Tanzania realizes vision for an integrated immunization system
By Kaleb Brownlow, Program Officer, BMGF and Tove Ryman, Program Officer, BMGF
May 25, 2017
A successful immunization program requires the uninterrupted availability of quality vaccines from the point at which a vaccine is manufactured to the moment a nurse administers it. But in order for manufacturers and health workers to walk in lock-step, they need end-to-end visibility into supply chains, to improve forecasting and procurement plans at a national level. The ability to link vaccine supply data to facility-level utilization and performance data ensures more cost-effective, efficient and reliable vaccine management.
Through the leadership of the Tanzania Immunization and Vaccine Development (IVD) Program, an ambitious vision for immunization-related data has been articulated for the country. As with many ambitious plans, progress has been incremental and at times parallel work streams have emerged. Yet, in Arusha region multiple efforts are converging to create one system that provides health staff and managers at all levels with greater visibility into immunization data and performance. Specifically, the Vaccine Information Management System (VIMS) which captures stock and coverage data from the district to the national level, has been integrated with the BID Initiative’s Electronic Immunization Registry (EIR) that contains child-based immunization data and stock at the service-delivery level. This achievement resulted from the collaboration of multiple stakeholders and partners committed to achieving the Government of Tanzania’s vision of a single system that provides end-to-end visibility for immunization.
On a recent trip to Arusha we observed this exciting development and were impressed by its potential to improve immunization services through the availability of real-time, integrated delivery and stock data. Real-time data allows health workers to make evidence-based decisions and unlocks potential future improvements by allowing for greater visibility and functionality of data at all levels of the health system: among nurses, district managers, and national program staff.
In Arusha region, immunization staff can now effortlessly check vaccine stock levels against the number of children due for vaccines in the coming month, which helps mitigate the risk of vaccine stock outs. At all levels of the system, stock distribution can be based on real-time data of current stock-levels and the exact number of children due for vaccines at each health facility.
In the future, there are also a number of potential system efficiencies that can be realized with an end-to-end stock and delivery data system. For instance, once Tanzania’s parallel paper systems are removed, local, regional, and national staff can focus on use of data rather than tabulation. This allows health workers to shift their focus to other things like stock distribution redesign, evaluating outreach session sites/timing, targeting of supervision visits, and identifying tactics to minimize defaulters in communities. With granular program data available at every level of the system the analytic possibilities are limitless. What if data could be used to predict which children are most likely to not show up for a scheduled vaccine? Imagine if we could predict which health facilities and immunization days will be busiest? Health workers could take preventative measures to reduce the likelihood of defaulters, and could plan for additional stock and human resources at high-volume facilities, on high-volume days.
We are excited by the possibilities as this end-to-end integrated approach is scaled to other regions of Tanzania.