Exploration of the Completion Quality of Routine Vaccination Cards Kept At Home in the Provincial Health Division of Équateur, Democratic Republic of the Congo

Abstract

Introduction: Vaccination cards kept at home are an important source of information for verifying children's vaccination status and for vaccination coverage surveys. However, the quality of the information recorded on them determines their usefulness as a documentary source.

Methods: A descriptive exploratory study was conducted through secondary analysis of 100 photographs of vaccination cards for children aged 6–23 months, collected during the 2022 Vaccination Coverage Survey in Équateur Province, DRC. Cards were assessed using WHO data-quality review criteria across ten predefined elements. A card was considered complete when all identification, vaccination, chronology, legibility, and documentation fields were correctly completed, with provider validation by signature or stamp assessed separately. Frequencies, percentages, and descriptive observations were used to summarize findings.

Results: Of the 100 cards examined, errors or omissions concerned the child's name in 25% of cases, the date of birth in 11%, the sex in 2%, and the name of the parent or guardian in 15%. Omissions or inconsistencies in vaccination dates were observed in 48% of the cards, and discrepancies in vaccination chronology in 59%. No card bore the vaccinator's signature or the facility's stamp. The handwriting was legible and indelible in 60% of the cards, while 29% contained erasures or annotations. Excluding validation by signature or stamp, 9% of the cards were complete and correctly filled out.

Conclusion: Review of the cards reveals documentation deficiencies, primarily concerning vaccination dates, dose sequences, validation of procedures, and completeness. Strengthening the standardization of data formats, training, supervision, and data quality control mechanisms appears necessary to improve the reliability of the information recorded on the cards.