The Expanded Program on Immunisation (EPI) and the Sindh Health Department launched an android-based application -- Zindagi Mehfooz Digital Immunization Registry in Sindh -- developed by Interactive Research and Development (IRD), with the Indus Health Network (IHN) supporting implementation across the province to reduce child mortality from vaccine preventable diseases.
The provincial scale-up is funded by WHO-Pakistan with GAVI’s support. The registry was initially funded by the UN Foundation Innovation Working Group and was later supported by WHO for limited pilots and scale-up.
The core team working on the IRD vaccination program is led by Dr Subhash Chandir, IRD’s director of Child Health & Vaccines Program and faculty at the Harvard Medical School, and IRD founder Dr Aamir Khan.
Other instrumental members directly contributing to the program’s development and execution include Dr Abdul Bari Khan (CEO -Indus Health Network), Ali Habib (CEO -Interactive Health Solutions), Saira Khowaja (Deputy Executive Director Global Health Directorate- Indus Health Network), Dr Vijay Kumar, Danya Arif and Dr Mubarak Shah (Senior Program Managers - Child Health & Vaccines Program, IRD).
“Out of every 1,000 live births, 82 children die before their first birthday in Sindh, according to Multiple Indicator Cluster Survey (MICS) 2014. Most of these deaths are due to vaccine preventable diseases.
“In children aged 12-23 months in Sindh, only 35 per cent of children received Expanded Program Immunisation- recommended vaccines during the first year of life. Some contributing factors to suboptimal immunisation coverage are- overburdened immunisation staff, inadequate health infrastructure, lack of awareness and wrong perceptions regarding immunisation among parents, and paper-based systems that make it difficult to track and monitor a child’s immunisation coverage,” said Dr Abdul Bari Khan, CEO of the Indus Health Network.
“About three out of four children are under vaccinated in Sindh. The Zindagi Mehfooz Digital Immunisation Registry will change the landscape of child health by engaging parents for timely immunisations, systemising vaccinator’s jobs by creating centralised immunisation records, reducing time spent on paper-based reporting and creating more time and opportunities for vaccinators to immunise children,” said Dr Subhash Chandir, rirector of Child Health & Vaccines Program at the IRD.
The Zindagi Mehfooz registry will enable mobile-based data entry of the child’s name, biodata and immunisation history which is linked to a web-based monitoring dashboard. At the time of the child’s visit to the EPI center, the vaccinator will enrol the child in the registry by assigning him/her a unique ID in the form of a Quick Response (QR) Code and submitting the data to the web dashboard in real time.
The registry also enables automated SMS reminders for parents to remind them of their child’s upcoming vaccination, a decision support system for routine and catch-up immunisations and a real-time tracking and monitoring system for vaccinators.
The registry was piloted in Karachi in 2012 and the Shikarpur district in 2015 before being scaled up to the entire province. Once expanded throughout Sindh, it would be used by more than 3,000 government vaccinators using smartphones across 1,600 basic health units in the province.
This technological innovation is expected to increase routine immunisation enrolment, improve uptake and timeliness of vaccinations, generate real-time actionable data and improve quality, logistic management and monitoring of the EPI in Sindh.