OVATE EVALUATE ALE UP IMPROVE ALTH RESEARCH ALUATE SCALE UP PROVE INNOVATE ALUATE SCALE UP PROVE HEALTH
Improving immunization registration, coverage and monitoring in Viet Nam – PATH’s Digital Immunization Registry (IR) System Viet Nam’s public health system currently uses a paper-based immunization registry system. Health workers based at the commune health centres (CHCs) compile handwritten lists of children and pregnant women due for vaccinations and inform them through home visits or mail. When the vaccines have been administered, the details are recorded by hand and compiled in monthly reports, which are sent to the district health centre. But this system is time-consuming and prone to errors, which can cause delays, leaving children and pregnant women at greater risk of contracting vaccine-preventable diseases. Data inaccuracies also make planning difficult, leading to poor management of vaccine stocks and overall lack of efficiency. PATH’s new Digital Immunization Registry System (Digital IR) allows for real-time access to immunization data and easy generation of reports at the CHC and district levels. It also allows for faster and more accurate recording and reporting of immunization details; improves the timely delivery of services; and facilitates programme monitoring. This system is designed to ultimately replace the current paper-based immunization registry, thereby increasing efficiency at all levels of the health system (commune, district, provincial and national) and reducing the workload of health staff.
How Digital IR works Digital IR eliminates the need for handwritten lists, calculations and reports by providing CHCs with a web-based application that is accessible on computers and smartphones. Newborns and pregnant women are registered by a health worker via a computer or smartphone. The system then sends text message (SMS) reminders to parents about monthly child immunization days, and tracks the vaccines they receive. Digital IR also generates information on the types and numbers of vaccines CHCs need to administer every month, thus avoiding stock-outs, and provides lists of individuals due for vaccinations.
Supporting national public health programming The Digital IR project supports Viet Nam’s Expanded Programme on Immunization (EPI) and efforts to mainstream technology solutions in health management, as highlighted in the Ministry of Health’s Five-year health sector development plan 2011–2015 (1). The system’s ability to track pregnant women’s due dates and tetanus toxoid vaccination dates will contribute to the Government’s efforts to ensure more than 90% coverage in pregnant women. Digital registration of newborns will also assist the National EPI by providing the actual number of births for careful planning and accurate monitoring of childhood immunization coverage, instead of the crude birth rate. The Digital IR pilot project in Ben Tre Province, Southern Viet Nam, aims to provide the Government and the Ministry of Health with evidence of the value that can be added by this system, and this model can eventually be scaled up nationwide. Both the National EPI and the programme in the Southern Region (Southern EPI) will help coordinate the pilot project activities by providing technical support in software development, training sessions for trainers and health workers, and remote support and field visits.
Digital IR
Pregnant women and newborn babies are registered in the Digital IR system
Parents receive SMS reminders about monthly immunization days for their children
Pregnant women and infants receive prompt services, improving the rate of on-time immunizations
Digital IR allows for real-time access to immunization data and easy generation of reports, reducing workload and errors
Digital IR contributes to planning and monitoring of immunization coverage and vaccine stocks
They will also participate in workshops to hear feedback from endusers and address any issues that arise during early implementation. Based on the lessons learnt, National EPI and Southern EPI will consider regional and nationwide scale-up of Digital IR.
Viet Nam
Pilot project: Ben Tre Province, Southern Viet Nam Districts reached: all 9 districts in the province CHCs reached: all 164 CHCs in the province
Target number of individuals to be reached during the pilot project, by district, 2014: District: Ba Tri 2 809 Ben Tre 1 463 Binh Dai 1 876 Chau Thanh 1 901 Cho Lach 1 491 Giong Trom 2 452 Mo Cay Bac 1 662 Mo Cay Nam 2 125 Thanh Phu 2 335 Total 18 114
Partnerships for support and sustainability PATH is collaborating with relevant national health programmes – National EPI and Southern EPI – to implement this project, and will foster their continued commitment. Given the limited capacity of the current Global System for Mobile Communications (GSM) to accommodate SMS messages sent during the project, PATH has partnered with a service provider that has better capacity to manage the increased number of SMS messages when the project is scaled up. Through the project, PATH will build a long-term partnership between National EPI and the country’s largest telecommunications company to maintain continuous SMS provision, supporting future nationwide implementation. 3 233 1 696 2 184 2 163 1 640 2 719 1 851 2 506 2 659 20 651 2 809 1 463 1 876 1 901 1 491 2 452 1 662 2 125 2 335 18 114
Viet Nam Number of children under 1 year old Number of children exactly 18 months of age Number of pregnant women
IWG catalytic grant for mHealth programme scale-up PATH’s Viet Nam office was awarded a grant to scale up the Digital IR programme in Viet Nam by the United Nations Innovation Working Group’s (IWG’s) catalytic grant competition for maternal, newborn and child mobile health (mHealth), managed by the United Nations Foundation. PATH was successful in the grant competition because it employs an effective delivery strategy for an evidence-based maternal and child health intervention, combined with creative financing strategies to promote sustainability – elements that are critical for mHealth tools to contribute to Millennium Development Goals 4 and 5.1 Through IWG, PATH is receiving assistance from MDG 4 is to reduce child mortality; MDG 5 is to improve maternal health (www.unmillenniumproject.org/goals/gti.htm) 1
the World Health Organization’s Department of Reproductive Health and Research to optimize scale-up of the Digital IR programme while contributing to the mHealth evidence base and best practices on implementation and scale-up. Please visit http://www.who.int/ reproductivehealth/topics/mhealth/en/ or www.path.org for more information. Partners: National Expanded Programme on Immunization (National EPI), Southern Region Expanded Programme on Immunization (Southern EPI), Ben Tre Health Department, Ben Tre Provincial Preventive Medicine Centre and nine district preventive medicine centres For more information please contact: Vu Minh Huong, Director, Vaccines and Immunization (hvu@path.org), or Nguyen Tuyet Nga, Deputy Director, Vaccines and Immunization (ntnguyen@path.org)
Reference: 1. Five-year health sector development plan 2011–2015. Hanoi: Ministry of Health, Government of Viet Nam; 2010 (http://www.wpro.who.int/health_ services/viet_nam_nationalhealthplan.pdf, accessed 8 August 2014). Credits: Icons from The Noun Project designed by: Jack Biesek, Gladys Brenner, Margaret Faye, Healther Merrifield, Kate Keating, Wendy Olmstead, Todd Pierce, Jamie Cowgill and Jim Bolek, Luis Prado, Matt Daigle, Roger Cook & Don Shanosky, Jens Tärning, Yorlmar Campos Photo: Nguyen Phu Cuong, PATH Editing, design and layout: Green Ink (www.greenink.co.uk) WHO/RHR/14.34 © World Health Organization, 2014 The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable precautions have been taken by the World Health Organization to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use.