Gavi Digital Health Information Strategy Technical Brief Series

"There has been a huge focus on strengthening health systems to accommodate COVID-19 challenges and new vaccine rollout throughout the world....It is an opportune time to embed digital health sustainably into global health systems."

Building on systematic prioritisation of strategic digital health investments conducted in 2020, Gavi, the Vaccine Alliance engaged HealthEnabled to lead a participatory design of the Gavi Digital Health Information (DHI) Strategy 2022-2025. As part of this process, a series of technical briefs were developed by HealthEnabled to inform the strategy development process. They cover both cross-cutting considerations such as gender and COVID-19 innovations, as well as areas aligned with digital health information priorities, such as effective use of sub-national data, timely detection of vaccine-preventable diseases (VPDs), and digital interventions for the strengthening of vaccine confidence and demand.

The briefs include:

• COVID-19 Innovations and Digital Applications for Routine Immunisation [PDF, 8 pages] - provides a summary and review of experiences with new and adapted digital solutions for COVID-19 vaccine delivery at the global, regional, and country levels to ensure that the lessons, challenges, and successful application of DHI innovations are captured as part of Gavi's DHI strategy. Recommendations for prioritised Gavi DHI strategy investment at the global level include (see the brief for country-level recommendations):
  • Systematically document COVID-19 innovation experiences across all the Alliance Members and share through experience exchange or a learning hub.
  • Develop a guide to rapidly adapt digital health global goods for expanding use cases in emergencies.
  • Support digital health global goods to create a set of tools that meet the range of use cases and needs of resource-poor health systems - both in routine immunisation and during health emergencies.
  • Document positive COVID-19 innovation experiences that can be packaged and presented (e.g., as a written guide, videos of case studies, or a series of training workshops and webinars) in ways that national Ministries of Health and other Essential Programme on Immunization (EPI) implementers can use and adapt for routine immunisation.
  • Engage with the private sector and other role players to ensure equitable representation/inclusion by gender, race, language, and other known biases in artificial intelligence (AI) initiatives, as well as responsible approaches to privacy and security.
• Sub-national Multi-source Data for Immunisation Programme Decision-making [PDF, 12 pages] - provides a review of the state of evidence and experiences with sub-national data use for decision-making, which is one of six priority areas for Gavi's 5.0 strategic goals. The idea is that sub-national and district-level immunisation programme managers have the local knowledge and understanding to improve immunisation coverage, identify missed settlements, target areas for action, and optimise immunisation planning and service delivery to reach all children within their catchment area. Digital and electronic systems create opportunities to share and analyse relevant data to facilitate rapid decisionmaking and action. Recommendations for prioritised Gavi DHI strategy investment at the global level include (see the brief for country-level recommendations):
  • Facilitate the development of a comprehensive immunisation data toolkit to aid data-driven decision-making with a focus on promotion of standard indicators, systems integration, data triangulation, data quality, and data use.
  • Invest in evaluation and validation of supported interventions to support scale-up.
  • Document case studies that advance the use of multi-source data, beginning with coverage and equity, VPD surveillance, and stock management and expanding to demand data and adverse events following immunisation (AEFI) reporting.
• Increasing Demand for Immunisation, Preventing and Reducing Loss to Follow-up, and Promoting Community Engagement through the Effective Use of Digital Health Interventions [PDF, 12 pages] - provides a summary of how DHI and related technologies can improve immunisation completion and reduce loss to follow-up by encouraging community demand and improving the service delivery experience. Gavi has prioritised immunisation demand and community engagement as one of the six areas for digital health information investment to support the successful achievement of Gavi's 5.0 strategic goals. Recommended Gavi DHI investments at the global level include (see the brief for country-level recommendations):
  • Engage with relevant Gavi Alliance members and digital health experts to prioritise and conduct a review of community-based digital health interventions that help register, track, and improve immunisation completion to create a menu of validated tools for country consideration and adoption, as well as a resource to guide adoption, adaptation, and implementation.
  • Develop and standardise digitally-assisted tools and approaches for the systematic assessment of priority areas for targeted demand interventions.
  • Conduct a review of DHI interventions and models to address barriers related to cost, transportation, and motivation.
• Gender and Digital Health Information in Immunisation Programming [PDF, 11 pages] - provides a summary of the state of evidence and priority areas for investment and attention at the intersection of gender, immunisation, and digital health and data. With the growing gender digital divide, Gavi recognises the importance of a gender-intentional lens for all digital health and data interventions in immunisation programming, reflective in its DHI strategy, which includes gender-intentional strategies, outcomes, outputs, and inputs for global and country consideration and action. Recommended Gavi DHI strategy investments at the country level include (see the brief for global-level recommendations):
  • Promote and support gender-responsive and -transformative approaches in all aspects of DHI and immunisation activity, from prioritised interventions to enablers, including policymaking, design, planning, implementation, and evaluation.
  • Work with local community organisations to identify existing avenues and groups to address and support women, such as by recruiting community advocacy groups to participate in advisory boards, focus groups, and capacity-building initiatives on digital health literacy.
  • Give power and responsibility to local groups, and engage in long-term listening/relationships. Examine power dynamics on the ground, between ethnic groups, households, etc. Create feedback loops that extend beyond the vaccination campaign.
  • Promote meaningful male engagement in gender-intentional capacity building and behaviour change interventions.
  • Support a local gender advisor in Gavi-supported countries or regions.
• Timely Detection of Vaccine-Preventable Diseases for Targeted Vaccination and Outbreak Response [PDF, 10 pages] - provides a review of the state of evidence and experiences with DHI-enabled VPD surveillance, which enable timely VPD data capture, sharing, analysis, and visualisation linked to decentralised testing and electronic case reporting. Recommended Gavi DHI strategy investments at the country level include (see the brief for global-level recommendations):
  • Develop a community-based surveillance framework to roll out the many existing tools in an integrated way.
  • Facilitate capacity building for different roles focused on decentralised testing systems and data triangulation.
  • Scale aggregate electronic integrated surveillance and response systems, taking lessons from polio and other disease areas in support of decentralised testing.
  • Support the integration of laboratory information systems to link test results with case-based reports and improve the coordinated investigation of suspected disease events (in countries with more advanced systems for disease surveillance already in place).
  • Incorporate geospatial data into an integrated disease surveillance and decentralised reporting system for better visualisation and decision making.