TABLE 2.

Comparison of Electronic Immunization Registries Across Vietnam, Tanzania, and Zambia

VietnamTanzaniaZambia
System nameNational Immunization Information SystemTanzania Immunization RegistryZambia Electronic Immunization Registry
Technology platformBespoke system developed by ViettelOpenIZ platform (now known as SanteDB, SanteSuite), an open-source immunization management system33OpenSRP, an open-source mobile digital global goods platform34
System functions
 Registration of individuals, including demographic informationXXX
 Registration of vaccination events, including information on administered vaccineXXX
 Growth monitoring dataX
 Individual monitoringXXX
 Aggregate reportsXXX
 Stock managementX (from national to commune level)X (facility)X
 Health worker decision supportXXX
 SMS reminders for clientsXX
 Automated scheduling and remindersX
Interoperability/data exchange

Vietnam developed an API based on HL7/FHIR to enable the NIIS to exchange data with other systems since many fee-based immunization facilities and private hospitals have their own systems to track their clients (covering multiple health areas beyond vaccination).

The NIIS is also interoperable with a mobile phone application, known as the e-immunization card, that allows parents/clients to access their individual NIIS data.

TImR is integrated with the VIMS, an electronic logistics management information system that tracks vaccine supplies from national level down to district level.

An attempt to integrate TImR with the national birth registry compromised the TImR system performance; this challenge is currently being addressed.

ZEIR is in the process of being integrated with DHIS2, the country’s national HIS. ZEIR reports are currently pushed to a cloned version of DHIS2, mirroring the official HIS.

ZEIR is integrated with mVacc (mobile vaccination), a community-level RapidPro system that community health workers use to send SMS messages to remind families to bring their children for immunization.

Workflows

Individuals are registered from birth using a unique ID, which is generated by the NIIS.

Data are entered by immunization health workers at health facilities, often using computers shared across health areas.

Aggregate data reports are generated for users at all levels of the health system to view.

Individuals are registered from birth. A barcode sticker is applied to the child’s health card and scanned as the TImR unique ID. The caregiver’s ID captured in TImR is linked with the national civil registration and vital statistics system.

Immunization providers at health facilities enter data using tablets. Data can be captured in offline mode and later synced.

Aggregate data reports are generated for users at all levels of the health system to view.

Individuals are registered from birth using a unique ID generated by ZEIR.

Immunization providers at health facilities enter data using Android-based tablets. Data can be captured in offline mode and later synced.

Aggregate data reports are generated for users at all levels of the health system to view.

  • Abbreviations: API, application programming interface; DHIS2, District Health Information Software 2; HIS, health information system; HL7/FHIR, Health Level 7/Fast Healthcare Interoperability Resources; ID, identifier; NIIS, National Immunization Information System; SMS, short message service; TImR, Tanzania Immunization Registry; VIMS, Vaccine Information Management System; ZEIR, Zambia Electronic Immunization Registry.