BACKGROUND
Vietnam is one of the first low-middle-income countries to develop and implement a national-scale EIR. This system was finalized into the national immunization information system (NIIS), and scaled-up to a national level system in 2017. As a result, immunization coverage and timeliness of vaccinations has drastically improved. The time spent on planning and reporting vaccinations has drastically reduced, and as a result is more accurate and effective. However, to date, end-users have been tasked with managing both NIIS and paper-based systems in parallel until a formal assessment on the readiness to fully transition to NIIS was conducted.
OBJECTIVE
This study evaluated the readiness to move entirely to a digital national immunization information system (NIIS), in two provinces in Vietnam, Ha Noi and Son La.
METHODS
All health facilities were surveyed to assess their infrastructure, capacity and need of human resources. NIIS end-users were observed and interviewed to evaluate their NIIS knowledge and skill-sets. Data from immunization cards and facility paper-based log-books were compared to data in NIIS, and vaccine stocks at selected facilities were tallied and compared with data in the NIIS.
RESULTS
Of the 990 health facilities evaluated, most used NIIS to enter and track immunizations (99.7%) and vaccine stocks (90.8%). Majority had stable electricity (98.1%), had at least one computer (99.6%) and had two trained NIIS end-users or more (83.3%). End-users reported that the NIIS supported them in managing and reporting immunization data and saving them time (90%). Although many end-users were able to perform basic skills, almost half struggled with more complex tasks. Immunization data is compiled from the NIIS and immunization cards (89%) and paper-based log-books (91%). However, only 54% of immunization IDs matched, 56.5% of BCG vaccinations were accurate, and 70% of the facilities had consistent physical vaccine stock balances. Feedback received from NIIS end-users suggests that more supportive supervision, frequent refresher trainings to strengthen their skill-sets, and detailed standardized guides to improve data quality are needed.
CONCLUSIONS
The readiness to transition to a digital system was promising. However, additional resources are required to address timeliness, completeness, and accuracy of the data.