Tanzania’s electronic immunization registry rolls out new features to respond to COVID-19

By Celina Kareiva, Senior Communications Associate, BID Initiative

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Photo: PATH/Trevor Snapp. Paulo Urioh, a nurse in-charge at Mareu Health Center, uses the Tanzania Immunization Registry to administer vaccines to patients.

As COVID-19 rattles many countries and their health systems, Tanzania is turning to its robust network of digital health systems to help curb the pandemic. Under the government’s strong leadership, the Tanzania Immunization Registry (TImR) has been in use since 2017. Now, the country is exploring new features for TImR that will strengthen the system and enable its role in the pandemic response.

“Electronic immunization registries (EIRs) provide digital records of children’s vaccine histories to ensure no one is left behind,” explains Hassan Mtenga, Country Lead for the BID Initiative in Tanzania. “Now, because of the government’s leadership we have an unprecedented opportunity to strengthen TImR and respond to this global moment.”

Working in close partnership with the Immunization and Vaccine Development (IVD) Program, the BID team has developed a new scheduling feature for TImR that will pull patient data and vaccine histories to enable immunization scheduling in each static session. Caregivers are notified through SMS about the specific hour of the day that they should visit the health facility for vaccination, taking into consideration the facility’s capacity for the day. In the past, patients visited health facilities without an appointment, when their next vaccine was due. However, this often led to long wait times, surges of patients, and made it difficult for health workers to trace patients that had defaulted. The new scheduling feature will help manage patient queues, while maintaining the government’s social distancing guidelines.

The messaging features will also allow health workers to send notes to caregivers about the availability of immunization services during COVID-19. For example if a clinic closes, if health workers need to correct for misinformation circulating about COVID-19, or if certain preventative protocol is required of patients, they’ll receive a message in advance of their visit.

Maybe most importantly, though, will be TImR’s ability to help district officers and health workers determine their daily clinic capacity so they can better plan for immunization services. Using these digital features, the system will notify caregivers’ about a specific date and time to bring children to the health facility for upcoming vaccines. By scheduling patients’ clinic visits, facilities will ensure smaller groups, limit wait times, and reduce the risk of transmission.

“This new feature will support the country’s response to COVID-19 by reducing large gatherings of people waiting for immunization services, and the risk of transmission in clinic settings. It will improve immunization service delivery, which has been affected by COVID-19, as many caregivers were worried about taking their children for vaccination out of fear they will be infected,” explained Hassan. “In fact, research suggests that the risk of transmission is low in health care settings and the morbidity and mortality of missing vaccines is far greater than the risk that children will be infected visiting clinic. SMS reminders will help to instill these messages of health promotion and maintain essential health services throughout the pandemic.”

In addition, a new functionality has been added that will allow the Ministry of Health at a central level to share real-time content with frontline health workers about emergent issues, whether it be an outbreak, treatment, or prevention protocols. This functionality provides a platform for the Ministry of Health to disseminate information to frontline health workers quickly and easily.

This enhanced version of TImR is being rolled out in phases, beginning in three facilities in Ilala district and two facilities in Hai district for two weeks each. After determining their progress and troubleshooting any challenges that may arise, the functionality will be deployed to half the facilities in both districts. Following that milestone, health facilities in all 15 regions where TImR is currently in use will introduce the enhanced system. Throughout rollout, BID will work with the government of Tanzania to evaluate its success, measured by the number of caregivers that visit the clinic at their scheduled time and which facilities they visit after receiving an SMS alert.

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Original author: Celina Kareiva