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. 2024 May 28:11:e53071.
doi: 10.2196/53071.

Electronic Immunization Registry in Rwanda: Qualitative Study of Health Worker Experiences

Thaoussi Uwera #  1 , Mahima Venkateswaran #  2 , Kiran Bhutada #  3 , Eleni Papadopoulou #  4 , Enock Rukundo #  1 , David K Tumusiime #  1 , J Frederik Frøen #  2
Affiliations

Electronic Immunization Registry in Rwanda: Qualitative Study of Health Worker Experiences

Thaoussi Uwera et al. JMIR Hum Factors. .

Abstract

Background: Monitoring childhood immunization programs is essential for health systems. Despite the introduction of an electronic immunization registry called e-Tracker in Rwanda, challenges such as lacking population denominators persist, leading to implausible reports of coverage rates of more than 100%.

Objective: This study aimed to assess the extent to which the immunization e-Tracker responds to stakeholders' needs and identify key areas for improvement.

Methods: In-depth interviews were conducted with all levels of e-Tracker users including immunization nurses, data managers, and supervisors from health facilities in 5 districts of Rwanda. We used an interview guide based on the constructs of the Human, Organization, and Technology-Fit (HOT-Fit) framework, and we analyzed and summarized our findings using the framework.

Results: Immunization nurses reported using the e-Tracker as a secondary data entry tool in addition to paper-based forms, which resulted in considerable dissatisfaction among nurses. While users acknowledged the potential of a digital tool compared to paper-based systems, they also reported the need for improvement of functionalities to support their work, such as digital client appointment lists, lists of defaulters, search and register functions, automated monthly reports, and linkages to birth notifications and the national identity system.

Conclusions: Reducing dual documentation for users can improve e-Tracker use and user satisfaction. Our findings can help identify additional digital health interventions to support and strengthen the health information system for the immunization program.

Keywords: childhood immunization; digital health interventions; electronic immunization registry.

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Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Workflow of immunization pertaining all the duties of a health worker (immunization nurse) on a vaccination day.
Figure 2
Figure 2
Immunization e-Tracker showing the client registration page and data visualization dashboard.
See this image and copyright information in PMC

References

    1. Global immunization coverage 2021. World Health Organization. 2021. [2022-10-26]. https://www.who.int/en/news-room/fact-sheets/detail/immunization-coverage .
    1. Carter A, Msemburi W, Sim SY, Gaythorpe KAM, Lambach P, Lindstrand A, Hutubessy R. Modeling the impact of vaccination for the immunization agenda 2030: deaths averted due to vaccination against 14 pathogens in 194 countries from 2021 to 2030. Vaccine. 2023;S0264-S0410X:00854-X. doi: 10.1016/j.vaccine.2023.07.033. https://linkinghub.elsevier.com/retrieve/pii/S0264-410X(23)00854-X S0264-410X(23)00854-X - DOI - PubMed
    1. Tozzi AE, Gesualdo F, D'Ambrosio A, Pandolfi E, Agricola E, Lopalco P. Can digital tools be used for improving immunization programs? Front Public Health. 2016;4:36. doi: 10.3389/fpubh.2016.00036. https://europepmc.org/abstract/MED/27014673 - DOI - PMC - PubMed
    1. Murray E, Hekler EB, Andersson G, Collins LM, Doherty A, Hollis C, Rivera DE, West R, Wyatt JC. Evaluating digital health interventions: key questions and approaches. Am J Prev Med. 2016;51(5):843–851. doi: 10.1016/j.amepre.2016.06.008. https://europepmc.org/abstract/MED/27745684 S0749-3797(16)30229-X - DOI - PMC - PubMed
    1. World Health Organization . WHO Guideline. Recommendations on Digital Interventions for Health System Strengthening. Geneva: World Health Organization; 2019. https://iris.who.int/bitstream/handle/10665/311941/9789241550505-eng.pdf... . - PubMed

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