Smart Paper Technology adoption at scale in Western Regions, The Gambia

Author: Sarah Strassburger

Editor: Josef Prygodzicz

From the inception of Smart Paper Technology (SPT) in The Gambia under the MyChild project in 2017, Shifo Foundation together with ActionAid International The Gambia (AAITG) and the Ministry of Health and Social Welfare (MoH&SW) in The Gambia have worked in close collaboration to implement the solution to support the delivery of the Expanded Programme of Immunisation (EPI) across the country.

MyChild was introduced in The Gambia with children and front-line health workers at the forefront of our minds. The solution was designed to ensure retention of routine work processes while concomitantly relieve from administrative burden by digitisation of data through scanning of filled SPT forms. Essential novelty of the SPT system is the assignment of unique ID numbers to children. Thus, electronic registers with individual-level information are created, ensuring that children are followed up with vital health care, and allowing decision makers at different levels to make choices based on reliable data.

The MoH&SW, AAITG and Shifo have continued to work in close collaboration to implement SPT in all public health facilities and their outreaches. Due to the wide acceptance and acknowledgement of the benefits brought by SPT, the Regional Health Directorate of Western Region 1 (WR1) spoke in favour of an expansion of SPT to the (20) private facilities in Western Region 1 to unify the process of data collection and reporting in 2018. Today SPT is implemented in 90 public and privately owned health service delivery points (HSDPs) in Western Region 1 and 2 (37 fixed and 53 outreach sites). Additionally, 4 Medical Research Council sites are included.

The most recent implementation in Brikama Hospital in January 2020 marked the milestone of complete roll-out in Western Region 1 & 2. With being the biggest immunisation services provider, not only in the Western Regions, but in the whole of Gambia, implementation in Brikama Hospital was essential in ensuring provision of complete and reliable data. As of our data from February, immunisation visits from Brikama Hospital accounted for 15% of all documented visits in Western Regions 1 & 2 carried out during that month.

The gradual expansion of SPT in the Western Regions over a course of more than 2 years has unavoidably led to data gaps when children have visited HSDPs where MyChild wasn’t implemented yet. However, MyChild has reached 143.117 children as of today, of which 43.752 are already fully vaccinated. Per 2013 census, the Western regions were the most populated with a population of 699,704. Considering a birth rate of 33.0 births/1,000 population as of data from the Multiple Indicator Cluster Survey (MICS) 2018 report, the importance of implementation in these regions gets evident.

As a result of complete roll-out from the beginning of this year, it is expected that more complete and reliable EPI data will be generated for the country in 2020. Thus, allowing MoH&SW, AAITG and Shifo to continue their collaboration with a focus on evidence-based monitoring, strengthening and improvement of immunisation service provision. With an expansion into further regions to yield national coverage it is expected that generated data will be of excellent quality to inform on the ministry level as well as aid health workers in delivering quality health services.

References:
(1) “The Gambia Demographic and Health Survey 2013” https://dhsprogram.com/pubs/pdf/FR289/FR289.pdf
(2) “The Gambia Multiple Indicator Cluster Survey 2018” https://mics-surveys-prod.s3.amazonaws.com/…/The%20Gambia%2…