Triangulation for improved decision-making in immunization programmes

Triangulation is the synthesis of two or more existing data sources to address relevant questions for programme planning and decision-making. Triangulation can include assembling the data together in one graph or stitching information from several graphs together with a narrative thread. Triangulation requires critical thinking and some basic analysis skills, but the activity goes beyond making graphs — it's about turning data into reliable information for action.

Even in the absence of perfect data, public health practice has long accepted that combining many pieces of weaker evidence through triangulation can form a strong basis for more informed decision-making. Through the use of multiple data sources, the triangulation process identifies and addresses the limitations of any one data source and/or data collection methodology. A more complete view of the programme issue can be obtained by making sense of different information, as well as the broader context.

This guidance provides a systematic approach to using triangulation for programme improvement at the national and subnational levels. For both levels, there are separate documents for general triangulation guidance and annexes that provide specific triangulation guidance for key topics: immunity gaps; programme performance; and programme targets (denominators).

The target audience for the national guidance documents are immunization and VPD surveillance programme staff at the national, regional or provincial levels. The subnational guidance documents have been developed to orient staff to triangulation for key programme questions at the district or health facility levels. These guides may also be useful for non-governmental organizations providing programmatic and technical assistance to national immunization and/or VPD surveillance programmes.

Triangulation is relevant for most contexts and a variety of different applications. To achieve success in triangulation (i.e., conducting analysis, incorporating into tools and processes, and building capacity) requires adaptation to local context. Materials to support capacity building are also available below. Feedback on the triangulation guidance is welcome and can be addressed to: This email address is being protected from spambots. You need JavaScript enabled to view it.. You can also start a discussion or comment on the TechNet-21 forum.

Triangulation guidance (English)

This collection contains guidance documents in English describing how to use data triangulation for programme improvement at the national and sub-national levels.

TitleAuthorYearTypeLanguage
0. Cover and orientation to triangulation guidanceCenters for Disease Control and Prevention (CDC), UNICEF, World Health Organization (WHO)2020GuidanceEnglish
1. General Triangulation Guidance (National Level)Centers for Disease Control and Prevention (CDC), UNICEF, World Health Organization (WHO)2020GuidanceEnglish
2. Triangulation Annex: Immunity Gaps (National Level)Centers for Disease Control and Prevention (CDC), UNICEF, World Health Organization (WHO)2020GuidanceEnglish
3. Triangulation Annex: Programme Performance (National Level)Centers for Disease Control and Prevention (CDC), UNICEF, World Health Organization (WHO)2020GuidanceEnglish
4. Triangulation Annex: Programme Targets (National Level)Centers for Disease Control and Prevention (CDC), UNICEF, World Health Organization (WHO)2020GuidanceEnglish
5. General Triangulation Guidance (Sub-national Level)Centers for Disease Control and Prevention (CDC), UNICEF, World Health Organization (WHO)2020GuidanceEnglish
6. Triangulation Annex: Immunity Gaps (Sub-national Level)Centers for Disease Control and Prevention (CDC), UNICEF, World Health Organization (WHO)2020GuidanceEnglish
7. Triangulation Annex: Programme Performance (Sub-national Level)Centers for Disease Control and Prevention (CDC), UNICEF, World Health Organization (WHO)2020GuidanceEnglish
8. Triangulation Annex: Programme Targets (Sub-national Level)Centers for Disease Control and Prevention (CDC), UNICEF, World Health Organization (WHO)2020GuidanceEnglish

Triangulation guidance (French/français)

This collection contains guidance documents in French describing how to use data triangulation for programme improvement at the national and sub-national levels.

TitleAuthorYearTypeLanguage
0_TRIANGULATION POUR UNE MEILLEURE PRISE DE DÉCISION DANS LES PROGRAMMES DE VACCINATION: UTILISATION DE CE GUIDECenters for Disease Control and Prevention (CDC), UNICEF, World Health Organization (WHO)2020GuidanceFrench
1_Guide Général sur la Triangulation (Niveau national)Centers for Disease Control and Prevention (CDC), UNICEF, World Health Organization (WHO)2020GuidanceFrench
2_Annexe : Lacunes immunitaires (Niveau national)Centers for Disease Control and Prevention (CDC), UNICEF, World Health Organization (WHO)2020GuidanceFrench
3_Annexe : Performance du programme (Niveau national)Centers for Disease Control and Prevention (CDC), UNICEF, World Health Organization (WHO)2020GuidanceFrench
4_Annexe : Cibles du programme (dénominateurs) (Niveau national)Centers for Disease Control and Prevention (CDC), UNICEF, World Health Organization (WHO)2020GuidanceFrench
5_Guide Général sur la Triangulation (Niveau national)Centers for Disease Control and Prevention (CDC), UNICEF, World Health Organization (WHO)2020GuidanceFrench
6_Annexe : Lacunes immunitaires (Niveau infranational)Centers for Disease Control and Prevention (CDC), UNICEF, World Health Organization (WHO)2020GuidanceFrench
7_Annexe : Performance du programme (Niveau infranational)Centers for Disease Control and Prevention (CDC), UNICEF, World Health Organization (WHO)2020GuidanceFrench
8_Annexe : Cibles du programme (dénominateurs) (Niveau infranational)Centers for Disease Control and Prevention (CDC), UNICEF, World Health Organization (WHO)2020GuidanceFrench

Triangulation training resources

This collection contains recorded webinars and presentation slides that can be used for training on data triangulation.

TitleAuthorYearTypeLanguage
BID Learning Network Webinar on TriangulationCenters for Disease Control and Prevention (CDC), World Health Organization (WHO)2020TrainingEnglish
Comment faire un graphique combiné, un nuage de points et graphique avec boules (vidéos et exemples)Organisation Mondiale de la Santé (OMS)2020TrainingFrench
Formation de certification niveau 2 de l'OMS: La triangulation des données pour une meilleure prise de décisions dans les programmes de vaccinationOrganisation Mondiale de la Santé (OMS)2020TrainingFrench
How to make a combo, scatter and bubble charts (videos and examples)World Health Organization (WHO)2020TrainingEnglish
Webinaire 1: Triangulation des données (Formation de certification niveau 2 de l'OMS)Organisation Mondiale de la Santé (OMS)2020PresentationFrench
Webinaire 2: Données pour renforcer le programme - Niveau national (Formation de certification niveau 2 de l'OMS)Organisation Mondiale de la Santé (OMS)2020PresentationFrench
Webinaire 4: Données pour la communication (Formation de certification niveau 2 de l'OMS)Organisation Mondiale de la Santé (OMS)2020PresentationFrench
Webinaire 5: Données pour l'équité (formation de certification niveau 2 de l'OMS)Organisation Mondiale de la Santé (OMS)2020PresentationFrench
Webinar 1: Data Triangulation Overview (WHO e-scholar Level 2 Course)Centers for Disease Control and Prevention (CDC), World Health Organization (WHO)2020PresentationEnglish
Webinar 2: Data for Programme Strengthening at National Level (WHO e-scholar Level 2 Course)Gavi, the Vaccine Alliance2020PresentationEnglish
Webinar 3: Data for Programme Strengthening at Sub-national Level (WHO e-scholar Level 2 Course)Centers for Disease Control and Prevention (CDC)2020PresentationEnglish
Webinar 4: Data for Communication (WHO e-scholar Level 2 Course)Centers for Disease Control and Prevention (CDC), World Health Organization (WHO)2020PresentationEnglish
Webinar 5: Data for equity (WHO e-scholar Level 2 Course)World Health Organization (WHO)2020PresentationEnglish
WHO e-scholar course on triangulation: Video recordings of webinarsCenters for Disease Control and Prevention (CDC), Gavi, the Vaccine Alliance, World Health Organization (WHO)2020TrainingEnglish

Other relevant documents related to triangulation

This collection contains other relevant documents related to triangulation, data use, data visualization and communication.

TitleAuthorYearTypeLanguage
Data Analysis GuidanceGavi, the Vaccine Alliance2020GuidanceEnglish
Data Triangulation: Use of Health Facility Immunization Reporting ToolsJSI2017GuidanceEnglish
Effective communication of immunization dataWHO Regional Office for Europe2019GuidanceEnglish
Public Health Data Triangulation for Immunization & VPD Surveillance Programs: Draft FrameworkCenters for Disease Control and Prevention (CDC), UNICEF, World Health Organization (WHO)2019GuidanceEnglish
WHO Handbook on the use, collection, and improvement of immunization dataWorld Health Organization (WHO)2020GuidanceEnglish