Recent health challenges across the globe have highlighted strained health workforces and the need for effective preventative health measures such as vaccinations. In response to these demands, countries around the world are actively seeking innovative solutions. One notable example is found in Côte d’Ivoire, where the Ministry of Health, in partnership with VillageReach and Orange, has spearheaded the development of a pioneering digital tool known as M-Vaccin. This groundbreaking solution aims at enhancing vaccination coverage while streamlining healthcare delivery. If successfully scaled nationwide, M-Vaccin has the potential to significantly reduce administrative burdens by an astonishing 96%, transforming healthcare accessibility and resource allocation in the country.
While in the past four decades, global routine vaccination coverage has increased to over 80%, progress has hit a wall recently, with global vaccination rates slipping from 86% in 2019 to 84% in 2022. In Africa, under-immunized and zero-dose communities remain a public health concern. These communities face significant challenges in accessing life-saving vaccines, resulting in lower vaccination rates and increased vulnerability to preventable diseases.
A major contributing factor is the shortage of health workers in the region, making it difficult to educate under-reached populations about the importance of immunization, administering vaccines, and providing regular follow-up care. Addressing this challenge aligns with Gavi, the Vaccine Alliance 5.0 strategy, which focuses on strengthening African countries’ health systems and workforce capacity.
The health care resource challenge
In Côte d’Ivoire, the shortage of health workers is a significant concern for the government. Despite the recruitment of 16,481 health care professionals between 2016 and 2020, the number of health workers remains insufficient. Even though the density of health care personnel per 10,000 inhabitants has increased from 6.6 in 2015 to 8 in 2019, it remains below the minimum WHO-recommended threshold of 23. At the same time, the population of Cote d’Ivoire has grown at an average of 2.5% a year and the number of health care services, including vaccines, has grown.
The deficit in health care workers strains the existing professionals and limits the ability to meet the growing demand for services. Only 50% of health care services at primary care facilities were utilized in 2019. These factors negatively impact the country’s health care services performance and quality.
How the resource shortage affects vaccination
The Expanded Program on Immunization (EPI) in Côte d’Ivoire plays a crucial role in protecting the health of pregnant women and children aged 0 to 23 months. This program is heavily impacted by the shortage of health care workers. In response, the EPI has partnered with Gavi, the Vaccine Alliance, and Orange, a private telecom company, under the coordination of VillageReach. This partnership has given rise to M-Vaccin, an innovative digital platform, and electronic immunization registry (EIR) that leverages existing mobile networks to send parents SMS reminders about vaccination sessions. The tool reduces time spent by health workers on reporting, freeing up health workers to spend more time providing health care to those needing it.
Health workers play a crucial role in reporting during immunization sessions, but the process can be time-consuming. It involves accurately recording the number of immunized children and those who drop out, across all health facilities in the 113 districts in Côte d’Ivoire. The collected data must then be analyzed and made accessible through a dashboard for the EPI management team. However, the current approach is mostly manual, demanding significant time and effort from frontline health workers.
Electronic Immunization Registries (EIRs), like M-Vaccin, streamline this process, making it more efficient. These registries digitize data and improve the management of vaccination programs, saving valuable health worker time in several ways:
- Data Accessibility and Management: M-Vaccin replaces traditional paper-based records, allowing health workers to quickly and accurately input, access, and analyze data. This saves time, enabling them to focus on providing immunization services.
- Improved Decision Making: M-Vaccin facilitates real-time data tracking, allowing health workers and decision-makers to rapidly identify areas with low immunization coverage or where outbreaks may occur.
- Reduced Duplication of Vaccinations: A unified and easily accessible registry decreases the likelihood of duplicated vaccinations, saving resources and time.
- Effective Recall and Reminder Systems: M-Vaccin sends proactive reminders to parents or caregivers about upcoming immunization sessions, reducing the need for health workers to manually track and communicate schedules.
- Improved Training and Supervision: A centralized and digital immunization data allows supervisors to monitor health worker performance, provide targeted coaching, and identify training needs. This enhances productivity and service delivery.
M-Vaccin addresses the resource challenge for vaccination
The existing process for monthly EPI reporting is a four-step procedure that takes 12 days:
This process currently consumes the equivalent of 387 full-time workers per year. However, using M-Vaccin across the country can significantly reduce this administrative burden to just 15 full-time equivalents, a reduction of 96%. This means the equivalent of 372 health care workers, or 8% of the national workforce, can be redirected to patient care.
By reducing the administrative burden, M-Vaccin allows health workers to spend more time engaging with communities, educating about vaccinations, and delivering other essential health care services. It enables timely follow-ups with caregivers, helping to increase the number of fully vaccinated children by reducing the time spent on administrative reporting. With M-Vaccin, EPI can enhance vaccination coverage and protect the health of women and children in Côte d’Ivoire within the same personnel costs.
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M-Vaccin is also featured in Gavi, The Vaccine Alliance’s VaccinesWork blog. Read more: M-Vaccin : La technologie mobile au service de la vaccination en Côte d’Ivoire | Gavi, the Vaccine Alliance