Public-private partnerships in immunization data strengthening: Lessons from deploying Vietnam’s electronic immunization registry
By Tu Nguyen Xuan Cam, Program Officer, PATH
Jan 29, 2021
Posted in Uncategorized
Public-private partnerships in health care have been used widely in higher income countries as well as in lower-middle-income countries, such as Vietnam. The partnerships bundle together multiple phases or functions of the health system infrastructure—such as design, build, finance, maintain, operate, and service delivery. This health system infrastructure can effectively build on the experience and resourcing strategies of partnerships.
Vietnam’s National Immunization Information System (NIIS) is a sustainably planned, government-run, nationwide electronic immunization registry (EIR) and vaccine tracking system. NIIS demonstrates a public-private partnership that both built the infrastructure and provided the service delivery. The NIIS is the product of a partnership between the Vietnam Ministry of Health and one of the country’s largest mobile network operators (MNOs), Viettel Business Solutions Corporation. The NIIS can track all vaccinations, including those within and outside of the National Expanded Program on Immunization (NEPI), and is available to a variety of both public and private health center providers. The aim is to track immunization records for all individuals in Vietnam from birth until the end of their lives. Nationwide implementation of the NIIS requires engaging private, fee-based immunization facilities that help to expand the reach of immunization services to the population.
Throughout the decade-long evolution of the EIR in Vietnam, PATH has played the role of a catalyst to accelerate coordination and bridge the gap between the two sectors. The IDEAL Vietnam project (Introducing Digital Immunization information systems–Exchange And Learning from Vietnam) is funded by the Bill & Melinda Gates Foundation and working in collaboration with NEPI. IDEAL has captured the challenges and lessons learned from two different public-private partnerships. These findings are described in the following two case studies summarized here.
Mobile Network Operator Partnerships in Action for Health: A Vietnam Case Study on Mobile Network Operator and Ministry of Health Engagement for Electronic Immunization Registry Application
To launch an EIR and vaccine tracking system in Vietnam, it was necessary to select an MNO with the largest resources and capabilities in the country. This ensured that the necessary technology, core connectivity, and support and business infrastructure would meet the high demand of large datasets, nationwide application, and sustainable transition from paperless to digital. Trust also played a key role: Viettel is not only one of the largest MNOs in the country, it also has a long-standing working relationship with the Ministry of Health and other governmental agencies. Vietnam’s partnership with the MNO provided many benefits, expanding its expertise, recognition in the country, relationships with government bodies, and credibility.
There are key challenges that need to be considered when developing partnerships and maintaining an EIR application. In Vietnam, these included learning curves associated with technical content and areas of expertise, differing business models between the MNO and Ministry of Health, and the importance of planned formal agreements from the outset.
Engaging Private Sector Providers in Immunization Data Management and Use: Perspectives from Vietnam
Fee-based immunization services in Vietnam follow the same standards, guidelines, and regulations as Expanded Program on Immunization services, including the mandate to use the NIIS to document immunization service delivery since its launch in 2017. The status of NIIS data entry, quality, and use at fee-based immunization facilities (FIFs) varies depending on:
- The interoperability between the NIIS and the FIF’s own existing immunization information system;
- Human resources available for data entry into both systems;
- Willingness to comply with regulations; and
- An understanding of the benefits of the NIIS in immunization coverage for the population.
The government is emphasizing private-sector engagement as the number of FIFs continues to grow in Vietnam, especially in large urban areas, such as Hanoi and Ho Chi Minh City. Barriers to their engagement were identified and solutions proposed, including developing a strict legal framework for NIIS uptake, providing training for immunization staff at FIFs on the benefit of the NIIS, enhancing data use and data quality, and creating standard operating procedures for data transfer between systems via an application platform interface.
These case studies provide valuable insights for other countries and government bodies as they collaborate with the private sector to build and scale EIR systems.