This report presents an evaluation of the Vaccine Land Cruiser’s performance in Niger, Burkina Faso, Senegal, and South Sudan, focusing on its ability to enhance access, efficiency, and safety in vaccine distribution.

Vaccination campaigns allow countries like Malawi to vaccinate large numbers of people in a short period of time against vaccine-preventable diseases such as polio and cholera.

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The Zindagi Mehfooz (Safe Life) Electronic Immunization Registry (ZMEIR) in Sindh Province, Pakistan is a comprehensive suite of digital health interventions which aims to improve equitable access, timeliness, and coverage of child immunizations through a smartphone-based application (app) for vaccinators, web-based dashboards for supervisors and managers, and a text message reminder system and call centre for caregivers.

In Guinea, this evaluation was conducted in collaboration with Africa Health Consulting which oversaw the planning, conducting, and managing of the fieldwork. At the request of the Government of Guinea, a technical committee and a steering committee were established to provide strategic direction and oversight to the whole process and to provide a directive counterpart to the researchers deployed in the field. Different stakeholders were represented in the two committees.

In Rwanda, this evaluation was conducted in collaboration with the Center for Impact, Innovation and Capacity Building for Health Information Systems and Nutrition (CIIC-HIN) which oversaw the planning, conducting, and managing of the fieldwork. Participatory meetings on the data analysis and report writing guided the development of and the finalization of the current report.

In Tanzania, this evaluation was conducted in collaboration with the Mbeya Medical Research Center of the National Institute for Medical Research (NIMR-MMRC).

This report presents a series of brief case studies supported by the existing literature on the deployment of digital solutions during the COVID-19 pandemic. It specifically describes how electronic Immunization Registries (eIR) and electronic Logistics Management Information Systems (eLMIS) have been newly developed and/or repurposed in Guinea, Honduras, India, Rwanda, and Tanzania. Importantly, the findings are influenced by the state of the implementation which, because of the delayed availability of COVID-19 vaccines in the LMICs, is still in its early phase.

This Technical Brief provides a review of the state of evidence and experiences with DHI-enabled VPD surveillance, identifies gaps and makes recommendations to inform the development of Gavi’s Digital Health Information Strategy

Digital Health Information (DHI) applications can help facilitate data capture, sharing, analysis and visualisation of information related to the surveillance and outbreaks of Vaccine Preventable Diseases (VPDs). The digitisation of VPD data can be used to trigger rapid outbreak response, enhanced immunisation activities and identify priority pathogens targeted for action. Gavi, the Vaccine Alliance, has identified digital health information systems that enable timely VPD data capture, sharing, analysis, and visualisation linked to decentralised testing and electronic case reporting as a priority area for country support in the coming 5 years. Building on progress and advances in aggregate electronic Integrated Disease Surveillance and Response (eIDSR) and VPD case-based surveillance systems, Gavi will support countries to more efficiently and rapidly target vaccination efforts in response to detected VPD outbreaks through VPD data exchange applications. Drawing from the literature, key informants, Gavi’s DHI prioritisation exercise and Gavi board priorities, the following priority steps are recommended for Gavi and Alliance Members.

# Digital-Health-Information, immunisation, digital health, data, Vaccine Preventable Diseases (VPDs) surveillance, outbreak, decentralised testing, electronic case based surveillance, aggregate electronic Integrated Disease Surveillance and Response

This Technical Brief provides a summary of the state of evidence and priority areas for investment and attention at the intersection of gender, immunisation and digital health and data that have been used to inform the development of Gavi’s Digital Health Information Strategy, which includes gender intentional strategies, outcomes, outputs, and inputs for global and country consideration and action.

Digital Health Information (DHI) applications can support immunisation programme functions, facilitate decision-making and provide a direct link of communication and engagement between caregivers, the community and the immunisation programme. DHI tools and applications can also provide an opportunity to understand and analyse data on gender-related indicators and can serve as an opening to promote gender equity, agency and decision-making power for marginalised groups. However, the cultural contexts and gender dynamics that surround digital health for immunisation adoption and use affect men, women, children and gender-diverse people differently.

With the growing gender digital divide, Gavi, the Vaccine Alliance, recognises the importance of a gender-intentional lens for all digital health and data interventions in immunisation programming to ensure that every child receives the full course of life-saving vaccines. Drawing from the literature and key informants to align with Gavi’s DHI Priorities, the document provides recommendations for collective action by Gavi Alliance Members, Gavi-supported countries, and other partners.

# Digital-Health-Information, gender, immunisation, digital health, data, gender-related indicators, gender digital divide, gender-intentional lens

This Technical Brief provides a summary of how digital health information (DHI) and related technologies can improve immunisation completion and reduce loss to follow-up to inform the development of Gavi’s Digital Health Information Strategy. Immunisation programmes are tasked with delivering life-saving vaccines for all children. This responsibility requires immunisation programmes to respond to community needs and concerns, reduce barriers that limit caregiver access and provide respectful, quality services so that individuals and communities have a positive attitude about vaccines, the services available to them and actively seek out and advocate for immunisation. Digital health information (DHI) systems and technologies can be applied in a variety of ways to help improve immunisation uptake by encouraging community demand and improving the service delivery experience.

Immunisation demand is influenced by layers of complex factors that contribute to successful and complete immunisation. One component involves the identification, tracking and retention of children to ensure that they receive the recommended schedule of vaccinations on time. Digital health information tools and technologies can help immunisation completion and reduce loss to follow-up by engaging and supporting caregivers as well as improving the quality of services provided. Gavi, the Vaccine Alliance, has prioritised immunisation demand and community engagement as one of the six areas for digital health information investment to support the successful achievement of Gavi’s 5.0 strategic goals. Drawing from the literature, reports and documented country experiences, the documents provides recommendations for both Gavi Alliance Members and other partners to support country programmes.

# Digital-Health-Information, immunisation, digital health, data, demand, vaccine hesitancy, loss to follow-up