Nurse Joyce Ngowi: Learning a new electronic immunization registry to provide better service
By Saumu Juma, Implementation Coordinator, BID Initiative Tanzania
Sep 21, 2016
I recently sat down with Joyce Ngowi, the nurse in charge of the Reproductive Child Health (RCH) Department at Endabash Health Centre in Karatu District, a rural facility located about 50 kilometers from Karatu town. This facility was opened in 1973 by the late Mwalimu Julius Nyerere, the founder of Tanzania. It provides services to a number of villages in the area. Joyce’s department in particular handles all issues concerning babies, pregnant women, family planning, and prevention of mother-to-child transmission.
Endabash Health Centre is among the facilities we visited during the second week of rollout in Karatu District and has been doing exceptionally well adopting BID interventions, including the new electronic immunization registry. Joyce has worked here for more than 20 years and despite her age and lack of familiarity with technology, she is excelling at learning new practices and policies.
Hi Joyce, can you describe your role at your facility?
I am the assistant matron here and am also the head of the RCH department. I attend children coming in for clinic; assess their growth, give vaccinations, and nutritional counselling. I also attend the pregnant women and conduct family planning.
How many children do you typically see in a month?
We are quite busy, I see around 120 to 150 children in a month.
How has your job changed with the introduction of the BID Initiative and the electronic immunization registry?
For now, my job has increased because now I have two systems to collect information in, the existing paper system that we are still reporting with and the new electronic registry. I believe my work will be much easier after I have learnt everything in the new system and we stop using the old paper system.
Before the new electronic immunization registry, how did you identify children missing vaccination?
I would have to flip through the paper register to see if there were gaps on vaccination dates which I honestly did infrequently because we are so busy. I depended entirely on the child’s health card when they came in for appointments, but it was impossible to track vaccinations when the card was lost. It was almost impossible to identify children missing vaccinations.
What kind of new skills are you learning?
I have learnt how to use a smart phone, which I have never used before! I have learnt how to identify defaulters (kids missing vaccines) and how to assess stock inventory on hand using the new system and without using a ledger book or opening my fridge to physically count vaccine vials. I am more modern now because I’m using technology.
What are you looking forward to once the electronic immunization registry is fully implemented and replaces the existing paper system?
It will be a dream come true for me. For a long time, I wished that we would stop using so many paper forms and the day that we were introduced to the BID Initiative, I knew that the opportunity was now with us. It is hard work learning and using the new system but I want to be ready when we are finally told to stop using the paper forms. There aren’t very many of us in the facilities and there is so much paper work, less time for service and it becomes a problem when someone forgets to write down something. This ends up having us cut corners with the clients and I am not happy with that.
What has been the most challenging part of learning new skills and tools?
Everything was challenging in the beginning such as registering and searching for children in the system. The will was there, so I knew I would eventually grasp it with more practice. As time goes on, I am learning something new every day and am happy with my progress.
The implementation of the BID Initiative in Karatu District is going on for a month now but the reception of the solutions and new practices is positive. I feel I am part of the process and do take ownership of these interventions. I am thrilled with the support and progress by BID Initiative implementation team and health facility staff for the great job they are doing.