Developing What Works Best
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History of the BID Initiative

Routine immunizations and new vaccine introductions are two of the best investments to improve people’s health around the globe. But without reliable, easy-to-access, and actionable health data, coupled with trained data managers, health professionals must work with limited and often anecdotal immunization data that may not correlate with the actual issues.

Led by PATH with support from the Bill & Melinda Gates Foundation, the BID Initiative was grounded in the belief that better data, plus better decisions, lead to better health outcomes. Between 2013 and 2019, BID partnered with the governments of Tanzania and Zambia to design, test, and roll out a holistic suite of interventions to address their most critical routine immunization service delivery problems through improved data collection, quality, and use. These included:

  • Electronic immunization registry (EIR) integrated with a supply chain information system.
  • Automated, simplified report generation and visualization.
  • Data use campaigns.
  • Peer support networks and targeted supervision for health workers.
  • Barcodes or QR codes on child health cards and vaccine supplies to help uniquely identify patients and track vaccine stocks.
  • Dashboards to monitor facility and neighboring facility performance.


By the end of 2020, more than 1.5 million children had been entered in both EIRs. Though the initial phase of the BID Initiative ended in 2019, PATH continues to support the governments of Tanzania and Zambia to ensure the sustainability and scale-up of their EIRs.

In Tanzania, the government expects to scale the Tanzania Immunization Registry (TImR) nationally by the end of 2021. Health facilities in one region have also begun retiring paper immunization registers in favor of TImR and transitioning to fully electronic facilities. In Zambia, PATH is working with the Ministry of Health and other implementing partners to scale the Zambia Electronic Immunization Registry (ZEIR) to additional provinces, providing technical support to the government as it builds capacity for long-term sustainability.

BID Learning Network