TechNet-21 - Forum

  1. Robin Mowson
  2. Immunization information systems & coverage monitoring
  3. Thursday, 10 May 2018

This document is designed to support EPI managers and their teams in the implementation of EIR-related information systems, using the various experiences compiled at the global level – and, especially, in the Region of the Americas – as a foundation.

Within this context, the main objectives of this document are as follows:

1) To generate knowledge related to information systems and immunization registries for immunization program managers at the national and subnational levels;

2) To provide teams, EPI managers, and experts in health information systems with relevant background and experiences for development, implementation, maintenance, monitoring, and evaluation of EIR systems, so as to support planning of their implementation;

3) To provide technical, functional, and operational recommendations that can serve as a basis for discussion and analysis of the standard requirements needed for development and implementation of EIRs in countries of the Region of the Americas and other regions;

4) To serve as a platform for documentation and sharing of lessons learned and successful experiences in EIR implementation.

This document is structured into three major sections: background; EIR planning and design; and EIR development and implementation, taking into account the relevant processes and their structure. The content of the chapters is supported by a literature review of aspects related to EIR requirements and summarizes the experiences of the countries of the Region of the Americas and other regions that already have EIRs in place or are at the development and implementation stage. Many of the experiences presented herein have been shared during the three editions of the “Regional Meeting to Share Lessons Learned in the Development and Implementation of Electronic Individualized Vaccination Registries,” held in 2011 in Bogotá (Colombia), in 2013 in Brasilia (Brazil), and in 2016 in San José (Costa Rica), in addition to ad hoc meetings held by the Pan American Health Organization/World Health Organization (PAHO/WHO), Member States, independent consultants and other agencies such as WHO, BMGF, CDC, PATH, ECDC, AIRA, among others.

We appreciate the technical and financial support from the Bill and Melinda Gates Foundation.

Publication is also available in Spanish and French 

Attachments (1)
Accepted Answer Pending Moderation

This is an excellent report and many thanks for sharing. There are extremely useful considerations and it is very comprehensive.

We have been struggling to deal with some of the issues related to EIR. One of the issues that strike us is the lack of robust evidence on the effects of EIR. As the report rightly points out that better measurements of coverage may lead to coverage improvements; however, we need to be careful in extrapolating evidence from other interventions, even if similar, to EIR. For example, Jacobson 2005 (updated in 2018) refers to text messaging reminders, which may not be automatically applied to EIR. Another assumption that may not always hold is that interventions working on HIC may also work in LIC.

The review of Blaya et al, used in the report, illustrates this concern when saying that "Most evaluations [of EHR] found provided insight into possible impacts of these systems, but had limited scientific rigor"; or "With the rapid growth of e-health in developing countries, there is clearly an urgent need for solid evidence of its impact to justify and guide the investment of resources in such systems. Despite major increases in evaluations in recent years, most large e-health implementations have little or no evaluation data".

We need to work together to build this evidence base and to ensure that LIC countries are not made dependents of systems that (like the cold chain, for example) pose sustainability challenges with uncertain returns.

Accepted Answer Pending Moderation

Hi there,

Great document indeed, and it seems really user-friendly. 

Xavier, thank you for sharing your concerns and that particular quote from Blaya et al:

"With the rapid growth of e-health in developing countries, there is clearly an urgent need for solid evidence of its impact to justify and guide the investment of resources in such systems."

In the PAHO EIR doc here, there is an interesting table is on p.65 - 4.5 How system success is measured. What do you think of it, as a starting point to evaluate electronic health systems in countries? 




Accepted Answer Pending Moderation

Thanks Olivia. I would read 4.5 as a quite nice list of outcomes to measure performance of vaccination programmes. However, I understand that Blaya may be referring to robust research studies to assess the effects of EIR (e.g. comparative or experimental studies).

Accepted Answer Pending Moderation

Congratulations PAHO colleagues! This is an excellent compilation of practical guidance based on still accumulating experiences. I agree with the other comments that eEvaluating the usefulness and impact, as well as costs, of Electronic Immunization Registries is the next step for the global community.

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