A multi-country evaluation looked at different electronic systems in four LMICs, at different levels of their implementation, digitization, and integration into the country HMIS. The findings provide actionable evidence, experiences, and practical lessons learned on the governance and modalities of the use of electronic immunisation registries (eIR) and electronic logistics management information systems (eLMIS).
Key Findings from Guinea, Honduras, Rwanda, Tanzania
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Process efficiencies: 81% of eIR users reported faster workflows; eLMIS reduced vaccine stock-outs (e.g., Tanzania saw fewer stock-outs in facilities with integrated eIR/eLMIS).
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Data quality: Accuracy was higher in fully electronic (60%) or paper-only systems vs. hybrid systems (45%).
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User acceptance: 87% satisfaction among health workers; 95% valued improved data accessibility.
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Critical gaps: Poor interoperability with birth registries (CRVS) hindered tracking of unvaccinated children; unreliable power/internet impeded real-time use.
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Digital literacy: 77% of health workers were digitally skilled – not a barrier to adoption.
Actionable Guidance for MICs
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Prioritize full digitization: Phase out parallel paper systems to avoid duplication and errors.
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Invest in fundamentals:
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Secure power backups and internet connectivity (bigger bottleneck than hardware).
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Integrate eIR with CRVS to track defaulters.
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Build local ownership:
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Develop in-house tech capacity to reduce dependency on external partners.
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Co-design tools with frontline health workers.
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Start practical use cases:
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Use eLMIS for proactive vaccine ordering to prevent stock-outs.
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Leverage eIR for defaulter lists and session planning (↑ efficiency in Rwanda).
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Avoid These Pitfalls
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❌ Hybrid paper-electronic systems (45% accuracy vs. 60% in full digital/paper).
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❌ Centralized data entry: Enable health workers (not clerks) to input data for real-time decisions.
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❌ Fragmented tools: Ensure eIR/eLMIS integrate with national health systems.