A recent multicountry mixed-methods analysis conducted across Guinea, Honduras, Rwanda, and Tanzania quantifies the financial costs associated with rolling out electronic immunization registries (eIRs) and electronic logistics management information systems (eLMIS). The authors reveal total implementation expenses of $ 2.2 million in Guinea, $ 6.4 million in Honduras, $ 6.8 million in Rwanda, and $ 44.3 million in Tanzania—costs variably influenced by customization needs, hardware procurement, and training investments. While per-facility costs rose in Honduras ($ 626; 95% CI: 516–821) and Rwanda ($ 399; 95% CI: 108–691), Tanzania experienced per-facility savings of $ 2,539 (95% CI: –4,290 to –789), and Guinea saw no significant cost change, underscoring a highly context-dependent economic impact.
Electronic systems accounted for a variable share of national immunization budgets—ranging from 0.7% in Guinea to 7.7% in Honduras, 3.3% in Rwanda, and 4.8% in Tanzania. The study highlights that potential cost savings and efficiency gains fundamentally rely on replacing redundant paper-based processes and, crucially, embedding electronic data systems into routine decision-making, particularly at the facility level. The authors advocate for forward-looking planning, emphasizing sustained investment in training, infrastructure, and governance to fully unlock the value of eIRs and eLMIS in resource-constrained settings. The findings may be useful to national health authorities in low-resource settings, as well as to multinational organizations that are committed to investing in and sustaining eIR and eLMIS to improve immunization outcomes.
Thumbnail image credit: WHO
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