In the last decade many African countries have accelerated the national roll-out of digital tools in their healthcare systems. Digital systems help health workers anticipate disease spikes, better direct resources to underserved areas, and deliver more targeted patient care. Now those systems are providing a new and different kind of value in the face of COVID-19. Using the data made available by digital systems, such as the electronic immunization registries introduced under the BID Initiative in Tanzania and Zambia, PATH is working to curb the spread of the epidemic.
Here are three key ways that's happening where PATH works.
1. Spreading messages of health promotion by mobile phone
Electronic immunization registries (EIRs) provide digital records of patients' vaccine histories, replacing cumbersome paper-based systems for recordkeeping. They provide timely, accurate, and complete data to ensure no child misses lifesaving vaccines. Several countries have adopted EIRs, including Tanzania and Zambia, with support from PATH.
Many EIRs, such as the Tanzania Immunization Registry (TImR), include contact information and messaging features for patients’ caregivers. With more than 253,000 contacts in TImR, the system allows for direct communication with caregivers. These messaging features have historically been used to notify patients about upcoming immunization clinics or overdue vaccines. But as the global community develops a greater understanding of COVID-19—including its transmission patterns, full range of symptoms, and treatment options—health workers have the ability to share messages of health promotion with patients. This might include information about safely accessing health facilities, upcoming immunization clinics, and preventative measures.
In Zambia, SMS (text messaging) is being piloted to further improve communication between health workers and their patients through a partnership between BID and mVacc. Messaging features also help health providers share accurate, up-to-date information directly with patients, to counteract what the head of the United Nations called “a dangerous epidemic of misinformation” around COVID-19.
Nurses at St. Joseph's Clinic in Zambia review immunization data on an electronic immunization registry. These digital platforms can help respond to COVID-19. Photo: PATH/Chimwasu Njapawu.
2. Peer support and messaging between health workers
Health workers have long used the "groups" function in the messaging app WhatsApp for peer support and to stay in contact with neighboring health facilities. These channels of communication have been critical for helping health workers master the new electronic immunization registries when they were first rolled out, to locate and share vaccine supplies to avoid stockouts, and for other forms of peer support.
“We borrowed vaccines from a neighboring facility, after reaching out to them on WhatsApp,” said Susan Siatwiko, a nurse at Siakapisa Health Facility in Zambia, after using one of the groups BID helped establish as a communication forum.
The need to stay connected has become even more critical under COVID-19. Messaging apps offer a lifeline between health facilities triaging supplies and coordinating patient services under a strained health system.
“We borrowed vaccines from a neighboring facility, after reaching out to them on WhatsApp.”— Susan Siatwiko, nurse at Siakapisa Health Facility, Zambia
One of the greatest challenges of the COVID-19 pandemic is the unprecedented strain it places on health systems. As COVID-19 patients flood facilities, it becomes critical to maintain other essential health services. By analyzing electronic immunization record data, health officials can identify health trends, such as changes in immunization service delivery. Better health data can prioritize and coordinate upcoming immunization clinics so as not to further overburden facilities. In both Tanzania and Zambia, the systems can help schedule individual children for immunizations at specific dates and times to comply with guidance on social distancing. Furthermore, messaging features and TImR’s data visualizations can project patient volumes and help officials better plan for upcoming immunization clinics. By scheduling patients’ clinic visits, facilities will ensure smaller groups, limit wait times, and reduce the risk of transmission.
The BID Initiative and PATH will continue to advocate for and work towards the strengthening of routine immunization, while accelerating digital tools and approaches to control vaccine-preventable diseases. Follow the discussion on Facebook and Twitter, using the hashtags #VaccinesWork.
A version of this article also appears on the website for the BID Initiative, a PATH-led immunization data initiative grounded in the belief that better data, plus better decisions, will lead to better health outcomes.
