M-Vaccin: Mobile technology boosts vaccination in Côte d'Ivoire
Thanks to a partnership between Gavi, Orange Côte d'Ivoire and the Ivorian Ministry of Health, Public Hygiene and Universal Health Coverage, M-Vaccin is paving the way for a significant improvement in routine immunisation coverage in Côte d'Ivoire.
- 20 September 2023
- 8 min read
- by Lassina Sermé
Vaccination is one of the essential pillars of public health, helping to prevent and control many infectious diseases. In Côte d'Ivoire, routine vaccination coverage is a major challenge in protecting the population, especially pregnant women and young children.
It was essential to find a new solution, with 76% of children in Côte d'Ivoire receiving all three doses of the diphtheria, tetanus and pertussis-containing vaccine (DTP3), according to the latest figures from the World Health Organization and UNICEF, and with healthcare staff facing a heavy workload.
"Health workers tell us that they are more efficient in their work, simply because they no longer have to search through paper registers to find out which people they need to go and vaccinate."
– Joseph Roussel
M-Vaccin stepped in with an innovative technological platform that simplifies vaccination management and enables accurate data tracking. These advances, currently available in just a few districts, but set to be rolled out across the whole of Côte d'Ivoire, are helping to improve public health by increasing vaccination coverage and facilitating the work of healthcare providers.
An innovative partnership to improve routine vaccination coverage
For Orange, this was no trial run. Indeed, back in 2016, the company developed the M-Tew app in collaboration with UNAIDS. The aim of this initiative was to improve HIV care services to ensure regular monitoring of patients and compliance with treatments. Within this framework, data was collected and analysed, enabling gaps in existing services to be identified and measures to be taken to improve the quality of care for people living with and affected by HIV.
"That's what inspired Gavi's interest in the initiative," explains Ibrahim Diallo, senior manager for market development at Orange Côte d'Ivoire. "The idea was to say: let's see what we can do with Orange, because there are people we are targeting who don't come for vaccination, either because they're not mobilised, or because they're not aware and don't have the information. Given that today we are able to reach everyone thanks to advances in mobile technology, it was important to see how we could use this to help the Expanded Program on Immunization."
That was when the partnership between Orange, Gavi and the Ivorian Ministry of Health, Public Hygiene and Universal Health Coverage was created. In concrete terms, M-Vaccin is a mobile application that registers women who are pregnant or who have a child under the age of two, creates a digital vaccination record for them, and sends them automatic reminders to get their children vaccinated via voice messages available in French as well as in a dozen local languages, for people who can't read or write.
VillageReach, an international NGO focused on public health and with the vast majority of its staff on the African continent, has stepped in to support the implementation of the M-Vaccin project: "Our belief is that governments need to work with the private sector in their countries to achieve their universal health coverage goals," says Joseph Roussel, Director of Private Sector Engagement at VillageReach.
"Our role is to work with the Expanded Program on Immunization (EPI) so that it can express its wishes, understand how to work with the private sector and give the private sector the keys to working with a state entity. There's a lot of technical work involved, as well as a whole methodology for deployment.
"Deploying an application is an exercise that requires change management and technical management, because you have to motivate people to adopt a new tool and also, for example, know how to transform the application's data into a dashboard that can be used by EPI management," continues Roussel.
Personalised, proactive follow-up to reinforce vaccination compliance
The vaccination process itself takes place in two stages. "When a mother arrives to have her child vaccinated, she is then registered if she isn't already. Registration involves collecting identity and location information in the application. The child is then vaccinated, and the nurse updates the electronic record in the application. Registration and vaccination information is also recorded in the physical registers traditionally used by health workers. This is the register we're trying to load onto the application," explains Diallo.
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As the date of the next vaccination approaches, the mother will receive messages telling her that she has an appointment for her child's vaccination in three or six days' time. "This follow-up is also carried out with pregnant women, reminding them that after the first dose, they are required to come and have the second dose administered at the indicated time," explains Dr Kouadio Nestor, Head of the Strategic Planning Project Department at the EPI.
Selected close contacts, such as a spouse or other family member, also receive the reminder, to minimise the chances of the appointment being forgotten.
This approach relies on the essential involvement of community health workers, who are perfectly integrated into their communities and have in-depth knowledge of individuals.
Community health workers (CHWs) are informed of vaccination reminders and know exactly who the people are. "Before M-Vaccin, comunity health workers had to search through the registers," recalls Diallo. "Today, thanks to the app, they get a quick overview of the children who have missed their appointment."
If a person who has received a reminder misses his or her appointment, the CHW goes straight to meet them to find out why. Sometimes it's because of a temporary absence, a move, or other difficulties encountered in daily life.
In many cases, it is the CHW who personally accompanies the parent to the health centre to ensure that the child actually receives their vaccine. This personalised, proactive approach ensures better vaccination management and strengthens the bond of trust between health workers and community members.
The benefits of M-Vaccin
Overall, the M-Vaccin initiative has been welcomed by users and beneficiaries. The results of the preliminary evaluation carried out in May 2021 showed that 73% of health workers and 100% of community health workers perceive that M-Vaccin has a positive impact on generating demand for immunisation.
"Health workers tell us that they are more efficient in their work, simply because they no longer have to search through paper registers to find the people they need to go and vaccinate," says Joseph Roussel with satisfaction. A VillageReach report on the solution's initial results corroborates this: 96% less administrative work for health workers when using M-Vaccin.
According to the study, 90.8% of mothers found the SMS content useful or very useful, and 72% of mothers surveyed said they had received personalised follow-up from the CHWs, helping to improve search activity for unvaccinated people.
M-Vaccin is more than just an application where parents and caregivers can register for vaccinations, according to Joseph Roussel of VillageReach. "It's also a fantastic management tool for the EPI, because it tells us how many children are vaccinated in one district compared with another, whether booster vaccination efforts are working, whether we need to step up our efforts to promote vaccination." M-Vaccin therefore facilitates decision-making.
Working towards full digitisation of the vaccination process with M-Vaccin
The M-Vaccin application can now also track zero-dose children. But, according to Diallo, for it to be even more effective, the vaccination activity needs to be digitised from end to end. "Today, the big challenge is that health workers are still forced to use paper registers, as this is the official standard. The application is proving its worth as an effective replacement for paper. Everyone recognises the impact of M-Vaccin and the real added value it brings," he explains.
"We've set up a pilot project which will soon be launched in the Cocody-Bingerville district of Abidjan, where we've provided health workers with tablets. They'll be able to enter information on their available vaccine stock, enter other interventions, for example, for those giving vitamin A injections, the COVID-19 vaccine, and other types of information that we weren't tracking," he continues.
"Then the mother and child information will be automatically populated on the dashboard. There will be no need to create a separate dashboard."
By combining mobile technology, community engagement and effective data management, M-Vaccin has demonstrated its potential to improve routine immunisation coverage in Côte d'Ivoire.
The EPI's ambition: a nationwide roll-out
The M-Vaccin solution has now been deployed in 17 health districts and 1,041 health workers have been trained.
"We started with five districts. We're aiming for a gradual increase. There may be minor shortcomings, which we will correct as the we go along, in collaboration with the telecoms operator, Orange," stresses Dr Kouadio.
Some 43,394 pregnant women and 29,696 children are registered, for a total of 54,101 notified procedures, including 14,266 administered doses of vaccine. Over the course of the project, 104,300 voice messages and 248,823 text messages were sent to patients.
M-Vaccin also reminds us that although public-private partnerships and collaboration between governments, companies, international organisations and communities can be challenging, with each party having to get used to working with the others in their own way, the results can be game-changing, bringing innovative solutions to the world's health challenges to life.
This article was translated from the original French. To view the original click here.