A Community Change Agent sitting at a desk with paperwork in Mozambique

The power of partnerships: transforming vaccine coverage in Mozambique

Related tags: Vaccines

More than 35,000 children in the northern Mozambique province of Nampula are now registered with the mVacciNation pilot programme that was rolled out in 2015 by GSK and Vodafone, with funding from GAVI and USAID.

The partnership combines GSK’s healthcare and vaccines expertise, knowledge and resources with those of Vodafone, harnessing innovative mobile technology to help vaccinate more children against common infectious diseases in Africa. Despite major advances in the funding and availability of vaccines worldwide, it is estimated that up to a fifth of children worldwide still do not receive basic vaccines.

Mozambique was chosen for the one-year pilot because of its devastating child mortality rate and the high proportion of deaths stemming from vaccine preventable diseases. It is also a country where Vodafone, GSK, GAVI and USAID have a strong presence.

The programme is already having a significant impact on the province - over 55,000 total vaccination visits, and an average of five stock updates and three cold chain updates per week have already been recorded at each of 17 healthcare facilities. In December 2015, the service was expanded to 76 facilities.

The initiative involves a smartphone being provided to each healthcare facility taking part in the programme. The device has an application (app) installed that allows health workers to register caregivers and infants, view and record vaccination histories and schedule vaccination appointments, while also sending automatic SMS text message reminders to registered caregivers when their child is due for his or her next vaccination. The aim is to make sure children complete their full schedule and become fully immunised.

The app also enables the healthcare facilities to report regularly on vaccine stock levels and refrigerator temperatures, improving critical supply chain and cold chain management and decision making. This will make sure that vaccines are available when and where they are needed, particularly in rural areas.

“The widespread availability of mobile phones in Africa offers an opportunity to help create innovative and cost-effective solutions to address barriers to universal vaccination,” explains Sarah Pasternak, Director, Marketing Access Programmes in GSK’s Africa and Developing Countries Unit.

“Countries within Africa often suffer from supply chain issues which can have a significant impact on availability of vital vaccines and medicines” Sarah adds. “In addition, as tracking vaccine use in local communities is limited, it is difficult for healthcare organisations to effectively target immunisation services to those most in need.”

All of this means that as many as one in five children worldwide remain unimmunised with even the most basic childhood vaccines, and one million of them die every year from vaccine-preventable diseases.

“Innovative programmes such as mVacciNation, which harnesses new technologies and the power of public-private partnership to increase childhood immunisation coverage rates, can help transform global health and save lives,” Sarah says.

“One of the benefits in using mobile technology is that we don’t lose track of the children,” says Monica Silvero, Preventative Medicine Technician at Namicopo Health Facility. Inacio Mbalate, from the Expanded Programme of Immunisation Provincial Health Department in Nampula, adds: “Every week mVacciNation helps staff register vaccine stock levels, and this information is very important to monitor the availability of vaccines in our facilities.”

With funding from USAID and GAVI (the Global Alliance for Vaccines and Immunization), the programme is being independently evaluated as a randomised control trial led by the Abdul Latif Jameel Poverty Action Lab (J-PAL) Africa research unit, based at the University of Cape Town (UCT), and the National Institute of Health in Mozambique. The UCT team includes researchers from Yale University and Harvard School of Public Health.

As well as rigorously measuring the impact of the mVacciNation app on vaccine coverage rates and stock levels, the evaluation will also assess the app's cost effectiveness and qualitatively investigate its impact on health system processes.

If successful, the model could be replicated throughout Mozambique and then across Sub-Saharan Africa, where two-thirds of the population live in rural areas, as well as other middle and lower income countries.

“The ideal outcome for us is that we were able to take the lessons learned from a national programme such as this one in Mozambique and share that with all the other countries in Sub-Saharan Africa so that they can do the same thing,” says Davies Gichuhi, General Manager, GSK Southern Africa.

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