Immunisation Registry and Information System within TFYR Macedonia's E-Health Framework

In order to better understand and document the specific bottlenecks in management of national maternal and child health programmes (e.g., monitoring is not articulated or assigned to a particular institution), the initial phase included a review of the functions, operations, expected outputs, and performance monitoring indicators of the national immunisation programme. A participatory approach to maternal and child health programme assessment was central to reaching common strategies for improving current management practices and defining a methodology for planning, budgeting, and monitoring of maternal and child health programmes. For instance, consultations were held with all stakeholders to map the flow of data generating, sharing and utilisation patterns, and priorities and needs, including the e-health card.

Afterward, programme management guidelines were developed for overall public health and immunisation as a pilot. These documents outline programme application requirements, outlining a step-by-step process in planning, budgeting, monitoring, and evaluation, with clearly assigned roles to public health institutions. This part of the process served as a framework for software developers who went on to develop an immunisation management information system and software. Undertaken by a local institution under the MoH, the first version of the software is expected to be piloted, along with its components on immunisation and home visiting care, in selected health facilities in the first half of 2013. The challenge involves translating complex "business processes" among institutions into a user-friendly e-environment and accommodating software language with requirements of already developed specification of health information system. Interactive visualisation and presentation are based on how longstanding problems in immunisation (vaccines management, planning/reporting delivery) will be addressed through the software. Consequent to this, adjustments to the software will be made to ensure national scale-up. At the same time, a capacity-building programme will be designed to allow education of all end users of the mother and child programmes on the use of this software.

According to UNICEF, one advantage of the software is to enable health managers and staff to monitor all components of the immunisation programme at all levels in an integrated fashion, including individual vaccination registries, immunisation coverage, vaccine and supplies logistics, disease and adverse effects following immunisation (AEFI) surveillance, and performance indicators of service providers. Another value of this approach is positioning the immunisation information system as an integral part of the overall health management information system from the start and relying on the existing technical capacity and institutions in the country.

Immunisation and Vaccines, Maternal and Child Health, New Technologies

UNICEF explains that the maternal and child health programme software and its component on immunisation is part of the national strategy of immunisation; hence, this initiative had its policy framework already developed and ensured its implementation. Integration of software solutions into government e-health system proved to be a good sustainability strategy.

The guideline for programme management and, in particular, the demonstration immunisation programme software were developed in a very generic manner. Therefore, UNICEF states that application in other countries of the regions is possible, as long as there are similarities in composition of the mother and child health system.