The World Health Organization, UNICEF, and Gavi, the Vaccine Alliance have partnered with DHIS2 to improve national immunization program coverage through better data collection, analysis and use
Since 2017, UiO has partnered with the World Health Organization (WHO) as a Collaborating Centre for Innovation and Implementation Research on HIS strengthening. Through this partnership, UiO has developed a suite of DHIS2 tools and metadata packages that support countries to adopt WHO immunization program standards into national HMIS.
Through our partnership, 44 countries in Africa and Asia have successfully integrated Expanded Programme on Immunization (EPI) data into their national DHIS2-based HMIS platforms. The DHIS2 tools and guidance developed through our collaboration have empowered EPI program managers and district staff to identify gaps in immunization coverage, reduce stock wastage and monitor cold chain metrics and follow up on facility reports. Thanks in part to the use of DHIS2 analytics and data quality tools, some countries have achieved more than 98% completeness of their immunization data. Increasingly, countries are using tracker programs in DHIS2 as an Electronic Immunization Registry (EIR) to improve adherence to the national vaccination schedule and reduce drop-out rates. These tools are designed with integration and sustainability at the forefront, underpinned by WHO recommendations to strengthen national HMIS through integration of immunization, health service delivery and other program data.
The DHIS2 toolkit for immunization includes the following apps and metadata packages, designed for modular implementation and adaptable to local program needs.
Visit the DHIS2 Health Data Toolkit page for links to additional documentation and downloadable metadata files, and go to the DHIS2 App Hub for the latest versions of the immunization-related applications.
The routine immunization module is developed with the WHO department for Immunization, Vaccines & Biologicals with subject matter expertise from WHO AFRO’s immunization programme. The module supports analysis of key indicators for the Expanded Programme on Immunization (EPI) such as vaccine coverage, cold-chain equipment, and facility stock management. We also provide guidance on integrating new antigens such as the malaria vaccine into routine immunization data systems.
The Big Catch-Up (BCU) is a global initiative led by WHO, UNICEF, Gavi, and key partners to restore immunization coverage following disruptions caused by the COVID-19 pandemic. It focuses on reaching Zero-Dose and under-immunized children through catch-up activities and strengthening routine immunization (RI) systems. The module supports the analysis of key indicators for the BCU vaccine distribution, uptake, and Behavioral and Social Drivers of Vaccination. The guidance also provides information on how to adapt the existing RI frameworks and smoothly integrate the catch-up activity from the data entry to the analytic stages.
These tools support the digitization of national-scale immunization registries with DHIS2 Tracker. Designed for clinicians and staff at health facilities, the tool enables registration and tracking of children through the routine immunization schedule. The design is based on the WHO recommended schedule for routine immunizations for children and can be adapted to national vaccination policies, as well as for other use cases such as vaccination of health care workers and adult populations for influenza or COVID-19. The registry supports the generation of key indicators that are included in the routine immunization module for HMIS, as well as additional analyses made possible with individual level data to detect immunity gaps and delayed immunization.
Immunization campaigns or supplemental immunization activities (SIA) are typically run in areas with immunity gaps or low coverage rates. Such campaigns can be conducted as a response to an outbreak of a vaccine-preventable disease like meningitis, or can be targeted in areas or populations that face barriers to accessing routine health services.
The HISP Centre in partnership with WHO Health Emergencies, WHO AFRO and CDC WHO AFRO’s Technical Guidelines for Integrated Disease Surveillance & Response (IDSR). These can be adapted based on regional and country context. Dashboards bring together both aggregate and case-based reporting for triangulation and include configurable outbreak/alert thresholds. System design guides explain how to configure disease thresholds, integrate lab data into case-based surveillance and use DHIS2 functionalities for surveillance use cases.
Designed in collaboration with Gavi and WHO, this Mpox toolkit leverages extensive feedback from the HISP network and partner countries. It offers a flexible, scalable solution for integrating Mpox vaccination into existing health systems or introducing it in epidemic contexts. The toolkit’s adaptable structure can support other vaccines like Ebola, ensuring its utility in broader public health responses while maintaining essential functionality for epidemic-prone diseases.
DHIS2 Tracker can be used to support the notification, reporting, investigation and analysis of adverse events following immunization. This tool is ideal for countries that already manage their immunization programme data in DHIS2, and can streamline reporting from the lowest levels of the health system and triangulate with other programme data, including immunization registry data. The tool incorporates WHO recommended core variables for AEFI reporting and can be used to generate data for reporting into WHO’s global system for pharmacological surveillance, VigiBase.
Vital Events notification expands coverage of the reporting of vital events from health facilities such as birth, stillbirths, and death to the national CRVS. When implemented in DHIS2 using the Tracker data model, health facilities can send notifications to relevant CRVS stakeholders for registration or can exchange data with electronic CRVS systems. Notifications are not intended to replace the official national CRVS or the legal framework of implementing countries, but it is expected to improve and strengthen reporting of births and deaths. In turn, strong CRVS systems often provide key denominator data for many health performance indicators in the HMIS such as vaccination coverage.
An installable web app providing enhanced data visualizations to support the analysis and use of WHO-EPI programme data.
An installable web app for performing bottlneck analysis on your programs to identify, analyze, and resolve bottlenecks.
An installable web app for creating scorecards for immunization programs or other health interventions. Can be used alone, or in conjunction with the BNA app.
An installable web app that works in conjunction with the BNA and Scorecard apps, for tracking actions taken to address the root causes of bottlenecks.
Additional metadata packages are being developed for mapping of cold-chain logistics and integrated analytics between health service data and supply chain information.
As part of an integrated HMIS, new interventions such as the malaria vaccine are also supported in DHIS2 as part of an integrated immunization module and can be triangulated with routine malaria surveillance data.
DHIS2-based immunization systems can also be rapidly adapted to meet the needs of emerging health crises. As a recent example, in response to the COVID-19 pandemic, we developed the DHIS2 toolkit for COVID-19 vaccine delivery, which expanded field-tested designs and tools from the WHO DHIS2 immunization data toolkit to enable countries to rapidly update existing DHIS2 systems to support the equitable delivery of lifesaving COVID-19 vaccines at scale.
With support from Gavi, WHO AFRO, and UiO, HealthEnabled produced a guide to support countries that intend to use DHIS2 for immunization-related activities. This guide presents relevant information that can inform the implementation of DHIS2 for immunization through learning from other country experiences, by providing a review of published literature on the use of DHIS2 for immunization program management, as well as a listing of helpful resources on facility-based data, data quality, interoperability, electronic registry using DHIS2, case-based surveillance and reporting on VPDs, vaccine supply chain information systems, bottleneck analysis and scorecards, DHIS2 and birth notifications, Adverse Events Following Immunization (AEFI), immunization campaign monitoring and other general DHIS2 resources.
Learn more:Â The Guide to DHIS2 and Immunization Evidence and Resources is available in PDF format. Download the Guide
Here are just a few examples from a selection of countries that show how DHIS2 can make an impact in management of immunization programs.
The Community of Practice (CoP) is the primary forum for DHIS2 discussion and support. There, you can read, discuss, and share user stories and best practices, raise and help resolve questions and issues, and connect with other members of the global DHIS2 immunization community. Visit the CoP Immunization forum to join the conversation.
In partnership with Gavi, HISP UiO has hosted a webinar series on DHIS2 for Immunization. Each webinar covers a different topic, including details on the latest metadata packages and tools and real-world experiences from implementers and experts in the field. Webinars are offered in English and French.
To get announcements about upcoming webinars, sign up for our mailing list and join the DHIS2 Community of Practice. You can watch recordings from previous webinars on the DHIS2 YouTube channel.
Work on DHIS2 immunization packages and resources has been done in collaboration with–and with the financial support of–our international partners:Â The World Health Organization, UNICEF, and Gavi, the Vaccine Alliance.
