Tanzania at forefront of digital transformation thanks to government leadership
By Celina Kareiva, Communications Associate, BID Initiative and Saumu Juma, Communications Associate, BID Initiative
Mar 21, 2019
Posted in People
A mother’s perspective
Dr. Dafrossa Lyimo has experienced Tanzania’s digital transformation as both a mother and a health professional. As a mother to four children, she understands the long distances children often travel for a life-saving vaccine and the disappointment of being turned away because of vaccine stock-outs, among other factors. As Tanzania’s Immunization and Vaccination Development Manager, she knows the consequences of missing, inaccurate, and untimely data to inform her decisions, particularly on where and when vaccines are most needed. In both roles, she has championed the use of data to improve immunization services.
Dr. Dafrossa’s leadership has been instrumental to the success of Tanzania’s immunization program and the BID Initiative, enabling Tanzania to achieve coverage of more than 95% for Penta 3 in 2018. Half a million children have been registered in the Tanzania Immunization Registry (TImR) under the BID Initiative.
Children under the age of five can now be easily reached and followed up with for child health interventions. But that wasn’t always the case.
“I remember back when I took [my children] to the immunization clinic, nurses would struggle and spend a lot of time searching for my child’s name and details, and updating the records of interventions my child has received across several forms. It is a tedious process for both the mother and the nurses. I had always asked myself isn’t there a better and more efficient way to do this, so that we can all go home early and spend time with our families,” recalls Dr. Dafrossa. “I had an opportunity to try responding to this challenge with PATH, through the BID Initiative, as a mother and the head of the immunization program in the country.”
From the beginning, the BID Initiative has put mothers and frontline health workers at the forefront of its efforts as they are the ones most impacted by the long wait times for immunization clinics, the potential for vaccine stock-outs, and the risk of defaulting.
They are also the most likely to benefit from data quality and use interventions. Dr. Dafrossa has been involved in BID from its earliest days. She participated in the User Advisory Group that helped design, test, and fine-tune Tanzania’s suite of interventions. She advocates for its use at all levels of the health system, and she fosters a culture of data use by applying data to her own day-to-day work.
Tanzania in the driver’s seat
Tanzania is on the cusp of a data revolution and its embrace of TImR, barcodes on child health cards, and peer support networks, among other data quality and use interventions, is contributing to a tidal change in how health workers collect and act on health data. Health care workers can now pull up children’s vaccine records in seconds, easily update their information, and carefully examine each child’s growth monitoring, tracing their progress as they care for patients. By automating reporting, streamlining data collection, and integrating stock management, health workers in Tanzania now spend eight fewer working days on immunization reporting each year.
“I’m very excited to see this transformation of how we deliver care to our people with the technology revolution. I can now, while sitting in my office, understand what is happening at the lowest level of care without waiting for the submission of reports at the end of the month, using the dashboard from the electronic immunization system,” says Dr. Dafrossa. “I’m excited to have real-time provision of services and accurate and timely data at a national level.”
Understanding how health facilities are performing against immunization targets is critical to reaching children with lifesaving vaccines. In the past, Dr. Dafrossa had only a big-picture view of immunization at a district-level, but that data masked local challenges and variation.
“The most important data,” says Dr. Dafrossa, “which [we’ve been] collecting is the one which monitors the performance: the coverage data. It helps me to know in certain areas how many children we are reaching and how many children we have missed. It helps me to plan for [what’s next].”
Dr. Dafrossa is now empowered by the data available to her. TImR provides coverage, defaulter, and dropout reports, which help her determine how individual health facilities are performing so she can provide targeted supervision and more resources to those facilities falling short of their immunization targets.
A national plan
Dr. Dafrossa is excited by the potential for data quality and use interventions to expand beyond BID’s initial regions. She envisions a national system in which children are recorded at birth and tracked throughout childhood, allowing for a continuum of care.
“I’m very optimistic that we can achieve a greater benefit when the [electronic immunization] system is used countrywide, rather than just pockets of the country and in absence of the existing paper-based system. The burden of data collection, accessing, analyzing, and reporting has gone down drastically in the regions using the systems and we believe we can still achieve more if we put more efforts into it,” says Dr. Dafrossa.
BID’s success in Tanzania—in large part—can be attributed to the government’s leadership and local champions like Dr. Dafrossa.
“No health care worker should be deprived of her/his personal or family time just because of the need to do data entry or compile monthly reports.”