As part of the WHO African region efforts to improve immunization and surveillance performances in terms of quality, effectiveness, efficiency, coverage and equity and in order to strengthen the capacity of policy makers and health providers in countries, there is a need for accurate data in order to gauge the effectiveness of existing policies and programs in health care system to make it more accessible and reliable.
Guided by the WHO regional office, the IVD cluster of the Inter-country Support Teams for the ESA sub-region (IST/ESA) is supporting the use of innovative technologies within the immunization systems through GIS and mHealth. The rapid proliferation of mHealth projects (mostly pilot efforts), has generated considerable enthusiasm among governments, donors, and implementers of health programs. GIS and mHealth are not a new concept to be adopted and recommended by the WHO or MoHs, and they are among the key technologies that have proven impact on the quality, timeliness, and cost effectiveness of the program activities at all levels reaching up to subnational, health facility, and case-based levels (i.e. for VPD surveillance, AFP environmental surveillance, routine immunization and micro-planning, LQAs, EPI reviews, containment, certification and Monitoring & Evaluation etc.).
One of the innovations is the Integrated Supportive Supervision (ISS). The ISS is an Integrated Electronic Checklist used for supervision during Active Case Search and Routine Immunization which is mostly administered by both WHO staff and Government personnel via Smart mobile phones in the field at Health Facilities and Focal Sites. These supportive visits are automatically mapped on the country profile server managed by WHO. Supportive Supervision remains the bedrock for highlighting good surveillance and routine Immunization practices through systematic visits to priority sites for assessment, evaluation and on the job training for health workers and entire health system.
As we move towards the last miles of polio eradication, advanced well to eliminate measles in our sub-region, thus to bridge immunity and surveillance gaps, WHO IST/ESA has gone a step further in institutionalizing supportive supervision by encapsulating the activity into mobile format that can be administered using smart phones in order to increases the accuracy and reliability of information collected. Accuracy of data can be enhanced by proper data collection and management, the development, execution and supervision of plans, policies, programs and practices that control, protect, deliver accurate, relevant and up-to-date data in the shortest time. In the use of m-health, data collection and management has become a critical component, which requires portable software, mobile devices and the software that houses the collected information. Open Data Kit (ODK) is a free and open-source set of tools that can help organizations author, field, and manage mobile data collection solutions.
In the ESA sub-region, Ethiopia, Tanzania, Madagascar, Zambia, Kenya, Uganda and South Sudan had already adopted the use of this real time mobile assisted supportive supervision with over 1,603 visits to health facilities in three months (August – October, 2017) across different regions and districts. Other countries that adopted the tool and are ready to commence using it includes South Africa, Botswana, Namibia, Malawi, Seychelles, Lesotho, Eritrea, Zimbabwe, Swaziland. The Target is to have all countries under the ESA region to conduct all their supportive supervision using smart phones to foster accountability of WHO and Government staff. It also supports other health interventions outside the EPI programmes and countries are encouraged to take advantage of the opportunity to support other health interventions (e.g. Cholera outbreak).
We therefore call to Government EPI managers and surveillance officers to position themselves to embrace and use the new innovations to enable them to attain and sustain immunization and surveillance targets.
Contributors as well as members of the editorial board: Dr Ahmed Y, Mr Bello I, Dr Byabamazima C, Mr Chakauya J.M, Dr Daniel, F, Dr Eshetu, M.Shibeshi, ,Dr Lebo E, Mr Katsande R, Ms Machekanyanga ,Mr Masvikeni B, Dr Manyanga D, Dr Mumba,M. Dr Okiror S,Dr Petu A, Dr Umar S and Dr Weldegebrie G.