Between 2013 and 2018, BID designed, developed, and introduced an electronic immunization registry in three regions in Tanzania and one province in Zambia. The Initiative’s financial records were used to account for the financial costs of designing and developing the EIRs, BID staff time, expenditures for rolling out the EIR systems and the related suite of interventions to health facilities, and recurrent costs. Total financial costs, cost per facility and cost per child were calculated in 2018 US$. By documenting the costs associated with introducing an EIR, BID hopes to help other countries introduce more affordable platforms for their own health landscapes. Read the full article in BMJ Global Health.
The governments of Tanzania and Zambia identified key data-related challenges affecting immunization service delivery including identifying children due for vaccines, time-consuming data entry processes, and inadequate resources. To address these challenges, since 2014, the countries have partnered with PATH’s Better Immunization Data (BID) Initiative to design and deploy a suite of data quality and use interventions. Two key aspects of the interventions were an electronic immunization registry and tools and practices to strengthen a culture of data use. As both countries deployed the interventions, three distinct changes in data use emerged organically. This article provides a detailed summary of these three phases or waves, based mostly on qualitative data or observation: (1) strengthening data collection using new data collection tools and processes and increasing efficiency of health workers; (2) improving data quality regarding accuracy and completeness; and (3) increasing use of data to take action to strengthen their work and for programmatic decision making. These waves clearly demonstrated the growing ability of health workers to move from data collectors to data analyzers who began to focus on the data quality and then the value of using the data in their day-to-day activities. For the full article, visit Global Health: Science and Practice.
The BID Learning Network invites you to view a webinar presentation titled “Cultivating a Data Use Culture: Lessons Learned from the BID Initiative.” Global and national stakeholders have acknowledged that routine immunization programs face significant challenges related to the collection, availability, and use of data for planning, management, and improvement of program performance. To address these critical data challenges, the BID Initiative worked with the governments of Tanzania and Zambia, to introduce a suite of interventions at facility and district levels.
As part of the work the BID Initiative undertook starting in 2013 to improve countries’ collection, quality, and use of immunization data, PATH partnered with countries to identify the critical requirements for an electronic immunization registry (EIR). An EIR became the core intervention to address the data challenges that countries faced but also presented complexities during the development process to ensure that it met the core needs of the users. The work began with collecting common system requirements from 10 sub-Saharan African countries; these requirements represented the countries’ vision of an ideal system to track individual child vaccination schedules and elements of supply chain. Through iterative development processes in both Tanzania and Zambia, the common requirements were modified and adapted to better fit the country contexts and users’ needs, as well as to be developed with the technology available at the time. This process happened across four different software platforms. The BID Initiative recently published a paper to Frontiers in Public Health that outlines the process undertaken and analyzes similarities and differences across the iterations of the EIR in both countries, culminating in the development of a registry in Zambia that includes the most critical aspects required for initially deploying the registry and embodies what could be considered the minimum viable product for an EIR. Read the full article in Frontiers in Public Heath.
The BID Learning Network invites you to view a webinar presentation on The Data Use Partnership. The use of reliable information from a well-designed health information system is critical for: decision-making during disease outbreaks; enhancing efficiency; fostering innovation; and ultimately ensuring improved health outcomes. To this effect, the Government of the United Republic of Tanzania, with the support of PATH, has been implementing the Data Use Partnership (DUP) under the Ministry of Health’s transformative Digital Health Investment Road Map in health data systems and use. This is intended to close key gaps so that Tanzania can make informed decisions within public health to strengthen health outcomes.
Vaccine coverage is routinely used as a performance indicator for immunization programs both at local and global levels. For many national immunization programs, there are challenges with accurately estimating vaccination coverage based on available data sources, however an increasing number of low- and middle-income countries (LMICs) have begun implementing electronic immunization registries to replace health facilities’ paper-based tools and aggregate reporting systems. These systems allow for more efficient capture and use of routinely reported individual-level data that can be used to calculate dose-specific and cohort vaccination coverage, replacing the commonly used aggregate routine health information system data. With these individual-level data immunization programs have the opportunity to redefine performance measures to enhance programmatic decision-making at all levels of the health system. In this commentary, we discuss how measures for assessing vaccination status and program performance can be redefined and recalculated using these data when generated at the health facility level and the implications of the use and availability of electronic individual-level data. Read the full article in Vaccine.
Mott MacDonald conducted an independent evaluation of the BID Initiative with the aim of verifying and explaining results and identifying lessons learnt. This report presents a synthesis of findings from successive milestone evaluations. Full reports for each of these evaluation exercises are included as annexes. This report also includes findings from a special study in Dodoma Region to assess the effectiveness of an alternative rollout strategy.
Mott MacDonald conducted an independent evaluation of the BID Initiative with the aim of verifying and explaining results and identifying lessons learnt. This presentation is a synthesis of key findings from successive milestone evaluations, including a special study from Dodoma Region.
The BID Initiative Story highlights the value of collaborative, country-driven planning; local leadership and ownership; user-centered design; and continuous learning and adaptation when developing and deploying innovations. It also shows why we are optimistic about our progress and future efforts to improve health services and outcomes across sub-Saharan Africa by transforming data collection, quality, and use.
The purpose of this document is to present a description of the Tanzania Immunization Registry (TImR), a system developed in collaboration with the Government of Tanzania and PATH through the BID Initiative to address many of the challenges the immunization program faces. This document explains the purpose and features of TImR, how it should interface with external systems, the constraints under which the system must operate, and the data that needs to be collected. The full document is available here.