This post is part of an ongoing bi-weekly series feature key Boost partners, who are working to support the immunization professional community as it strives to adapts to shifting situations due to the current pandemic. This week, we are featuring PATH. PATH represents a global team of innovators working to accelerate health equity so all people and communities can thrive. They advise and partner with public institutions, businesses, grassroots groups, and investors to solve the world’s most pressing health challenges.
This week we are highlighting their Introducing Digital Immunization information systems: Exchange and Learning from Vietnam (IDEAL-Vietnam) project. The IDEAL Vietnam project, funded by the Bill & Melinda Gates Foundation, has been supporting the transition to complete paperless system by working closely and directly with immunization officers from the CHC grassroots level to the NEPI at national level, and with Viettel, the technical partner developing the NIIS, to address end-users’ concerns, improve the system, and comply with any updates in the health system and immunization regulations.
Vietnam National Immunization Information System (NIIS) at the grassroots level of the commune health center (CHC)
Mrs. Do Thi Phai operated the computer and its keyboard in her own nonconventional way, with only the two pointing fingers like a woodpecker — yet, she was efficient. The electronic immunization registry didn’t pose much challenge to her, a long-term healthcare worker who has been working at Phieng Khoai CHC for the past 30 years, 17 of those as an immunization officer.
This remote CHC nests in between the mountains of Yen Chau District, Son La Province,Vietnam; it serves the largest commune in the District, with population of more than 11,000, over 1,000 children under 5, and a birth cohort of more than 200 a year, spreading over 9,200 square kilometers of hard-to-reach mountainous area, and a 21-kilometer border with Laos. Immunization management is complicated, with barriers in access; low population awareness in immunization, especially in ethnic minorities; and a shortage of health care workers, with a high rollover rate. Vaccination occurs only once a month at the CHC and outreach vaccination to the most remote villages. Therefore, the concentration of work prior, after, and during immunization days is tremendous.
Since the implementation of the NIIS nationwide in 2017, Mrs. Do’s job has changed drastically. Like many immunization officers, she had to overcome the initial resistance due to lack of computer skills, misunderstanding of the system, and fear of change. Furthermore, immunization officers were also tasked with data input of all the children born from January 1, 2015, and their vaccination records into NIIS for a functional system. All provinces still operate dually with paper and electronic system.
Mrs. Do, though reaching her retiring age, is an eager pioneer and a full supporter of this new system. Having to learn the computer from the start, she fumbledeven with starting the machine, opening the web browser. She persistently practiced typing with her children at home, and diligentlystudied the system with her colleagues. Talking about the initial challenges, she said she was serving the system so when she is computer literate, the system can serve her back. The two days prepping for immunization day by going through allpaper logbooks to consolidate the list of children and theirduevaccines would turn into half an hour extracting and printing from the NIIS. With the four-step procedure to cross-check, input, and update data right on immunization day, immunization officers would then be able to generate electronic immunization and vaccine reports right on the system to the district and provincial levels within half an hour.