Resources

Since 2014, PATH has been working with the Tanzania Ministry of Health (MOH) under the immunization and vaccine development (IVD) program to implement the better immunization data (BID) initiative in Tanzania. The BID initiative is grounded in the belief that better data and better decisions will lead to better health outcomes. The vision at BID initiative is to support countries to enhance immunization and overall health service delivery through improved data collection, quality, and use. In partnership with the MOH through the IVD Program, the BID initiative identified several critical data-related challenges in issues of data quality, limited data use capacity, inaccurate or uncertain target populations, poor visibility into vaccine supplies, and difficulty identifying children who defaulted on immunization schedules. As part of resolving these challenges, the BID initiative, in consultation with the MOH, introduced a holistic package of interventions in Tanzania. This included information system products, evidence-based practices, and capacity-building to empower health workers at all health system levels toward data-driven action. The key outcomes of this work were:An electronic immunization registry with supply chain information integrated into the vaccine information management system.Barcodes on child health cards and vaccine supplies for unique identification of children and vaccine management, respectively.A change management package, including peer support networks, targeted supportive supervision, and mentorship.From 2015 through 2020, the designed interventions were deployed in 3,748 health facilities in 15 regions of Tanzania: Arusha, Dar es Salaam, Dodoma, Geita, Katavi, Kigoma, Kilimanjaro, Lindi, Morogoro, Mtwara, Mwanza, Njombe, Rukwa, Ruvuma, and Tanga.

Routine immunizations and new vaccine introductions have proven to be some of the best investments to improve the health of people around the globe. However, the trend in global vaccine coverage has been variable across regions, including completion of the vaccination package to meet the World Health Organization’s target of 90 percent coverage.Several factors have been found to influence vaccine access, vaccine coverage, and completion of the vaccination schedule. In Tanzania, these factors include socioeconomic status, gender dynamics, limited knowledge on the importance of immunization, and poor access to vaccination services.In addition, socioeconomic status in Tanzania is inadequately assessed in routine immunization to determine trends and population groups at risk of low immunization coverage and non-completion of the vaccine package. The existing immunization data collection tools, such as the tally book, monthly reporting form, and health management information system book do not capture the data elements necessary to determine the socioeconomic status of caregivers. Reporting tools provide aggregated data that do not provide the whole story on the collected data with other related factors on immunization inequities.The immunization and vaccine development program, in support of the GAVI HSS fund, the United Nations Children’s Fund, and PATH, through the better immunization data initiative, agreed to update the Tanzania immunization registry to capture socioeconomic data from routine vaccination services in Tanzania. The data will be used for analysis to determine trends and population groups at risk of low immunization coverage and non-completion of the vaccine package.In this report, we share the experiences of using the electronic immunization registry to accommodate assessment of immunization inequities, and the process used to develop the socioeconomic status assessment tool in Tanzania.

In Tanzania, a health facility serves as the first point of contact for vaccination and birth notification while the Registration, Insolvency and Trusteeship Agency (RITA) is mandated for birth registration and provision of birth certificates. At health facilities, newborns are provided with a child health card and notification card that instructs parents to process the birth certificate at RITA offices, which are decentralized at the district level.In 2015, birth certificates’ coverage for children under 5 years was under 50 percent, according to RITA, compared to birth notification provided at health facilities. This low coverage of birth certificates was due to several factors, including delays of parents in visiting RITA offices, loss of birth notification cards in the first 90 days, limited awareness of birth certificates, and inadequate tracking of records.These factors motivated the Ministry of Health (MOH), through the Immunization and Vaccine Development (IVD) Program and RITA, to initiate the registration of births and provision of birth certificates be conducted concurrently at health facilities. This intended to improve immunization service delivery as well as birth registration and coverage of birth certificates in the country.Since the launch of this initiative in June 2015, the number of registrations of children under 5 years old increased from 13 percent in 2012 to 65 percent in 2021.In this document we describe the process of integrating the electronic Tanzania Immunization Registry (TImR) and the Under 5 Birth Registration System to improve birth registration coverage. We also share lessons learned on the integration process of the two systems.

Human papillomavirus (HPV) vaccine programs in low- and middle-income countries face financial, programmatic, and social barriers to the introduction and sustainability of these programs. An HPV vaccine delivered through a microarray patch (MAP) could offer potential advantages to address some of those barriers. We asked global experts and stakeholders in Ethiopia about the acceptability and programmatic suitability of this option. In this report, we share the input from these stakeholders, both in terms of programmatic advantages and concerns regarding an HPV vaccine MAP, as well as some of their desired attributes.

Noncommunicable diseases (NCDs), such as cardiovascular disease, cancer, and diabetes, are the leading cause of mortality in the world. Every year, 41 million people die from NCDs, 15 million of them between the ages of 30 and 69. Despite the many proven solutions, progress has been slow and uneven globally. This document provides an overview of the NCD ecosystem, a description of primary findings, and recommendations for future action. Findings and recommendations are presented across four pillars—Access, Integrated Models of Care, Capacity Building, and Sustainability Efforts—to organize the information and analysis with a view toward the prioritization of gaps and opportunities for intervention and partnership, especially for non-state actors.The landscape identifies several enabling factors required to address the key barriers impacting NCD care, alongside intervention opportunities with a specific focus on hypertension and diabetes. The enabling factors are organized into four quadrants adapted from the WHO’s NCD capacity domains and subsequently mapped along a pathway to scale to identify archetypes of country capacity levels. The assessment is timely as countries set their universal health coverage (UHC) roadmaps.