Geo-Spatial Reporting for monitoring of household immunization coverage through Mobile Phones; Findings from a Feasibility Study

Background

The addition of Global Positioning System (GPS) to a mobile phone makes it a very powerful tool for

surveillance and monitoring coverage of health programs. This technology enables transfer of data

directly into computer applications and cross-references to Geographic Information Systems (GIS)

maps, which enhances assessment of coverage and trends.

Objective

Utilization of these systems in low and middle income countries is currently limited, particularly for

immunization coverage assessments and polio vaccination campaigns. We piloted the use of this

system and discussed its potential to improve the efficiency of field-based health providers and health

managers for monitoring of the immunization program.

Methods

Using “30 X 7” WHO sampling technique, a survey of children less than five years of age was

conducted in random clusters of Karachi, Pakistan in three high risk towns where a polio case was

detected in 2011. Center point of the cluster was calculated by the application on the mobile. Data and

location coordinates were collected through a mobile phone. This data was linked with an automated

mHealth based monitoring system for monitoring of Supplementary Immunization Activities (SIAs)

in Karachi. After each SIA, a visual report was generated according to the coordinates collected from

the survey.

Result

A total of 3535 participants consented to answer to a baseline survey. We found that the mobile

phones incorporated with GIS maps can improve efficiency of health providers through real-time

reporting and replacing paper based questionnaire for collection of data at household level. Visual

maps generated from the data and geospatial analysis can also give a better assessment of the

immunization coverage and polio vaccination campaigns.

Conclusion

The study supports a model system in resource constrained settings that allows routine capture of

individual level data through GPS enabled mobile phone providing actionable information and

geospatial maps to local public health managers, policy makers and study staff monitoring

immunization coverage.