Smartphones help fill vaccine gaps in rural Pakistan


A project giving health workers cheap smartphones to track their progress through rural Pakistan has seen vaccination rates soar, reported UK-based publication, The Telegraph.

According to the report, the scheme carried out in collaboration with the British cost less than £1m and has led to the immunisation of hundreds of thousands more children. It is now being replicated in different parts of the world.

Location data from the phones was used to help planners understand why workers were failing to hit vaccination targets in Punjab province.

According to the data revealed, villages were being missed or ignored because of a shortage of staff or because health teams had been bunking off, or because the government was not paying transport allowances.

Handing out the £60 phones ($80) saw the vaccination campaign quickly reach nearly every village and immunisation rates climb from 47 percent to 82 percent over two years.

The programme has now inspired similar attempts in Ethiopia, Congo, Mozambique and Afghanistan.

The scheme, called eVaccs, supported by British and World Bank funding, began in 2014 in Pakistan’s Punjab province which is home to nearly 110m people.

A team of 4,000 vaccinators was already employed to travel each month to every village to deliver immunisation against illnesses such as diphtheria, tetanus, whooping cough or measles.

However, the vaccinators were not reaching every community.

“The big challenge is you have got to get a vaccinator to visit every village in Punjab once a month,” said Fenton Whelan, a British-funded consultant on the project.

“The reason kids weren’t getting immunised was that that wasn’t happening. What became clear was that if we could get really good information on a sort of daily basis about which villages were getting reached and which weren’t then we would be able to crack it.

“Using the same technology that we all use everyday on WhatsApp or Google Maps to track location just seemed like the obvious way to do that.”

Punjab Information Technology Board built a simple bespoke app for the phones which allowed vaccinators to click a button whenever they injected a child, with the location data saved.

It took a few months for all the vaccinators to be trained to consistently use the app, but hundreds of thousands of data points were soon created and when linked to satellite maps, planners were able to see which villages were being missed.

Holes in the coverage showed flaws in the vaccination plans, with staff not deployed to the right places and confusion over which teams were responsible for which places.

The data also showed where teams had failed to do their job.

“About 10 percent of vaccinators actually quit during the first six months of the programme and those were the ones who essentially never showed up for work and the technology exposed that,” Whelan said.

The data also revealed where vaccinators were not reaching their targets because the provincial government was not paying their transport allowances.