Digital tools improve immunization efficiency in low- and middle-income countries

A multi-country evaluation covering Guinea, Honduras, Rwanda, and Tanzania—drawing on data collected between October 2021 and September 2022—has found that the introduction of electronic immunization registries (eIR) and electronic logistics management information systems (eLMIS) significantly improved National Immunization Programme (NIP) processes and outcomes. Health workers expressed high levels of satisfaction with the new tools: 87 % reported improved workflow experiences, while 95 % in African countries appreciated better access to information, and 91 % confirmed it was accurate and complete. Notably, eIR users reported enhanced service delivery and efficiencies (81 % and 89 %, respectively), and eLMIS implementation led to better stock data quality and fewer vaccine stock-outs—particularly in Tanzania, where facilities using fully electronic systems encountered fewer shortages compared to dual or paper-only systems. However, hybrid systems using both paper and digital records exhibited lower data accuracy (45 %) than those using fully digital or fully paper-based systems (60 %).

Despite the encouraging outcomes, the evaluation revealed persistent challenges that limit broader impact. Inadequate digital infrastructure—namely unreliable electricity, internet, and limited hardware access—continues to hamper real-time use of eIR and eLMIS in many facilities. Moreover, poor integration with Civil Registration and Vital Statistics systems (CRVS) severely restricts the ability to track unvaccinated or zero-dose children. In light of these findings, the researchers emphasize the need for comprehensive strategies that deepen governmental ownership, invest in infrastructure and local technical capacity, fully migrate away from parallel paper systems, and integrate eIRs with CRVS systems for improved tracking and program effectiveness.

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