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My Reflections: Melinda Gates Visits the BID Initiative

By Paulo Urioh, Nurse, Mareu Health Facility in Tanzania

Jul 25, 2016

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Photo: Bill & Melinda Gates Foundation/Riccardo Gangale. Paulo Urioh, a nurse in Tanzania, demonstrates the new electronic immunization registry to Melinda Gates.

Photo: Bill & Melinda Gates Foundation/Riccardo Gangale. Paulo Urioh, a nurse in Tanzania, demonstrates the new electronic immunization registry to Melinda Gates.

Demonstrating the electronic immunization registry at Magomeni Health Facility

When the BID Initiative asked if I could travel to Dar es Salaam to demonstrate Tanzania’s electronic immunization registry for Melinda Gates, I was nervous and happy at the same time – happy that I would meet Melinda, but nervous to speak to her. I was confident in what I was supposed to do since my health facility, Mareu Health Facility in Arusha region Tanzania, was one of six facilities that tested BID Initiative solutions. We’ve now been using it for over a year.

I arrived at Magomeni Health Facility in Dar es Salaam and patiently waited to do a demonstration for Melinda. First, the facility and BID staff walked her through the current immunization service delivery process. I noticed that she was surprised at the amount of paperwork and time needed to record immunizations and do reporting, when that time could instead be spent on providing care for patients.

After hearing about the challenges we as nurses experience with the current process, Melinda was ready to see how the new registry works and how it makes my job easier. We covered a lot of information including, but not limited to:

  • My point of view as a nurse and how nurses are and will continue benefiting from the BID Initiative. For example, with barcodes on child health cards, I can now simply scan the barcode and the child’s immunization record comes up in the electronic registry instead of searching through all the forms she just saw. The electronic registry tells me what vaccines are due for a child, when, and if our facility has adequate stock of the vaccine. Also, I can easily track children who missed a vaccination and follow up with them.
  • The way the immunization data generated from the system has been able to help nurses improve their day-to-day working activities. Melinda appreciated the effort put into the system to reduce the workload for nurses in the immunization sector.
  • The challenges we are experiencing adopting a new system. For example, we are currently using two systems in parallel, the new electronic system and the old ledger system until the government is comfortable moving forward with the new system. I explained how this impacts our workload and that the nurses are looking forward to using only the electronic system as it will reduce our workload.
  • How the User Advisory Group (UAG) ensures the system and other interventions such as data-use posters are relevant to the people who will use them. Melinda was very interested in the changes in data quality and use and asked how we addressed these issues in the UAG. As a UAG member, I explained how we provided feedback on the lack of reports in first version of the system and now, in the current version, all reports are included in the system.
  • How the WhatsApp group has been used effectively as a communication forum for nurses. I am the admin of the Meru District WhatsApp group and monitor its effectiveness based on the daily contributions, chats, and usefulness to the nurses. Nurses are communicating about challenges and helping each other on a variety of immunization-related issues such as learning the new system and transferring vaccine stock from neighboring facilities if supplies are low.
Reflecting on the visit and looking ahead

I personally appreciate the new electronic immunization registry and am looking forward to the system helping more nurses improve immunization service when it is scaled to other parts of Tanzania. I am very thankful for the Bill & Melinda Gates Foundation for funding the BID Initiative and investing in the work that I do.

To be selected among so many nurses to come to Dar es Salaam and demonstrate the system and other BID Interventions we are using, I feel privileged and motivated to keep learning about how to effectively use data to better deliver services. I am happy that my efforts are appreciated and I was seen as one among many to be able to demonstrate BID. This experience was a great honor to me.

I hope as BID is implemented in more facilities, other nurses will use the system effectively and enter correct data carefully. We need to cooperate and help each other. For nurses going on leave, they should make sure they explain to others in their facility how to use the system so it’s used consistently and effectively. At the end of the day, we will have better data, better health, and better decisions will be made for the improvement of the immunization sector in my country.

I never thought in my life I would meet Melinda Gates and having been able to talk to her, it was a great opportunity and it will remain forever in my mind.

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