The Zambia Electronic Immunization Registry (ZEIR), powered by the Open Smart Register Platform (OpenSRP), is an open source Android application geared towards frontline health workers with offline functionality and is interoperable with other open source global goods such as District Health Information Software (DHIS2). ZEIR is standard based and has been built to ensure timely, complete and accurate immunization data that enables the tracking of children and their vaccination records. This user manual provides instructions on how to use the ZEIR app during daily work at the health facility.
More than 150 leading global health and development thinkers convened on June 15, 2016, for The Innovation Effect: Powering Disruptive Global Health Solutions in Washington, DC. This conference report provides an overview of the insights shared when attendees explored what happens when unique partnerships, disruptive technologies, transformed systems, and data-driven insights combine in often unexpected ways to create dramatic improvements in the health and well-being of people around the world.
The Health Resources and Services Administration and All Kids Count (a national technical assistance center fostering development of integrated child health information systems) have been working together to foster development of integrated child health information systems.
Activities have included: identification of key elements for successful integration of systems; development of principles and core functions for the systems; a survey of state and local integration efforts; and a conference to develop a common vision for child health information systems to meet medical care and public health needs.
We provide 1 state (Utah) as an example that is well on the way to development of integrated child health information systems.
Health care experts, policymakers, payers, and consumers consider health information technologies, such as electronic health records and computerized provider order entry, to be critical to transforming the health care industry (1–7). Information management is fundamental to health care delivery (8). Given the fragmented nature of health care, the large volume of transactions in the system, the need to integrate new scientific evidence into practice, and other complex information management activities, the limitations of paper-based information management are intuitively apparent. While the benefits of health information technology are clear in theory, adapting new information systems to health care has proven difficult and rates of use have been limited (9–11). Most information technology applications have centered on administrative and financial transactions rather than on delivering clinical care (12).
Project Fives Alive! aims through the application of quality improvement (QI) methods to assist and accelerate Ghana’s efforts to achieve the Fourth Millennium Development Goal of reducing under— 5 mortality by 67% from its 1990 baseline of 110-120 deaths per 1000 live births to less than 40 deaths per 1000 live births by 2015. Operational since July 2008, PFA! has worked with frontline health workers to develop, test and implement successful change ideas that have proved useful in overcoming system barriers accounting for preventable deaths in children less than five in Ghana. Starting from three districts in the Northern sector of Ghana, the project is now scaled up in all 38 districts in Upper East, Upper West and Northern regions of Ghana and in 32 hospitals of the National Catholic Health Service scattered all across the country in various districts. Effectively tested and implemented ideas within districts, sub-districts and the hospitals to improve processes in the continuum of care have been documented into two “Change packages” - one for successful changes in antenatal, skilled delivery and post-natal care and the other in hospital-based care.
Poverty has deepened the crisis in health-care delivery in developing countries, particularly sub-Saharan Africa, which is a region facing a disease burden that is unmatched in the world. Whether access to proven and powerful information and communication technologies (ICTs) can improve health indicators is an ongoing debate. However, this brief review shows that in the last decade there has been significant growth in Internet access in urban areas; health-care workers now use it for communication, access to relevant health-care information, and international collaboration. The central message learned during this period about the application of ICTs is that infrastructural and cultural contexts vary and require different models and approaches. Thus, to harness the full potential of ICTs to the benefit of health systems, health workers, and patients will demand an intricate mix of old and new technologies.
The aim of this guide is to help health workers to use their own data to identify problems and causes of low immunization coverage, and to plan solutions to increase immunization coverage. These guidelines can be modified to suit the local context and needs, and can be used at various levels of the health system in any country.
Immunization is a program whose success or failure in achieving public health impact is often judged on the basis of data generated on a daily, weekly, or monthly basis by health workers in facilities ranging from remote health posts to regional hospitals. Because immunization is a service that can be scheduled (unlike, for example, treatment of ill children) its data can be used by health workers to answer such key management questions as: Are we reaching the people in each locale who need immunization? Are we making progress? Who are we not reaching? Are children starting the immunization schedule but then dropping out? How well do outreach services work? In principle but not always in practice, the answers to these questions can be found by health workers themselves with data that are readily available to them. The importance of data use is highlighted by the inclusion of facility-level microplanning as a core component of the WHO/UNICEF Reaching Every District strategy, used by most countries to strengthen routine immunization (RI).
The Better Immunization Data Learning Network (BLN) recently hosted a webinar entitled “Introduction and Formation of User Advisory Groups (UAG) in Arusha”. This webinar focused on the engagement of groups that are composed of users at different levels of the health system, who have a certain level of authority that enables them to validate the project. These users provide leadership for iterations of interventions as well as champion the process of improving immunization information systems.
In the current information age, the use of data has become essential for decision making in public health at the local, national, and global level. Despite a global commitment to the use and sharing of public health data, this can be challenging in reality. No systematic framework or global operational guidelines have been created for data sharing in public health. Barriers at different levels have limited data sharing but have only been anecdotally discussed or in the context of specific case studies. Incomplete systematic evidence on the scope and variety of these barriers has limited opportunities to maximize the value and use of public health data for science and policy.