The Challenge
Somalia, located in the Horn of Africa, is bordered by Djibouti, Ethiopia, and Kenya, and boasts a lengthy coastline along the Indian Ocean. The country is home to approximately 15 million people, primarily of a Somali population that is characterized by various clans and predominantly adheres to Sunni Islam. The healthcare system faces significant challenges, including high rates of communicable diseases, maternal and child mortality, and inadequate facilities.
For many years, Somalia relied on paper-based systems to track children’s immunizations. This traditional method proved inadequate, resulting in numerous children missing out on vital vaccines. The absence of a comprehensive and clear immunization history not only hindered vaccination efforts but also posed significant challenges in understanding both the immunization coverage of the population and the health status of individual children, particularly those who experienced reactions to vaccinations or infections.
The Solution: Digital Transformation with DHIS2
Recognizing the urgent need for change ,The Ministry of Health Somalia proposed introducing a digital system. HISP Tanzania partnered with the World Health Organization (WHO) to pilot an electronic Immunization Registry (eIR) in Somalia. The initiative aimed to streamline the immunization tracking process and ensure that no child was left unvaccinated through seamless identification of missed doses
Starting with WHO’s metadata package, the team built a framework that included all necessary immunization information tailored to Somalia’s specific needs covering two programs: one for capturing immunization records and the other for registering adverse events. A critical component of the new system was the integration of DHIS2, a robust health information system.
HISP Tanzania implemented a mobile application, which allowed health workers easy access to the digital registry, facilitating the registration process and empowering health workers to conduct their responsibilities effectively. The solution was also extended to be able to send sms messages to caregivers in Somalia language for reminding schedules of vaccination.
Implementation and Impact
In just six months, an impressive pilot program was launched by HISP Tanzania in the city of Banadir, Somalia, marking a significant milestone for immunization tracking in the region in which 14 facilities are currently using the eIR solution. The results were encouraging:
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Increased Vaccination Rates: With the introduction of the electronic Registry, health workers could accurately keep track of individual immunization records, resulting in a notable increase in vaccination coverage. This has been facilitated by the use of DHIS2 analysis tools such as line listing applications where healthcare workers can easily and in real time identify delayed or missed vaccination per individual child and make necessary follow ups. Also the presence of notification reminders to caregivers have a notable contribution to this achievement.
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Enhanced Monitoring and Reporting: Configured dashboard provided real-time data on the immunization status of children, allowing health officials at any level to quickly identify gaps in coverage and address them proactively, also a means of monitoring vaccines stock
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Improved Health Outcomes: The tool not only tracked vaccinations but also monitored post-vaccination reactions, enabling better response strategies and ultimately improving the overall health of children in the region.
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Scalability: The success experienced in Banadiri has paved the way for plans to scale the initiative across the entire country, ensuring that the entire Somali immunization program takes a positive shift through the use of digital platforms such as DHIS2, one of the digital public goods.
Looking Ahead
The eIR pilot has demonstrated the feasibility of obtaining accurate and timely immunization data. The use of DHIS2 ensures that the eIR system is interoperable with other existing digital systems, such as the DHIS2 HMIS, which collects aggregate information. And for that case, integration between eIR and DHI2 HMIS becomes a potential priority for Somalia’s healthcare system, aiming to enhance the quality and consistency of information while also reducing the reporting burden at the point of service delivery.
The pilot program in Banadir has proven the effectiveness and necessity of the electronic Immunization Registry (eIR). With funding from WHO Somalia, this initiative not only transformed immunization tracking but also unlocked a potential wave of digital health advancements in the country. Future scaling efforts aim to encompass all regions of Somalia, bringing reliable healthcare services to every child and fostering a healthier future for the community.
HISP Tanzania’s collaboration with WHO to establish an electronic Immunization Registry in Somalia has turned a once cumbersome and inconsistent process into a streamlined, efficient system. As Somalia continues to realize the benefits of this digital transformation, it stands as a beacon of hope for other regions facing similar challenges in public health and immunization coverage.