Assessment of usability of immunization e-tracker health system towards building a sustainable system in Rwanda

Abstract

Background: DHIS2 can efficiently capture and store immunization-related data, including vaccination schedules, doses administered, patient information and the importance of digital technologies was highlighted in 2018 by the World Health Assembly. In October 2020, Rwanda country was planning to start the implementation of e-tracker with configured birth notification/registration information. Objectives: We conducted an assessment of the usability of the immunization e-tracker health system towards building a sustainable system in Rwanda and, this study aims at assessing the usability of the immunization e-tracker as an individual record health system currently used in health centers in Rwanda. Method: We conducted a retrospective descriptive study using secondary data which were recorded in e-tracker of 510 health centers countrywide from 01 January 01 to 31 December 2022. Results: We found that the e-tracker is well performing with remarkable changes from July 2022 where there was an increase of health centers having matching data between HMIS and e-tracker from 101 (19,8%) to reach 190 (37,3%) in December 2022. We also found that there is still room for harnessing the benefits of interoperability between immunization etracker and CRVS as health centers are using effectively and progressively CRVS during. During the period of our study, they increased from importing 18.6% of BCG counts in 2021 to importing 23.8% of the cases in 2022. This level of operability offers even room for improvement in near future. From the observation we made, we identified elements that have the potential to improve/enhance the system and maximize its usability. At this point, we proposed starting a digital biometric-based vaccination and use of barcode technology in vaccination. Conclusion and recommendations: Our study has highlighted the evolution of using the etracker system use in vaccination services in Rwanda and made recommendations to make the system use sustainable. The recommendations include starting use of biometrics and barcode technology.