI data, and developed a short message system (SMS) text reporting strategy to generate daily RI data points from health facilities (HFs). The goal was to assess whether daily data collection produces complete, reliable and internally consistent data points. The SMS reporting platform was piloted between December 2017 and April 2018 in two Local Government Areas (LGAs, equivalent to districts) of Nasarawa state, Nigeria. The 145 healthcare workers from 55 HFs received one mobile phone and pre-configured SIM card, and were trained to send data through predefined codes. Healthcare workers compiled the data after each vaccination session and transmitted them via SMS. We analyzed completeness, number of weekly sessions, and supportive supervision conducted. During the pilot phase, we received data from 85% (n = 47) of the 55 HFs. We expected 66 fixed-post sessions and 30 outreach sessions per week, but received data for 33 fixed-post and 8 outreach weekly session on average. More HFs reported on Tuesdays compared to other days of the week. When assessing internal consistency, we observed that the reported number of children vaccinated was sometimes higher than the number of doses available from opening a given number of vaccine vials. When found, this discrepancy was noted for all antigens during fixed-post and outreach vaccination sessions. Despite these initial discrepancies, transmitting RI data sessions via texting is feasible and can provide real-time updates to the performance of the RI services at the HF level.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cell Phone / statistics & numerical data
  • Child
  • Data Accuracy*
  • Health Facilities / standards*
  • Health Facilities / statistics & numerical data
  • Health Personnel
  • Humans
  • Immunization / standards*
  • Immunization / statistics & numerical data
  • Immunization Programs / organization & administration*
  • Immunization Programs / standards
  • Immunization Programs / statistics & numerical data
  • Nigeria
  • Surveys and Questionnaires
  • Text Messaging / instrumentation
  • Text Messaging / statistics & numerical data*
  • Vaccination / standards*
  • Vaccines / administration & dosage*


  • Vaccines

Grants and funding

This work was supported by the Center for Disease Control, Atlanta, in the form of a pool of funds to the African field epidemiology network to support the Nigerian government through the Nigerian National Primary Health Care Development Agency. Dedicated staff for project management was provided by the Nigerian National Primary Health Care Development Agency. No additional external funding was received for this study.