TechNet-21 - Forum

This forum provides a place for members to ask questions, share experiences, coordinate activities, and discuss recent developments in immunization.

Discussions tagged SMS

Introducing data-driven, remote oversight (Vaccine Supply Chain Futures 4/6)

This is the fourth topic in my six-part Vaccine Supply Chain Futures series (Please see the attached file for the full text)  focused on the introduction of a system of remote temperature monitoring integrated with equipment maintenance management. Remote temperature monitoring systems represent an opportunity for a system-wide improvement in the performance of equipment maintenance and consequently, more reliable vaccine distribution. Remote temperature monitoring automatically transmits data to a central server where it is analysed and disseminated to managers. This is a significant step forward compared to stand-alone temperature recording in each refrigerator. It replaces manual recording and paper reporting systems that have always suffered from lack of compliance and inaccuracy due to incomplete, delayed and faulty data aggregation. Remote Temperature Monitoring is a means to: Supervise health facilities to maintain correct storage temperatures, Track the efficiency of equipment maintenance at local level, Country wide data on the performance in use of each model will inform the choice of equipment for procurement to maximize reliability, Suitably anonymous versions of the country data will be used at international level to inform equipment manufacturers and regulatory experts on the rates of failure and their principal causes. Please reply to this post with your views and I would be grateful if you could answer just four questions in this SurveyMonkey: https://www.surveymonkey.com/r/L38J79Q I will return the analysis to you at the end of this week and the results will be posted before the TechNet Conference for all five topics. Please see the attached file for the full text. Thank you! 

For Info - Immunization, urbanization and slums – a systematic review of factors and interventions

Immunization, urbanization and slums – a systematic review of factors and interventions Tim Crocker-Buque, Godwin Mindra, Richard Duncan and Sandra Mounier-Jack BMC Public Health 2017, 17:556 | Published on: 8 June 2017 Abstract Background In 2014, over half (54%) of the world’s population lived in urban areas and this proportion will increase to 66% by 2050. This urbanizing trend has been accompanied by an increasing number of people living in urban poor communities and slums. Lower immunization coverage is found in poorer urban dwellers in many contexts. This study aims to identify factors associated with immunization coverage in poor urban areas and slums, and to identify interventions to improve coverage. Methods We conducted a systematic review, searching Medline, Embase, Global Health, CINAHL, Web of Science and The Cochrane Database with broad search terms for studies published between 2000 and 2016. Results Of 4872 unique articles, 327 abstracts were screened, leading to 63 included studies: 44 considering factors and 20 evaluating interventions (one in both categories) in 16 low or middle-income countries. A wide range of socio-economic characteristics were associated with coverage in different contexts. Recent rural-urban migration had a universally negative effect. Parents commonly reported lack of awareness of immunization importance and difficulty accessing services as reasons for under-immunization of their children. Physical distance to clinics and aspects of service quality also impacted uptake. We found evidence of effectiveness for interventions involving multiple components, especially if they have been designed with community involvement. Outreach programmes were effective where physical distance was identified as a barrier. Some evidence was found for the effective use of SMS (text) messaging services, community-based education programmes and financial incentives, which warrant further evaluation. No interventions were identified that provided services to migrants from rural areas. Conclusion Different factors affect immunization coverage in different urban poor and slum contexts. Immunization services should be designed in collaboration with slum-dwelling communities, considering the local context. Interventions should be designed and tested to increase immunization in migrants from rural areas.

A method for measuring performance of outreaches

This report explains Shifo's approach and solution - MyChild Outreach, to strengthen outreach services to reach the fifth child and reduce equity gaps in vaccination services in rural and hard to reach areas:https://shifo.org/doc/MyChildOutreach.pdf/

CommTrack Request for Application: Mobile Logistics Proof of Concept in India and Nepal

Dimagi is pleased to announce that it will support five organizations from various sectors in India and Nepal to explore the use of mobile technology for logistics and supply chain management in low-resource settings. Each organization will be supported to launch a proof of concept of CommTrack, an open source mobile logistics tool that leverages CommCare and is part of the MOTECH Suite. CommTrack was developed through related projects in three countries with John Snow International. With successful deployments of the first generation of CommTrack already reaching national scale in the health sector, we are pleased to announce this opportunity for organizations to use CommTrack to strengthen their supply chain in health or other global development sectors. Through this RFA, India-based Dimagi staff will support five organizations in India and Nepal to rapidly deploy a proof-of-concept CommTrack application within twelve months of the award date. The objectives of this RFA are to: - Build capacity for organizations to implement mobile solutions for improved logistics and supply chain using CommTrack over either SMS or a mobile application. - Develop open source mobile applications and content that will be useful for ensuring availability of goods for health or other global development sectors. - Foster an environment for organizations to assess the costs and benefits of mobile phones for logistics and supply chain and help scale mobile programs where appropriate. Awardees will each receive *10 free phones* to deploy a CommTrack application designed for their organization, *free access to the CommTrack cloud-based server for one year*, and *one month of free support* from Dimagi’s experienced, India-based Field Managers, including a *2 week on-site visit* to help assess supply chain bottlenecks and launch CommTrack. For further information and to download the full RFA, please refer to ourwebsite (http://www.commtrack.org/poc/commtrack/). Applications are due by 23 December 2013. Sincerely, The Dimagi Team

SMS survey paves way for successful PCV and polio campaigns

by Sean Blaschke and Lilian Nabunnya, UNICEF On April 26, 2013, health workers at 3,240 health facilities in Uganda were sent the following short-message service (SMS) text message: Does your Health Unit have a cold chain fridge for vaccines? Please answer YES / NO. If you have a fridge but it is not working, please tell us about it. Within 48 hours, responses from 1,862 health facilities had been received. It was revealed that 391 facilities did not have vaccine refrigerators, and in those that did, 194 were not operational. Just 73 percent of health facilities that responded to the survey had working vaccine refrigerators—well below the World Health Organization/United Nations Children’s Fund target of 90 percent. The arrival of this information was timely. Just one day after the SMS survey was sent, the Uganda National Expanded Programme on Immunization (UNEPI) introduced pneumococcal conjugate vaccine (PCV) to the routine immunization schedule, and with a nationwide polio campaign beginning in September, a functioning cold chain was more important than ever. The survey provided UNEPI with an up-to-date list of the 194 health facilities with nonoperational refrigerators and the 391 health facilities with no refrigerators at all. The information was just a few days old, provided specific information on the nature of each problem, and included the contact details of the health worker who reported it. Armed with this information on cold chain gaps, UNEPI and its partners met with staff at the National Medical Stores to address the problem. Tapping into a database of more than 16,000 registered health workers, UNEPI was able to contact thousands of health facilities, capture the results, and analyze them within 48 hours. Gathering this sort of accurate and up-to-date information using traditional pen- and paper-based reporting systems would have been extremely difficult and expensive. But by using an SMS system to distribute and collect responses, the total cost of the survey came to less than US$150. The survey was managed by mTrac, a software application that uses SMS technology to track stock levels of essential medicines at health facilities in Uganda. Using their mobile phones, health workers provide the Ministry of Health with up-to-date information on drug supplies and disease outbreaks. Officially launched in December 2011, the system had now been deployed across the entire country. Each week, health workers at more than three thousand health facilities use their mobile phones to send information on stock levels and disease outbreaks. This information is then collected and validated by a central server. The data are made available to Ministry of Health and district health office staff using a browser-based web application. The system provides staff with timely, accurate figures with which to plan and monitor programs. It also enables donors and other partners to track the effects that their funding is having in real time, while identifying any bottlenecks or other issues as they occur. The SMS survey on vaccine refrigerators was just one of several surveys sent using mTrac to assess the preparedness of health facilities for the introduction of the new PCV vaccine. The first was intended to measure the awareness amongst health workers of the forthcoming PCV immunization campaign. A simple question was asked: had health workers heard about the immunization campaign? Within 24 hours more than three thousand responses from approximately two thousand health facilities had been received. Despite attempts to raise awareness on national radio and television, just 38.4 percent of health workers replied that they had heard about the PCV campaign. The survey revealed this lack of awareness was not the same in every district—some were significantly higher and lower than the average. In June 2013, this information was shared during an EPI partners meeting chaired by the UNEPI program manager; as a result, partners agreed to support districts with the lowest awareness. The following week, a survey was sent asking health facility workers whether they had received their PCV stickers and put them on their cold chain storage fridges. It was found that only 25 percent of health facilities had carried out this activity. Again, data showed the districts with the highest and lowest number of health facilities that had completed this activity. Another survey was then sent to more than ten thousand health workers from approximately 3,200 health facilities asking them about stockouts of key vaccines. The responses were alarming: 57.2 percent of health facilities replied that they were currently experiencing a stockout of at least one essential vaccine. The cause of the stockouts was subsequently investigated by UNEPI, the National Medical Stores, and district officials. The investigation revealed that additional vaccine management training was required, and as a result, vaccine management training has now been conducted. The availability of timely, accurate, and complete health information is critical for the planning, accounting, monitoring, and evaluation of activities and interventions in the health sector. mTrac had proved itself an affordable and sustainable solution that is helping the Ugandan Ministry of Health to improve services and prevent stockouts. To learn more about mTrac, please visit the mTrac website or email Sean Blaschke (sblaschke@unicef.org) and Lilian Nabunnya (lnabunya@unicef.org).

SMS-based AEFI reports

Excerpts from a discussion on another forum about adverse events following immunization (AEFI) data collection. Dhruv wrote: A wise option. Why don't we develop a cellphone-based VAERS? Prabir wrote: See http://www.slideshare.net/prabirkc/sms-based-death-reporting which has to do with a similar system. You are quite right. An EPI Surveyor form would be easy or else something costlier -- but more user friendly like CG NetSwara (http://cgnetswara.org/)* I believe that a good VAERS or adverse event reporting system with compensation for likely cases and treatment and rehabilitation for all is a human right in a society that uses vaccines. Here I think both vaccine supporters and doubters will find common ground. Questions of compensating residual paralysis patients, rehabilitation and disability benefits are where physiotherapists, virologists, social workers and activists can agree. Deaths after HPV, after JE and the AFP who are weak need attention. Dr Sunil Kaul wrote: That is a good system you are suggesting. Only worry is who will judge whether the adverse event is attributable to the vaccination or not? But all the same, it may actually increase the adverse events directory and allow research in the long run. theant, Udangshri Dera Rowmari, P O Khagrabari, via Bongaigaon Dist Chirang (BTAD), Assam 783380 INDIA http://www.theant.org sunil@theant.org Ph: 094351 22042 (m) 03664 293803 (r) IDeA 03664 293801 the ant Office: 03664 293802 Padma Prakash wrote: There are a number of commercially available medical alert systems marketed abroad. They use a Global Positioning System (GPS), and are one-button instruments that also are cellphones. I've always wondered at why hospitals haven't thought of offering the service to vulnerable--- older people, or those with particular problems---in their areas. At one time these were thought to be too expensive. But it should not be so with the spread of cellphone services and if a service provider could be drawn into it. But there are some initiatives today ---and several successful ones in Kenya and Nigeria I think-- that are cheap; used if I remember, for pregnancy and delivery related events in far-flung but demographically small communities. There are of course any number of youth-led groups that are using the mobile phone services very effectively for community-related work of all kinds including alerts on help on sexual assaults, police assaults, violence, etc. I don't see why this cannot be developed for adverse drug reaction reporting. A simultaneous website like CG NetSwara would be easy enough. The critical issue is the content. Do you know if it isn't in fact being developed here? * Moderator's note: CGnet Swara is a platform to discuss issues related to Central Gondwana region in India. It is a voice-based portal, freely accessible via mobile phone, that allows anyone to report and listen to stories of local interest. Reported stories are moderated by journalists and become available for playback online as well as over the phone.
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