Electronic immunization information systems: a case report of lessons learned from implementation in Pakistan

Area of Science:

• Public Health
• Health Informatics
• Vaccinology

Background:

• Pakistan faces a critical challenge with high rates of unvaccinated children, particularly in Sindh province, necessitating innovative solutions for routine immunization (RI).
• Traditional immunization delivery systems require enhancement, with limited focus on large-scale implementation of digital information systems in Pakistan.
• Electronic census-based immunization information systems offer potential to strengthen service delivery but require tailored implementation strategies.

Observation:

• A case report details technical support for the Sindh Department of Health/Expanded Program on Immunization (DOH/EPI) from 2015-2017 to bolster routine immunization.
• An immunization information system was developed and utilized by district health officers for individual immunization tracking, vaccine logistics, and population-based target setting.
• District immunization officers (DIOs) leveraged system data for microplanning, performance monitoring, and problem-solving in routine immunization.

Findings:

• Over 18 months, 830,610 children and 348,315 pregnant women were registered, leading to significant coverage increases.
• Tetanus toxoid vaccination coverage rose from 26% to 65% among registered women; Penta 3 coverage increased from 27% to 64%.
• Fully immunized children (0-23 months) increased from 18% to 52%, demonstrating the system's impact on comprehensive vaccination.

Implications:

• The immunization information system enabled targeted resource allocation to high-risk populations and improved monitoring of vaccination coverage and performance.
• The system facilitated timely reminders for due or missed vaccinations, enhancing patient and provider engagement.
• The Government of Sindh's commitment to routine immunization, driven by program results, supports future enhancements and scaled implementation of digital health solutions.