Acceptability of Peer Learning and Support for Strengthening Routine Immunization Data in Nasarawa State, Nigeria

Background: Peer learning and support network (PLSN) has been shown to improve real-time accountability processes in data management, foster a supportive learning environment, and contribute to improved quality of immunization data. Aim: This study was conducted to assess the acceptability of PLSN and the intervention-related enabling factors among primary healthcare workers and routine immunization programme managers in Nasarawa state. Materials and Methods: Monthly PLSN sessions were conducted at facility and LGA levels over a three-month period. The acceptability of the intervention was evaluated using six constructs of Theoretical Framework for Acceptability. Data were collected through 26 key informant interviews and survey of 111 primary healthcare workers. Acceptability was measured on a five-point Likert scale using a 32-item composite scale with six subscales for affective attitude, experienced burden, ethicality, opportunity cost, perceived coherence and experienced effectiveness on RI data quality. Median scores were estimated and these were used to generate the rates and levels of acceptability. Qualitative data was analyzed manually using thematic approach. Results: The composite score for acceptability was 4.02 (IQR: 2.89 - 4.90) Affective attitude had a score of 4.17 (3.17 - 4.67); experienced burden was 3.57 (2.43 - 5); ethicality was 4 (1 - 5); opportunity cost was 4 (2.25 - 5); intervention coherence was 4 (2.75 - 5); and experienced effectiveness was 4.4 (2.6 - 5). The overall rate of acceptability was 50.91% and the level of acceptability was 74.55%. There was no significant relationship between acceptability and participants' age, gender and years in service. The intervention-related enablers of the PLSN were, (i) its participatory and inclusive nature; (ii) the flexibility in scheduling of PLSN activities; (iii) integration of activities with existing data review processes. Although PLSN was perceived as burdensome, participants had a positive attitude and perceived it to be effective and ethical. Conclusion: Enablers of acceptability should be harnessed to reduce the burden of PLSN on health workers.