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Zambia’s Ministry of Health collaborates with BID and others to strengthen immunization system

By Masaina Bwakya, Change Management Lead, BID Initiative

Jan 9, 2020

Posted in

Photo: Bill & Melinda Gates Foundation/John Healey. Gertrude Tembo holds her baby during a vaccination service at the Mahatma Gandhi Clinic in Livingstone, Zambia. The Mahatma Gandhi Clinic is one of the first clinics to use data quality and use interventions under the BID Initiative.

The Zambian Ministry of Health (MOH) is taking an innovative, new direction to close the country’s immunization gap with a new partnership that touches every component of the immunization system. The EPI Optimization (EPI-OPT) strategy brings together a consortium of technical experts and partners working collaboratively with the government to improve coverage rates.

While the BID Initiative, with government leadership, has made significant progress in addressing data management challenges by introducing an electronic immunization registry, it is only one piece of the puzzle. BID is working with the Center for Infectious Disease Research in Zambia (CIDRZ), the Churches Health Association of Zambia (CHAZ), and the United Nations Children’s Fund (UNICEF), which have all been tackling different facets of immunization service delivery. Together the partners are collectively advancing four key pillars of immunization service delivery based on a series of surveys conducted across Zambia. EPI-OPT will strengthen EPI knowledge and the skillsets of health care workers; supply chains and logistics performance; data quality and EPI monitoring; and demand for immunization services.

“BID has been engaging these partners for some time, but this is the first time we’ve had an opportunity to work together so intentionally,” explained Masaina Bwakya, Change Management Lead for BID in Zambia. “This partnership is unprecedented and by working together we build on each other’s strengths to achieve better immunization coverage for all.”

BID is working with the Government of Zambia and other partners to support a range of activities, including:

  • Strengthening knowledge and skills among health workers within Zambia’s Expanded Programme on Immunization (EPI). This will include mentoring health facilities on data, stock, and vaccine management.
  • Improving EPI monitoring and data quality, visibility and use by implementing the Zambia Electronic Immunization Registry (ZEIR) that is now in use in all of Southern Province thanks to strong government leadership.
  • Improving the performance of the immunization supply chain and logistics by introducing Logistimo, an electronic supply chain management software. Logistimo will be available at a district and health facility level to help health workers track vaccine stock levels, avoid stockouts, and vaccine wastage.
  • Improving demand for immunization services by introducing a community-based SMS platform and reminder system that will help health workers collect information on homebirths through SMS messages. It will also allow them to send educational messages to caregivers about the importance of immunization.

While some EPI-OPT solutions have already been introduced in Southern Province, such as ZEIR, EPI-OPT will bring together all of the above interventions as a single, integrated package. The EPI-OPT package will then be evaluated, lessons will be documented, and the EPI-OPT partners will issue recommendations about how best to scale the strategy nationwide.

In addition to its deep expertise on ZEIR, the BID team brings a strong background in change management. Change management is critical to ensure that all stakeholders understand why change is being proposed and how it affects and impacts their work environment and day-to-day responsibilities. It’s particularly important for building a culture of data use in which health workers use systems like ZEIR for data analysis, not just data collection, to improve caregiving.

Under EPI-OPT, BID and its partners will close immunization gaps and pilot a model for immunization service delivery that could transform Zambia’s health system.


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