The moment a child is born is always one for celebration. From this moment on throughout the rest of their lives, documentation of their health, including the routine immunizations they need, is important to ensure that no child is left behind.
However, in Mozambique, this documentation is not always digitized, with parents receiving their child’s vaccination information in yellow booklets that are at risk of being lost or damaged.
The Electronic Child Registry Project aims to change that.
At the Matutuine Health Center in Maputo province, Mozambique, when Duruqui Benjamin Chivavele was born, he immediately received an electronic birth card, which records all his childhood vaccinations until he reaches adolescence. Duruqui also received the card printed on yellow cardstock. Although it will take him years to realize the benefits of having his vaccination information documented electronically, his mother is aware and happy.
“Registration is quick, about 10 minutes, but the benefits are for his whole life,” says Noémia Mário Uditemari, mother of the 7-month-old boy.
We visited Noémia and her family to learn how ECR has improved their lives and access to health.
Security with Digitalization
While speaking with Noemi in her home in Maputo province she revealed that electronic registration was not around when her older daughter, Telma, 17, was born. “I have two children. Telma is my eldest daughter. When she was born, this type of registration did not exist, so she only has a card printed on yellow cardboard,” said Noémia.
However, she explained that she had the booklet that contained her daughter’s vital information.
“I lost the cardboard booklet in which I recorded Telma’s vaccinations,” Noémia lamented, adding that “it got dirty easily. It would get wet on rainy days when we went to the maternity ward.” Though health workers would still treat her child even without the booklet, with an electronic record, now she doesn’t need to explain herself.
When they made the electronic record, Noémia remembered seeing the health technician using a tablet. “I liked the child’s record on the tablet. It’s a good innovation. I feel secure, and so does the child,” she said, visibly happy.
This sense of security has led Noémia to tell other women and mothers about ECR.
Another mother, Angelica Dionisio Mula, also spoke about her experiences with ECR when compared to using the yellow booklet for immunizations. She is the mother of Alírio Luis Macome, a one-and-a-half-year-old boy from the Boquisso area, on the outskirts of the municipality of Matola, Maputo province.
“I’ve had problems with the yellow booklet. It’s easy to damage. I had to adapt it, sticking stickers on it to prevent it from getting damaged or dirty,” she said.
She further emphasized that when she goes to weigh her child, she sees other mothers with damaged cards and complaints. Some even request a duplicate at the health center.
“I would like to thank the government and its partner for designing this solution for the children and mothers. I hope it can be extended to other communities in the country. It’s easy and safe,” she said.
Alírio Luis Macome with the mother Angelica Dionisio Mula. Photo Credit: Arsenio Manhice
Benefits for Health Care Professionals
Mothers are not the only ones who benefit from ECR. The healthcare technicians who treat mothers and their children, as well as government officials, also report various improvements.
Délsia Deolinda João Matola, preventive medicine technician, at the District EPI in the Matutuine health center, said she was trained by VillageReach in April 2024. During the training, she thought the ECR platform would be difficult to understand but it was actually simple to use.
“It’s easy to use. As a result, the waiting time for mothers when they come to the health center has been reduced. This allows us to provide quality care and gain time for other tasks,” she said.
Delísio Machava, head of the Expanded Vaccination Program in Maputo province, revealed that the advantages of the platform range from improved data quality, ease of accessing vaccination history and other child interventions, to data resilience, as the data is stored in the cloud and cannot be influenced or lost due to climatic events, disasters, fires, disappearance or theft of books, etc.
“With the card, we have access to the data. The child is registered at the maternity ward, and the ECR code is attached. We do our consultation in the mornings. On average, 150 children are seen per day, “ he said.
Notably, the only problems reported by health professionals have to do with internet failures, lack of synchronization between devices and the fact that there are too few tablets for the health center’s needs.
Henriqueta Chivale Siueia, a preventive medicine technician at the Boquisso Health Center, Programa Alargado de Vacinação (PAV, or Expanded Program on Immunization (EPI)), stated that these issues occur when there is a flood of mothers at the health unit. The platform may seem slow, but it is always faster than registering on the yellow card.
“Mothers are on board [with the ECR platform]. They know what is happening. [The yellow booklet] is no longer a major embarrassment. Once the advantages of the platform have been explained, mothers accept it,” she said.
VillageReach recommends that in order to solve these issues, there must be efforts to improve internet recharges by automating all tablets; strengthen the use of routers in health facilities to facilitate recharging, thus reducing the number of cards to be recharged, ensure frequent monitoring and supervision and work with other technology partners to ensure frequent updates and improvements to the system as needed.
Numbers recommend expansion
ECR is currently in its pilot phase, implemented in 25 health units in Maputo province, with 104,790 children registered on the platform. VillageReach is working with the Ministry of Health for the future of ECR.
Through the innovation of ECR, we’re working together with caregivers, health workers and government to transform child health care, ensuring that children like Duruqui and Alírio have timely, equitable access to lifesaving vaccines and health services.