In a recent Solutions Center webinar, VaxTrac and PATH shared how their teams are collaborating with frontline health workers and national governments in building better mHealth tools for vaccine data management.
VaxTrac’s mission is to provide developing countries with the customized and localized technologies they need to maximize the effectiveness of vaccination programs. The nonprofit has been working in Benin since 2012 and Nepal since 2014, focusing its work around a collaborative program model underpinned by two key facets: technology that’s responsive to users’ needs and the local capacity needed to ensure project sustainability long after the team intervenes.
“Building local capacity as well as national ownership through a customized approach to both technology development as well as project management is critical to long term success and sustainability,” shared Meredith Baker, VaxTrac Director of Programs and Partnerships.
VaxTrac users range from parents and guardians to immunization managers and decision makers, and the team has seen tremendous value in taking the time to get to know these users and adapt technology to meet their needs.
Meredith and team have found that balancing the diverse needs of such a wide range of users across the vaccine delivery system requires a thorough needs assessment phase as well as a testing period for rapid iteration in order to stay responsive. Technology needs, process needs and infrastructure needs are all considered when localizing the system in this initial requirements gathering period. Meredith said it has been especially important to identify and align with local and national priorities when assessing infrastructure needs. Often times, policies around technology either don’t exist or are incomplete, and VaxTrac has helped to define these policies as a result. With a better understanding of each of these needs, VaxTrac is able to launch a customized system in a testing period of rapid iteration in which the team responds to any unforeseen challenges or needs.
Meredith shared an example of launching the system in northern Benin, where it’s cultural practice for women to put henna on their hands and feet when they give birth. This posed unforeseen challenges for the fingerprint scanner and biometrics identification, as the scanner couldn’t read mothers’ fingerprints. VaxTrac engineers were able to fix the problem within six to eight weeks after getting the feedback from supervisors. Meredith emphasized that this responsiveness goes “a long way to increase buy-in and ownership and reduce user fatigue.”
Following Meredith, Laurie Werner, global director of PATH’s Better Immunization Data (BID) Initiative, shared their work to empower sub-Saharan African countries to enhance immunization and overall health service delivery through improved data collection, quality and use.
To start, PATH is partnering with demonstration countries Tanzania and Zambia to identify the most pressing routine immunization service delivery problems related to data quality and use; develop and perfect solutions to address these challenges; and share tools, lessons and best practices across the BID Initiative’s peer learning network.
In Tanzania, the BID team worked with the Ministry of Health and Social Welfare (MoHSW) and the Immunization and Vaccine Development (IVD) program in running a needs assessment to pinpoint challenges impeding the ability to deliver efficient immunization services. Like VaxTrac, PATH is also focused on aligning with stakeholders on the initiative’s goals and approach, and has helped MoHSW think through various policies as they build out the nation’s larger e-health architecture. The BID team is working towards the development of intervention packages that are “scalable, affordable and maintainable” in close collaboration with the health workers themselves.
Like Meredith, Laurie emphasized that long-term success is dependent on securing national participation and commitment. Working alongside the government from the get-go and ensuring interventions reflect national priorities is crucial to the initiative’s sustainability.
After the initial needs assessment and alignment phase, PATH kick-started a “collaborative intervention design” period. The team is currently leading a pilot in Arusha (a region suggested by the Ministry for its geographical diversity and leadership) with support from health workers—consulting users at all levels and MoHSW in the ongoing design, testing and iteration of interventions. Interventions include a national electronic immunization registry, data use tools such as automated and simplified reports, and barcodes on child health cards in response to difficulties in uniquely identifying and tracking infants.
Laurie recommended ensuring enough testing time to adapt these new systems and interventions to users’ needs. In the case of the barcodes, for example, the team had to take time to address unexpected resistance from mothers. To alleviate concerns, PATH worked with the Ministry and health workers to put together a campaign and messaging explaining barcode advantages.
For more lessons learned, click here to listen to the webinar recording or view webinar collateral >>