The Har Zindagi pilot aims to achieve significant performance improvements in immunization administration, such as augmented uptake, retention and quality of immunization, by engaging with disadvantaged communities and using low-cost technology to cohere the lower layers of the health system with the managerial layer.
Pakistan has one of the highest infant mortality rates in the world. According to the World Health Organization, one child in every eleven (87 per 1000 live births) born in Pakistan dies before the age of 5. UNICEF indicates how the extent of immunization coverage is strongly correlated to infant mortality, however even with vaccination programmes headed by the Expanded Programme on Immunization (EPI), with support from the United Nations, Pakistan will probably not meet the 2015 Millennium Development Goal target of 40 deaths per 1,0000 live births. This lapse can be attributed to many factors, however our research has suggested that intertwining technology and data-collection with healthcare practices can have a profound and positive impact on overall health care for developing countries. Issues such as outmoded vaccination cards, that are printed by the Pakistan government, are often difficult to interpret by parents and are manually maintained in bulky registers. Furthermore, vaccinator performances are not tracked and therefore unverifiable, as well as the fact that health officials have no way to identify children outside vaccination coverage areas and parents/vaccinators have no real incentive to vaccinate children. At IPAL, we hope to to target these service delivery issues using technological innovation, with the ultimate goal of increasing uptake and retention of immunization, and to improve the quality of immunization alongside satisfaction of mothers whose children are vaccinated.
After having secured funding to pilot the project from the District Delivery Challenge Fund and the Sub-National Governance Program, the ‘Har Zindagi- Every Life Matters’ initiative will aim to increase uptake, retention and quality of immunization by using a redesigned immunization card for parents and a smartphone application for vaccinators that stores real-time immunization records onto a centralized database. The user‐interface of the immunization card will be redesigned for low‐literate guardians, and centralized records will be visualized on a dashboard for policymakers. The Computerized National Identity Card and cell phone numbers of guardians will be saved on record, and informational messages and reminders regarding post-natal care will be sent via text and voice message. Vaccinator attendance and performance will also be measured from smartphone data, GPS tagging and guardian feedback via SMS.