Teeko: An mHealth App Helping Improve Routine Immunisation Coverage

Despite having a large number of vaccinators employed under the national immunisation programme, Pakistan is still a polio-endemic country. The immunisation rate for Pakistan’s second largest province plunged from 37% in 2007 to 29% in 2013, alarmingly lower that the global average that stands at a rate of 90%, as reported by the World Health Organization. Lack of transparency, accountability and ineffective monitoring by the government, inadequate visits to villages by vaccinators and poor efforts at creating routine immunization awareness are contributing factors for declining rates.

For a research project aiming to boost routine immunisation coverage in the Tando Mohammad Khan district of the Sindh Province in Pakistan, the Aga Khan University in collaboration with the AKDN eHRC and the Expanded Programme on Immunization (EPI), Sindh developed Teeko, an Android-based application and web portal to help track vaccinators and immunisation coverage. Teeko enables vaccinators to register children, record vaccination data and check vaccine stocks at health facilities via smartphones during field visits whereas supervisors and administrators are remotely able to track vaccinator activities and access immunisation data through its backend web portal. Teeko, meaning ‘vaccination’ in the local language, provides real-time data on a vaccinator’s field movements through GPS tracking.

Strengthening the immunisation programme through increased accountability, transparency and monitoring, Teeko helps improve governance. It ensures that life-saving vaccines are administered to children living in remote, marginalized communities, curbing vaccine-preventable deaths. Field testing of Teeko has shown promising results. Not only was it accepted by the end-users, but independent reports suggested a jump in routine immunisation rates from 15-19% surveyed for different vaccines to 49-84%. Through the project, Teeko has helped monitor 27 vaccinators and 400 lady health visitors. From October 2015 to June 2017, 147,627 vaccines of 33,616 registered children have been administered through the app.

Teeko is part of a research project titled, ‘Improving Routine Immunization Coverage through Health Systems Strengthening’, led by Dr Shehla Zaidi, Associate Professor at the Aga Khan University in partnership with AKDN eHRC and the government’s Expanded Programme on Immunization and funded by Gavi, the Vaccine Alliance. The research project initiated January 2015 and is to conclude in 2017.

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