Contributors: Catherine Nyambura Kahare, Charity Chao Shete and Davis Muli Musyoki
Few innovations have wielded as profound an impact on the global health landscape as vaccination. Vaccination shields vulnerable populations from the devastating reach of deadly diseases and is one of the most effective ways to prevent the spread of infectious diseases. Over the past decades, vaccines have dramatically reduced infant and child mortality. By training the immune system to recognize and combat potential threats, vaccines create an invisible arm or that enables children to face a world of pathogens with remarkable resilience.
While the introduction of vaccines has been a gamechanger to global health, some disparities exist and need to be addressed if we are to achieve vaccine equity and optimum global coverage. Africa has lower childhood vaccination coverage than the global average.
For example, according to the World health Organization (WHO), immunisation coverage in 2020 for BCG, DPT3 and measles in Africa was 69%, 74%, and 70% compared to a global coverage of 85%, 86% and 84% respectively. In Uganda, only 63% of children aged 12-23 months are fully immunized (received all eight basic vaccinations) while in Kenya, 80% are fully immunized. Disparities also exist between urban and rural areas. In many African countries, including Kenya and Uganda, current vaccination systems rely on paper records for parents to track their child’s vaccinations. Unfortunately, these records are often misplaced or destroyed due to factors such as poor housing conditions, damage by animals,
or other challenges making it less likely for families to return on time, or at all, for subsequent vaccine doses.
To address these gaps, various innovations have been proposed, including the digitization of vaccination schedules and records. One such innovation is being led by the African Population and Health Research Center (APHRC). APHRC, in collaboration with University of Michigan, USA, Rutgers University, USA, Ministry of Health, Kenya and Ministry of Health, Uganda, is currently testing the use of a digital childhood vaccine card and registry to tackle the uptake of vaccines in Kenya and Uganda through the Next Generation Vaccine Card Project. This initiative aims to raise awareness of vaccination timelines, prevent missed doses, and ensure children receive their vaccines on time. The project’s ultimate goal is to develop and test whether the use of a digital tool for early childhood vaccinations in different African settings can improve the coverage, timeliness, and equity of vaccination.
The initiative is being implemented in urban informal settlements in Kenya and peri-urban and rural settlements in Uganda. Digital recording and follow-up systems can significantly benefit parents and families by leveraging identification systems to verify eligibility, monitor patient progress between doses, and send timely reminders about upcoming vaccinations. These systems can also enable health facilities to track patients more efficiently while enhancing data quality for better decision-making and resource allocation. Such systems should be secure to prevent unauthorized access to data. For this reason, the project developed and The Next Generation Vaccine Card was developed with repeated consultation from the Ministry of Health (MoH) national, regional, and local stakeholders, facility managers, vaccinators, community health promoters, parents and caregivers. The digital card has a linked web: https://vaccinecard.aphrc.org, Android, and Unstructured Supplementary Service Data (USSD) application that can be used on smart and feature phones. The card enables parents to easily access digital records of their children’s past and upcoming vaccines while permitting health facilities and community health workers to track and register children more effectively.
The card was launched in 12th June 2024 in Kenya and 24th July 2024 in Uganda, In the initial months of implementation in Kenya and Uganda , the tool has been well-received at both the facility and community levels, thanks to the support of collaborators from Kenya’s Ministry of Health, Nairobi County, and Makadara Sub-County as well as from Uganda’s Ministry of Health Uganda, Kagando and Bwera hospital in Kasese district. The project will assess the impact of the card on vaccine uptake and timeliness.
Crucially, this tool addresses existing gaps in early childhood immunization programs: reaching potential vaccine defaulters who lost their paper vaccine records; aiding health facilities and community health workers to identify and reach children at risk of incomplete vaccination and, with higher data quality, contribute to improved evidence-based decision- making across the continent. Eventually, the platform could potentially be linked to other digital systems such as nutrition and growth monitoring or birth registration. It will provide data that policymakers can leverage to structure and deliver health, education, and other social services more equitably. The tool is designed to be adaptable and can be expanded to other countries, allowing them to customize it to meet their specific needs.