National Immunization Program Information System: implementation context assessment

Abstract

Background: The National Immunization Program Information System (SIPNI-Sistema de Informação do Programa Nacional de Imunização) in Brazil is a technological innovation management tool that enhances the performance of managers and health professionals in the evaluation and monitoring of immunization activities. In the country, the decentralization of the System is at an advanced stage, but it still faces challenges regarding its operation and use, impacting on its results. This study aims to evaluate the deployment of SIPNI in the state of Minas Gerais, in 2017. Method: Cross-section study performed in Primary Healthcare vaccination rooms in 54 municipalities in the Brazilian state of Minas Gerais, in 2017. A multidimensional questionnaire was used with nursing professionals who work in vaccination rooms, containing questions about the structure (presence of an internet-connected computer, instruction manual, software version, IT professional for technical support, trained healthcare professional, use of communication channels to obtain system information) and the process (activities performed by the staff to operate the immunization information system) of their work. Those questions refer to the components of the information system: system management, immunized-patient records, and Movement of Immunobiological. Implementation Degree (ID) was defined by a score system with different weights for each criterion, according to the importance level observed in it, with a rating of: adequate, partially adequate, inadequate and critically inadequate. For data analysis, median was used as the summary measure, and Pearson's Chi-Squared Test was used for proportion comparison.

Factors related to the adoption of the Brazilian National Immunization Program Information System

“…Furthermore, a stable internet is necessary to avoid compromising data entry, due to the slowness of the system and, consequently, the maintenance of paper forms. Some Brazilian municipalities face important challenges in implementing NIPIS, including good quality internet access [11] due to the size and diversity of the country.…”

“…However, systems in many countries only capture vaccines provided by public services and recommended by the national vaccination schedule [ 5 ], as is the case of the Brazilian IIS [ 11 ], the American IIS (California) [ 30 ], and the Italian IIS [ 27 ]. The disadvantage of such systems is that they may not provide reliable estimates of vaccination coverage since data do not contain complete information about the population vaccinated [ 30 ].…”

“…For data collection, vaccination rooms in 12 municipalities in the region were selected, covering 87 vaccination rooms. The selection of municipalities, which was the object of this research, was based on a preliminary study with a quantitative approach, carried out in 55 municipalities to assess the degree of implementation of NIPIS [11]. The degree of implementation was defined by a scoring system with different weights for established and validated criteria, according to the level of importance observed.…”

“…The degree of implementation was divided into adequate (80 to 100%), partially adequate (60 to 79.9%), inadequate (40 to 59.9%), and critical (under 40%). It is important to note that no municipality has achieved adequate implementation [11].…”

“…A study aiming to assess the implementation of NIPIS in Brazilian municipalities pointed out a partial performance of the system, signaling problems in its use by the nursing team that works in vaccination rooms. Even with the implementation of NIPIS web, paper forms are still kept to record vaccination activities, which presupposes flaws in their use [11].…”