Devoted to Maternal and Child Health
How electronic immunization registry eases the work of health staff in Lao PDR
Green leafy plants punctuate the concrete of Vang Vieng District Hospital. Young parents sit patiently, babies wriggling in their arms. Some of them are cassava farmers, some work on rubber plantations, and others on construction sites, but all of them are here for the same thing: to be called in, one by one, by Dr. Xia Bouapao for the vital routine immunizations that will protect their children from disease.
Dr. Bouapao is a clear-eyed, smiling young woman. “I enjoy this job for the opportunity to give vaccines to every child, helping to improve their health while also supporting my family, relatives, and everyone around me.”
Until recently in Lao PDR, maternal and child health medical records were dutifully recorded in paper books, colour coded by type: yellow for mother’s vaccinations, green for children’s, and pink for antenatal care. Parents needed to bring the booklets for every appointment, and they were sometimes lost – meaning that a child or mother’s immunization history was lost along with it. Dr. Bouapao and her fellow doctors used to spend much of their time filling out these booklets and poring over paper-based registries.
According to Dr. Bandith Soumphonphakdy, Head of the Lao National Centre of Mother and Child Health, the paper-based system caused information to be “incomplete, untimely, and inconsistently collected, hindering the ability to properly track program performance and make informed decisions.”
Clearly, healthcare workers like Dr. Bouapao faced a very heavy workload, and data inconsistencies across the country significantly complicated their jobs. However, all this is being transformed by an electronic immunization registry, part of a series of digital health initiatives supported by UNICEF through a generous donation from the Government of Japan.
For policymakers, it’s a step towards making the entire system more efficient. “UNICEF is adapting the electronic immunization registry to be appropriate for our country’s information reporting,” says Dr. Kongxay Phounphenghack, the Head of Vaccine-Preventable Diseases and Immunization at the Ministry of Health. “UNICEF will play a key role in consulting with us on what the government wants and how we can improve the information system.” A key part of this is being able to use the data to analyze what areas of the country have low immunization coverage, like some of the areas where Dr. Xia Bouapao works, and direct resources there.
“Data analysis allows for the tracking of specific populations, such as the number of children under one year old who are unvaccinated or under-vaccinated, or the number of children under five who have incomplete vaccination schedules. This facilitates targeted follow-up, improving access to vaccination services for at-risk groups,” says Dr. Soumphonphakdy.
The new system is more efficient for Dr. Bouapao, too. “Since we have the electronic immunization registry system, everything is much more convenient, and it saves us a lot of time,” she says. “It’s much easier to compare the data.” With the new system, reports are generated automatically, freeing up much more time for her patients.
In addition, Dr. Bouapao now gets to spend more time on outreach sessions. For families living in remote areas, with little time to take off work, it’s difficult to access services in towns and cities. For those families, immunization and antenatal care outreach sessions are crucial. Healthcare workers carefully pack vaccines into cold boxes, strapping them to the backs of their motorbikes, and weave their way through the verdant hills, bouncing along dirt roads to schools and village halls dotted across the landscape. There’s some hesitancy in rural areas too, so Dr. Bouapao spends time on these outreach sessions, listening to reluctant parents. “To address these concerns, we take the time to explain the safety and quality of vaccines. We also explain the purpose of each vaccine, the diseases they prevent, how those diseases spread, and the severe effects they can have on a child’s health.”
She still spends many afternoons with her computer, but now more time is devoted to digital learning, another of the digital health initiatives supported by UNICEF, which supports her lifelong ambition to support maternal and child health in and around her community.
“I feel very grateful and proud that I have put all my effort into taking care of children. I want the health of mothers to improve and for them to stay healthy. Every child should receive good protection and care for their health as much as we can provide. This is the goal for child health work.”
