RECORDER REPORT

KARACHI: Expanded Program for Immunization (EPI) and the Health Department Government of Sindh on Tuesday launched Zindagi Mehfooz (ZM) Digital Immunization Registry in Sindh, an android-based application developed by the Interactive Research and Development (IRD) with the Indus Health Network (IHN) to support its implementation across the province to reduce child mortality from vaccine preventable diseases.

Addressing the launch ceremony at a hotel Sindh Health Minister Dr Sikander Mandhro urged the need to promote friendly behaviours at the government-run health facilities to enhance vaccination ratio in the province.

“Out of every 1000 live births, 82 children die before their first birthday in Sindh according to Multiple Indicator Cluster Survey (MICS) 2014,” he said, adding that the most of these deaths were due to vaccine preventable diseases.

Dr Mendhro said that in children aged 12-23 months in Sindh, only 35% of children received EPI-recommended vaccines during the first year of life. Some contributing factors to suboptimal immunization coverage include: overburdened immunization staff, inadequate health infrastructure, lack of awareness and wrong perceptions regarding immunization among parents, and paper-based systems that make it difficult to track and monitor a child’s immunization coverage. Dr. Abdul Bari Khan, CEO Indus Health Network said that about 3 out of 4 children are under vaccinated in Sindh.

“The Zindagi Mehfooz-Digital Immunization Registry will change the landscape of child health by engaging parents for timely immunizations, systemizing vaccinator’s jobs by creating centralized immunization records, reducing time spent on paper-based reporting and creating more time and opportunities for vaccinators to immunize children,” said Dr Subhash Chandir, director of Child Health and Vaccines Program at the IRD and the PhD in vaccines.

The provincial scale-up is funded by the WHO Pakistan with GAVI’s support. The registry was initially funded by the UN Foundation Innovation Working Group and was later supported by the WHO for limited pilots and scale-up. The core team working on the IRD vaccination program is led by Dr. Subhash Chandir, IRD’s Director of Child Health & Vaccines Program and the Faculty at the Harvard Medical School, and IRD’s founder Dr Aamir Khan. Other instrumental members directly contributing to the program’s development and execution include: Dr. Abdul Bari Khan (CEO-Indus Health Network), Ali Habib (CEO-Interactive Health Solutions), Saira Khowaja (Deputy Executive Director Global Health Directorate-Indus Health Network), Dr. Vijay Kumar, Danya Arif and Dr Mubarak Shah (Senior Program Managers-Child Health & Vaccines Program, IRD) among others.

The ZM Immunization Registry enables mobile based data entry of the child’s name, bio-data and immunization history which is linked to a web-based monitoring dashboard. At the time of the child’s visit to the EPI centre, the vaccinator will enrol the child in the registry by assigning him/her a unique ID in the form of a Quick Response (QR) Code and submitting the data to the web dashboard in real time.

The Registry also enables automated SMS reminders for parents to remind them of their child’s upcoming vaccination, a decision support system for routine and catch-up immunizations and a real time tracking and monitoring system for vaccinators.

The ZM Registry was piloted in Karachi since 2012 and Shikarpur District since 2015 before being scaled up to the entire province. Once expanded throughout Sindh, the ZM Registry will be used by more than 3000 government vaccinators using smartphones across 1600 Basic Health Units in the province.

This technological innovation is expected to increase routine immunization enrolment, improve uptake and timely vaccinations, generate real-time actionable data and improve quality, logistic management and monitoring of EPI in Sindh province.