Since the introduction of the National Community Health Assistant Program in Liberia’s Rivercess County in 2016, coverage of the pentavalent vaccine has increased from 25% to 60% in 2020—protecting children against five major diseases: diphtheria, tetanus, pertussis, hepatitis B, and Haemophilus influenzae type b. Additionally, Rivercess County has seen a five-fold increase in children vaccinated via community outreach since 2017. Community health workers are crucial to this outreach, providing their neighbors with immunization education during routine household visits. These efforts are complimented by clinical nurse supervisors who administer childhood vaccines directly in rural and remote communities. After pausing community outreach for nearly six months due to COVID-19, the Rivercess County Health Team leveraged clinical nurse supervisors to deliver nearly 40,000 vaccine doses by October 2020—approximately the number of doses delivered in the same period in 2019. This suggests the County Health Team, with support from community health workers, has maintained similar levels of vaccine provision despite the pandemic.
Building on the success of immunization programs in Rivercess County, we are piloting two new digital health efforts to improve vaccine delivery and coverage:
Digital Tracking Tool Aims to Increase Vaccine Coverage
With support from Gavi, the Vaccine Alliance, we are partnering with the Ministry of Health and Ona to develop a smartphone-based tracking tool to increase vaccine coverage. The application, built with OpenSRP technology, allows community health workers and their supervisors to create and update individual childhood vaccine records. This information not only allows the Rivercess County Health Team to estimate vaccine coverage, but also aids community health workers in identifying and referring children who have defaulted on their vaccine schedule.
Equipped with smartphones, 271 community health workers in Rivercess County are now entering immunization information from child health cards into the vaccine tracking tool during home visits, creating a detailed digital record of vaccination history for all children in their community from birth to 24 months of age. This information is then transferred to clinical nurse supervisors, who can actively identify children due for vaccines and better plan vaccine outreach activities within the community. Digitization of vaccine records through the tracking tool improves access to data that better informs decision-making on vaccine outreach to improve vaccine delivery and access. Results from the pilot in Rivercess County will inform the rollout of this tool nationwide, bolstering Liberia’s efforts to reach targets of 90% childhood vaccination and ensuring more children live happy, healthy lives.
Digital Vaccine Education Deployed to Health Workers
Partnering with Liberia’s Ministry of Health we are supporting the development of digital education curriculum on community-level immunization delivery for vaccinators, clinical nurse supervisors, and community health workers. Available offline through the Community Health Academy’s smartphone-based learning application, around-the-clock access to engaging multimedia clinical content allows health workers to strengthen their diagnostic and treatment skills directly in their communities. To date, over 50 instructional videos have been produced for use on the Academy app. For community health workers, these materials include digitized job aids to promote vaccines in the community. For vaccinators and clinical nurse supervisors, the curriculum focuses on the clinical skills required for delivering vaccines effectively at the community-level. In late 2020, we supported the deployment of this digital educational material to all 280 community health workers and 94 vaccinators and clinical nurse supervisors in Rivercess County, who were able to supplement and refresh their knowledge and skills on immunizations during vaccine outreach activities. Learnings from the deployment of this content in Rivercess County will inform a wider national rollout and further digitization of health worker curriculum in Liberia.