Pakistan, Zambia, and Kenya are among a growing number of countries implementing electronic immunization registries (EIRs) to improve data quality and health facility performance. But EIRs can be costly to design and introduce. This case study explores the localization and adaptation of OpenSRP’s immunization module, the benefits of iterating on open-source software, and lessons learned during use in Pakistan, Zambia, and Kenya.
Kenya’s national immunization program was one of the most successful in East Africa in the 1990s. In the last ten years, Kenya’s immunization coverage for DTP3 has averaged between 73% and 88%. The drop-out rate nationally was reported at 7% in 2009 (see graph below). Coverage has varied, however, between provinces–with some reporting DTP3 below 70% and with DPT1-DPT3 drop-out rates above 10%. In 2008, a post-election political crisis destabilized the country, particularly in Western, Nyanza and Rift Valley provinces. This resulted in interruption of health services, including vaccination, during that year. There were also vaccine stock-outs in 2008 and the first quarter of 2009. Additionally, the division of districts and creation of new districts (from 78 to 254) has resulted in problems with denominator calculations and difficulty in ensuring fully functioning District Health Management Teams and services in many of the new districts. The recent creation of two separate health ministries with split program functions has also resulted in managerial and financial complications for preventive services like immunization.
The primary objective of the 2008-09 KDHS, like its predecessors, is to provide up-to-date information for policymakers, planners, researchers, and programme managers. This information guides the planning, implementation, monitoring, and evaluation of population and health programmes in Kenya. Specifically, the survey collects data on the following: fertility levels, marriage, sexual activity, fertility preferences, awareness and use of family planning methods, breastfeeding practices, nutritional status of women and young children, childhood and maternal mortality, maternal and child health, malaria and use of mosquito nets, domestic violence, awareness and behaviour regarding HIV/AIDS and other sexually transmitted infections (STIs), and HIV prevalence among adults.
This Comprehensive Multi Year Plan 2006 - 2010 will guide the immunization activities in Kenya. It highlights the national goals, objectives, and strategies derived from the EPI situational analysis. The analysis has been done through comprehensive review of DVI’s Annual operational reports, immunization coverage reports, programme sector’s assessment reports, programme evaluation reports, findings of surveys carried out during the plan period, and the KEPI joint review of April 2006.
Kenya reports that the majority of the listed actions to promote an enabling environment for information and communication technologies (ICT) in the health sector have been taken between 2000 and 2005. These actions are rated from moderately to very effective and are predicted to continue over the next two years. The implementation of a national eHealth policy, and creation of regulations to protect the privacy and security of individual patient data where eHealth is used are likely to be introduced by 2008.