TechNet-21 - Forum

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  1. Optimize.WHO
  2. Immunization information systems & coverage monitoring
  3. Monday, 02 November 2009
Albania explores computerized immunization registries by Jan Grevendonk, PATH, and Olivier Ronveaux, WHO In early 2009, the Albanian Institute for Public Health (IPH) asked Optimize, a WHO-PATH collaboration, to develop a strategy for a computerized national immunization registry and vaccine ordering system. Working with IPH and other large stakeholder groups, Optimize assessed the existing paper-based system this summer and developed a strategy for implementing a small-scale pilot under IPH management in one district (Skodra). In Albania, health workers are expected to record vaccinations for children in their catchment area on five different paper records. In order to determine vaccine orders, these records are compiled at the end of each month into two different reports that are aggregated at the district and national levels. The existing system, while functional, places a tremendous administrative burden on health workers and does not provide enough detail about populations that could be falling through the system’s cracks. The benefits of an online centralized registry linked to vaccine ordering are potentially enormous. Most importantly, a central registry would allow health workers to accurately track each child’s vaccinations even if that child moves between catchment areas. The system could also facilitate more accurate forecasting and improved inventory records of the vaccines needed in each area of the country. The success of the pilot will be measured by how well it can: • Improve the quality of the monitoring system for immunization coverage by providing access to more accurate and more relevant disaggregated data at the central level in a more timely fashion. • Increase ordering accuracy—using the information collected through the immunization registry, vaccine inventory and wastage can be better assessed enabling the right quantity of vaccines, diluents, syringes, and safety boxes to be available at each level of the system. This could possibly reduce the need for buffer stocks. • Decrease the administrative burden on health workers. The proposed system will integrate the immunization registry with the functionality of the basic logistics management information system. In the future, the two functions can be integrated further and expanded to accommodate other applications such as disease and adverse events following immunization surveillance. Albania, like many lower-resource settings, has varying levels of access to consistent electricity, internet access, and mobile-phone service. The pilot will therefore use a combination of three modes of communication: internet access with personal computers at the national and district levels as well as in large health centers; mobile phone access in other health centers and village outposts; and paper-based access in areas without access to mobile technology. The pilot system will role out in mid-2010 with the goal of expanding the program nationally after evaluating and revising the pilot system. We invite you to comment on or post a question relating to this article by clicking the “post reply” button on this page. You will have to log in or register; the process is very simple. To link back to the Optimize e-newsletter, click here.
Jan Grevendonk Accepted Answer
Dear Nehel, Thank you for your interest. As we are just about to initiate the project, a number of the technical choices will still need to be made, among which the actual database technology. As we are building a system for national implementation, with over a thousand users who would be accessing and modifying data over the internet and through cellphone applications, MS Access would be too light. Conceivably, we could use MS SQL Server for our database. However, for your needs - one clinic with likely only a few users (nurses) - Access may work just fine. Let us know how your project goes and what kinds of problems / barriers you are encountering! Are children easily identifiable? Would they always come to the same clinic or is there a lot of population movement? Will your system be able to estimate immunisation coverage for that area and if so, where will you get the denominator? Will you try to use it for calculation of vaccine needs? These are all questions we are also dealing with, so I would love to hear more! Jan
TechNet Admin Accepted Answer
Sounds awesome! Can you tell me a little more about it please? I work for a research organization in Pakistan and have designed a digital immunization records database that am planning to put into use in a vaccination clinic in a slum in karachi within the next week - I'm not much of a tech person though so my computer knowledge is very rudimentary and I am really interested in knowing what type of database is being put in use in Alabania. I've used Access and Visual Basic. Thanks! -nehel

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