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Concordance of self-assessment and self-reporting of National Immunization Technical Advisory Group process
Gerald Etapelong Sume1, Wedyan Meshreky1, Md Sharifuzzaman1
1Immunization, Vaccine Preventable Disease and Polio Transition Unit, Department of Universal Health Coverage Communicable Diseases, WHO Regional Office for the Eastern Mediterranean, Cairo, Egypt.
Background:
There have been concerns regarding the quality of immunisation data reported by countries through the WHO/UNICEF electronic joint reporting form (eJRF). The first region-wide assessment of the National Immunization Technical Advisory Groups (NITAGs) conducted in 2023 in the WHO Eastern Mediterranean Region using the NITAG maturity assessment tool (NMAT) offered an opportunity to verify NITAG process indicators.
Aim:
To assess immunisation data from different sources in the region and their concordance with the NITAG process indicators, in order to improve data reporting.
Methods:
We compared 6 NITAG process indicators reported by 19 Eastern Mediterranean Region countries and territories in 2023 using the eJRF and NMAT. Using WinPepi we calculated Cohen's Kappa coefficient and 95% confidence interval for conflict of interest and overall indicators.
Results:
Overall concordance of the 6 process indicators between eJRF and NMAT was 90% (102 of 114 indicator-pairs), adjusted Kappa 0.319 (95% CI -0.152-0.985). All indicators had ≥90% concordance except conflict of interest, which was 74% (adjusted Kappa 0.409; 95% CI -0.238-0.985). Concordance decreased with lower income level, from 100% in high-income countries to 77% in Gavi-eligible countries. eJRF reports indicated higher achievement of 5 out of the 6 process indicators compared.
Conclusion:
Concordance was weaker among Gavi-eligible (lower-income) countries. Harmonising indicator formulations, conducting external data audits and supporting lower-income countries can improve the reliability of NITAG reporting.
