Authored by: Awoke M. Temesgen and Steve Lim
Over the last year, our organizations, the Ethiopian Public Health Institute’s National Data Management Center (NDMC) and the Institute for Health Metrics and Evaluation (IHME), have engaged in a remarkable collaboration.
Our partnership, supported by Exemplars in Global Health, explored why childhood vaccination rates in Ethiopia have plateaued since 2010 and lagged behind the progress we’re seeing in other countries with similar socioeconomic development trajectories. Our findings yielded important insights into the factors underlying vaccination stagnation and pointed to potential pathways toward progress.
But we’re writing this article to share something equally noteworthy beyond our findings: the lessons to be learned from how we engaged in this important research.
To paraphrase a common saying: it isn’t what we did. It is how we did it.
We connected four data sources which are often unavailable, incomplete, or underutilized in LMICs: household surveys, health facility surveys, health registries, and health facility census.
In Ethiopia, these data sets are not merely available, they are collected in a manner that makes them compatible, and they are process, stored, and managed by a central authority, the National Data Management Center (NDMC). Established in 2017, the NDMC is unique in its role supporting data-driven decision-making. The center’s work collecting, managing, and analyzing the data not only supports evidence-based policies, but also increases the likelihood that other health researchers will use the data and further enrich our understanding of progress, challenges, and opportunities to gain momentum and reach our goals.
Our research is a case in point. Weaving these data sources together allowed us to tell a more nuanced story about the challenges Ethiopia faces and posit more tailored solutions.
Which brings us to our second point: our research was the result of a true and robust partnership.
The team at IHME brought to the table new statistical methods and tools to share with the NDMC team. While the NDMC team brought its intimate knowledge of the data characteristics and local context that were invaluable.
To leverage both teams’ strengths, our collaboration included in-person working sessions for one full week – which proved catalytic to propelling our investigation forward.
Both teams learned invaluable lessons that left both institutions stronger. The IHME team gained greater insights into data collection, data landscapes, and making findings actionable to policy makers.
While the NDMC team gained data analytics capacity that positions the institution to better serve Ethiopia’s policy makers going forward.
This type of partnership – featuring meaningful collaboration and capacity building for all sides – is what we need more of in global health.
Researchers interested in learning more about our underlying analytical approach, which relied on the same quantitative approach used in the Exemplars in Vaccine Delivery research, can find our manual, co-published by IHME and NDMC here.
Here’s a quick synopsis: First, in remote areas, such as pastoralist communities, the government could improve childhood vaccination rates by expanding access to facility-based and/or outreach-based immunization services as has been done in Zambia,and increasing transportation services for the purposes of healthcare delivery.
Second, efforts to increase demand for vaccination, such as media campaigns, and improve the readiness of facilities to deliver immunization services, such as increasing staffing and strengthening vaccine supply chains, can have an important role in increasing the likelihood that a child is vaccinated, particularly in communities where distance is not a barrier.
We believe the partnership model we adopted should be adapted and replicated across the global health research sector and that LMICs should invest in collecting, managing, and leveraging data resources to better support evidence-based decision-making.
Awoke Misganaw (PhD) Clinical Assistant Professor, Health Metrics Sciences, University of Washington, USA, Senior Advisor, National Data Management Center, Ethiopian Public Health Institute (EPHI), Country Lead, Subnational Burden of Disease Collaborative Initiative, EPHI & IHME, Adjunct Assistant Professor of Health Metrics Science of Bahir Dar University, Ethiopia
Stephen Lim is a Professor of Health Metrics Sciences, Senior Director of Science and Engineering at the Institute for Health Metrics and Evaluation (IHME), and an Adjunct Professor of Health Services at the University of Washington.