Participatory Qualitative and Quantitative Study on Capturing COVID-19 Vaccine Health Data in Lusaka
The COVID-19 global pandemic, caused by the Severe AcuteRespiratory Syndrome Coronavirus- 2 directly or indirectly, impacted all sectors. The crisis had a disproportionately worse effect on the alreadystrained healthcare systems in Zambia. Health service delivery was significantly impacted, especially during the early stages due to the rapid virus spread across all settings. This posed challenges in health human resource management, facility utilisation, medical supply management, and data capturing and storage.
The challenge of capturing maintaining real time granular health data is of particular concern to the Well Trust Foundation and Immunify Life. A number of patients have not had the provision of consistent health services as health data access is limited to registry personnel. Additionally, there is no sharing of health data across health centres. To address this, Well Trust Foundation aims to conduct research on capturing COVID 19 health data for patients. WellTrust Foundation expects this initial pilot project to significantly reduce theextreme stress health centres face in capturing, storing, and sharing COVID-19 health data.
The project's objective was to gather information on the health administrative and personal health data for each patient receiving the first and second dosage of the COVID-19 vaccine. The pilot project collecteddata from a target of fifty (50) individuals from selected COVID-19 vaccination centres. Furthermore, the project aimed to facilitate the capture, storage, and availability of the same data to healthcare professionals at any health institution where a patient attends to ensure they receive the correct treatment.
Objective:
The COVID Vaccination Management Pilot in Lusaka, Zambia, aimed to test and refine processes and systems for effectively managing the administration and distribution of COVID-19 vaccines within the city. This involved using the latest blockchain technology and simple handheld digital technology. The pilot sought to demonstrate the effectiveness of digital technology as a replacement for paper-based record-keeping, assess the feasibility of proposed solutions, and provide valuable insights for scaling up vaccination efforts across the country.
Implementation:
The pilot was carried out in collaboration with theMinistry of Health, local health authorities, and relevant stakeholders. A dedicated team of healthcare professionals, logistics experts, and IT specialists worked together to streamline the vaccine management process.
The study took place at Chawama Health Facility, situated in the densely populated Chawama compound in Lusaka, Zambia. Using consecutive sampling, due to demand the target of 50 patients was exceeded with a total 75 participants enrolled. The aim was to assess the effectiveness of using SMS reminders to prompt patients to return for their scheduled follow-up vaccination after receiving their first dose.
Procedure:
- First Vaccination and Data Entry:The study enrolled 75 patients who received their first COVID-19 vaccination atthe Chawama Clinic. During the vaccination process, their demographic data, contact details, and vaccination information were accurately recorded and entered the vaccination management system.
- Follow-up Vaccination Scheduling:After receiving their first dose, each patient was provided with a scheduled date for their follow-up vaccination. The date was selected based on there commended interval between doses, ensuring optimal effectiveness of the vaccination.
- SMS Reminder System: An SMS reminder system was integrated into the vaccination management platform. The system automatically generated SMS reminders for each patient to prompt them to return to Chawama Clinic on their scheduled follow-up vaccination date.
- Automated SMS Reminders: The system sent automatedSMS reminders to the contact details provided by the patients during their first vaccination. These SMS reminders were sent a few days before the scheduled follow-up vaccination date, serving as prompts and reminders for timely completion of their vaccination course.
- Patient Compliance Monitoring: The study monitored patient compliance with the SMS reminders and assessed their impact on follow-up vaccination rates. The system trackedwhether patients received and acknowledged the SMS reminders, as well as their subsequent return to Chawama Clinic for their scheduled follow-up vaccination.
Outcomes and Recommendations:
Study Outcomes:
The study conducted at Chawama Clinic yielded insightful observations regarding the effectiveness of real time data capture and SMS reminders in enhancing patient compliance and elevating follow-up vaccination rates.
Preliminary findings showed positive and encouraging outcomes, shedding light on the potential of SMS reminders to reduce missed appointments and guarantee the timely completion of the COVID-19 vaccination course.
Specific points of note and lessons learned:
- Enhanced Efficiency: The pilot demonstrated improved appointment scheduling and registration systems, streamlined processes and reduced waiting times. SMS reminders proved very efficient, as all 75enrolled participants returned for their second vaccine doses.
- Paper based record replacement: The pilot demonstrated that the health management tool was simple to learn and use and was very effective and capturing accurate real time data allowing for easy patient management and data sharing.
- Data-Driven Decision Making: Implementing a robust data management system provided insights into vaccination coverage, target populations, and areas needing increased outreach. This facilitated evidence-based resource allocation and vaccine distribution decisions.
- Stakeholder Collaboration: Collaboration among stakeholders, including government entities, healthcare providers, and community organisations, together with effective communication and coordination was crucial for the success of vaccination management efforts.
- Lessons Learned: The pilot identified challenges and lessons, such as the need for community engagement and targeted communication campaigns to address vaccine hesitancy and ensure equitable access to vaccination services.
- Scaling Up: Based on pilot findings, recommendations for scaling up COVID-19 vaccination efforts include:
- Expanding the appointment scheduling and registration systems to accommodate a larger population.
- Implementing a robust surveillance system for adverse events following immunisation (AEFI)monitoring.
- Increasing and enhancing communication campaigns to increase public awareness and address vaccine hesitancy.
- Upscaling training programs for healthcare professionals involved in vaccine administration and management
Implications
The utilisation of a paper based record replacement and automated SMS reminders demonstrated a cost-effective and efficient means of motivating patients toreturn for their scheduled follow-up vaccinations. The study's outcomes demonstrate that integrating SMS reminders into the vaccination managementsystem could notably improve patient engagement, decrease the risk of missed doses, and significantly contribute to achieving higher overall vaccination coverage rates.
Recommendations
Based on the positive results observed during the Chawama Clinic study together with the lessons learned and key points for scaling up the project for wider participation, the pilot has laid the foundations for recommending integrating SMS reminders into the broader COVID-19 vaccinationmanagement strategy in Lusaka and other regions of Zambia.
However, further research and larger-scale implementation is imperative to validate and refine these findings.
Application to Malaria PreventionActivities and Potential Long-Term Benefits:
The technology and systems used in the COVID vaccination present a significant opportunity to assist the Zambian Ministry of Health in tracking and managing malaria prevention activities.
Some of the benefits that could be achieved by utilising our approach include:
- Real-Time Data Collection: The mobile platform, initially employed in the COVID vaccination management pilot, holds potential for adaptable utilisation in real-time data collection for malaria prevention activities. This encompasses information regarding the distribution and utilisation of insecticide-treated bed nets, indoor residual spraying campaigns, and community health education initiatives.Real-time data collection is pivotal in furnishing accurate and up-to-date insights, presenting a comprehensive landscape of malaria prevention efforts.
- Enhanced Data Accuracy and Timeliness: Like the vaccination management system, the implementation of robust data validation mechanisms ensures the precision and dependability of gathered information. The synchronisation of real-time data can be harnessed to offer timely insights for informed decision-making processes. Consequently, theMinistry of Health gains access to precise and current data related to malaria prevention endeavours, thereby empowering proactive decision-making and effective resource allocation.
- Data Analysis and Reporting: Establishing data analytics capabilities facilitates profound analysis of the collected data.Being able to generate actionable insights and comprehensive reports on malaria prevention activities, empowers decision-makers with invaluable information for efficient resource allocation, targeted interventions, and evidence-based decision-making. The analytical capabilities play a role in identifying trends, areas of improvement, and openings for innovation within malaria prevention strategies.
- Evidence-Based Decision Making:By furnishing accurate and current information relating to malaria prevention strategies, this technology enables the Ministry of Health to confidently make evidence-based decisions. This encompasses the evaluation of intervention effectiveness, identifying areas for improvement, and optimisation of resource allocation. The resultant long-term benefits include more effective intervention targeting, reduced malaria transmission rates, and enhanced health outcomes for the Zambian population.
- Collaboration and Information Sharing:The mobile platform can effectively foster collaboration amongst healthcare workers, community volunteers, and relevant stakeholders engaged in malaria prevention efforts. By offering a platform for seamless data sharing and communication, stakeholders can exchange best practices, share success stories,and coordinate efforts to improve malaria prevention strategies. This collaboration and sharing of information coils lead to increased effectiveness and efficiency in malaria prevention activities.
Revolutionising Malaria Prevention:
By leveraging the technology and systems initiallydeployed in the COVID vaccination management pilot, the Zambian Ministry ofHealth has the potential to revolutionise the tracking and management of malaria prevention activities. This could result in improved decision-making, optimised resource allocation and ultimately, a significant decrease in the malaria burden in Zambia. The long-term benefits include improved health outcomes, reduced mortality rates, and an overall healthier population.
DR. Mwewa Kabaso 25-07-2023
