VaxTrac is pleased to announce a recent investment of $695,431 from the Bill & Melinda Gates Foundation which will provide new technology and ongoing support for the expansion—both geographic and functional—of mobile vaccine registry systems in health facilities in Benin, West Africa. This investment will enable new health centers to receive the resources and training necessary to effectively integrate the VaxTrac system into their vaccination program with the goal of improving record keeping practices, reducing vaccine waste, and improving schedule adherence, especially for children under the age of five.
The VaxTrac system is a suite of data collection and analysis tools tailored specifically for immunization programs in developing countries. It uses a technology portfolio comprised of laptops, tablets and mobile phones to collect data and fingerprint scanners to accurately identify patients. This serves to overcome the primary driver of the current inefficiency in the vaccine delivery system: a lack of information.
In addition to the geographic expansion, VaxTrac will also lead an effort in Benin to re-evaluate the vaccine information management system from a more holistic perspective, integrating the previously segregated functions of health records, population statistics, stock management, and cold chain performance monitoring. This activity will also identify the broad array of stakeholders throughout the vaccination process and how they interact with system data. Underlying all of these activities is the motivation that technology can—when thoughtfully applied in combination with a thorough understanding of the unique user requirements of community health workers—greatly facilitate efficiency and effectiveness improvements in the vaccine delivery system.
This award is the result of continued collaboration among VaxTrac, the Benin Ministry of Health, UNICEF, and the World Health Organization since early 2012 to implement and support clinic-level vaccine data collection technology in 30 health facilities throughout several districts across the coastal region of Benin. With this new phase of the project, VaxTrac will roll out the latest version of its system to approximately 120 health facilities, fully saturating an administrative division roughly equivalent to that of a US state.
By Jessi Hanson, Monitoring and Evaluation Manager
“Jessi, see here,” Fidel caught my attention. I watched as the young mother sat down and let the nurse position her so she could more easily get the child’s fingerprint. The Vaxtrac biometrics tool was a simple laptop connected to a fingerprint scanner through a USB cable. The computer screen showed a simple, user-friendly system especially developed for health workers with limited literacy. As a reading specialist, a person whose main profession is to work with people who cannot read or write, I found this aspect of the tool the most interesting. Looking at it, I thought, “Well, heck, I could figure that out easy enough, I think.” The scanner took the child’s index print and stored it as an image converted into a special key that would store the patient records to this individualized key. And yes, for any of you who are scratching your heads reading this, I was, too, at this point. But seeing the tool in action, I was seeing it was going to be much simpler than I first thought to measure our indicators, or our ‘how many’. No more Excel spreadsheets, no more counting files. It was all in the computer and uploaded to a central hub for larger tracking numbers.
The boy baby was good to let the nurse fool with his fingers to get the right scan. He didn’t cry once but wanted to play with the scanner as if a toy. The mother looked interestedly at the computer scan of her son’s finger and grinned. It was maybe one of her first times so close to a computer at all. The nurse explained it to the mother and us, showing us slowly with Fidel how it worked and what buttons she selected. Then the nurse pointed to a few molded boxes behind us, with stacks of patient records mushed together in alphabetical order. They were dusty and decaying like the boxes that held them.
“This is the normal way records are kept,” Fidel explained. My eyes were huge at the realization of what we were really doing. Throughout the country, and many countries like Benin, medical records were kept in this fashion, just like the files that Ministry of Education kept in Liberia. Systems were antiquated, cumbersome, and left large holes for beneficiaries to fall through. How did any nation achieve knowing how many of its people were getting access to the services they truly needed with systems built out of rotting files in boxes? How could it possible ensure all its mothers and babies had access to quality medical care? How did a nurse know she was vaccinating a child for the first time, or that the vaccine she was administering was stored properly before it arrived to her clinic? So many questions so quickly eliminated with this little biometric tool…
I looked again to the young mother who had shared her boy with me for a spell. She was fixing him with African fabric to her back to prepare to travel home. She adjusted his little form into the nook of her lower back comfortably. She waved goodbye to us all and made her way out. I watched as the little boy yawned and sank back into sleep before his mother even walked out the door.
My team would not only be measuring in the how many. The true impact of our new work would lay in the qualitative- the efficiencies and effectiveness of treating infants and working alongside their mothers, health workers and governments to track the invaluable.
By Jessi Hanson, Monitoring and Evaluation Manager
The road to one of our program clinic sites was smoother than I had expected. I had recently left Liberia, after working two years in the education sector. Monrovia, the capital city, was still recovering from the echo of its civil wars which left most government agencies, services and general infrastructure ravaged, including most roads that were little more than small sections of old pavement filled with holes and mud. Now I was in Benin, meeting for the first time some of my new team members including our new Program Manager and Executive Director, to visit the program, hold key meetings, and orient with our new Benin staff just hired. I had only just recently met everyone mostly through emails in preparing for this orientation trip. My first impressions were proving true- this was an enthusiastic and dedicated group, a patchwork quilt of experiences, professional development, and backgrounds.
As we drove along the smooth road, Fidel Marc, the head of our Benin operations, pointed out to his international visiting team members the Benin landscape. He talked about his boyhood, explaining that his tribe shared ties with Togo. He also discussed with everyone how the meeting went early with the Ministry of Health and our close partners. Fidel jumped in and out of speaking Africanized French and English. I barely spoke French, let alone a dialect version, so I didn’t add much to the conversations except for pieces. Things to add to my list: learn French immediately. It was just another bullet point to the quickly growing list of things I would need to achieve to feel like a contribution to this dynamic team. My job would be to work with our international and national teams to measure the impact of our work. In international development, programs are often measured by the indicators that they achieve- how many children saved, how many vaccines given, how many students attending school, what percentage of mothers aware of lifesaving information for their health and that of their families….We would define our indicators based on the goals of our program. These were the quantifiable how many.
Vaxtrac’s mission stated: to provide developing countries with the technologies and services they need to maximize the effectiveness of their vaccination programs. VaxTrac envisions a world where every child, regardless of background, has equal access to life-saving vaccines. Someday we hoped to explore new missions to better children’s lives through health, maybe even education and child protection. But first, we would focus our efforts on immunizations, and moreover, measuring the impact our work made. In order to prepare for the trip, I read through several documents sent to me by our director. It stated that a 2005 Benin government assessment based on the percentage of children who had been vaccinated properly determined an estimated 93 points. That meant out of nearly every ten children, nine received the required three doses mentioned in this study. Yet the World Health Organization (WHO) vaccination coverage survey of the same population demonstrated only a 67 percent coverage rate, which was a questionable disparity to the government’s findings. There were many factors for this, but the main problems lay with: 1) how vaccinations were tracked, and 2) tracking proper use of vaccinations. Too many children often went unvaccinated, received expired injections, or the same vaccine multiple times unnecessarily. All of these issues led to unnecessary infant and child mortality. Vaxtrac worked with health partners and government agencies to keep better tracking at national and local level of vaccinations, through a biometric tool. I had no idea yet how it worked, but I would see for the first time in the clinic.
We pulled up in the late afternoon and climbed down. Local female health workers dressed in nursing scrubs and simple gold jewelry greeted us gingerly. Fidel seemed to know each of them well from his frequent support visits. He introduced us and pleasantries were exchanged. I managed to respond repeatedly enchanté with a broken tongue. They smiled, realizing it would be better to speak to the other blonde, our program manager Meredith who by now was whizzing through fluent French about the program. I followed along in the shadows quietly observing. I stood further back to let the others talk, knowing they would translate for me when it was important.
After a moment, I realized the other women in the room, sitting patiently on the wooden benches, bouncing or cradling small babies in their long arms. I went and shook their hands. I couldn’t help being draw to the small little faces with their brilliant eyes staring back at me, and in no time, I was being offered a small baby boy just awake after a long nap. He looked up at me then his mother who next to me laughing, and he registered, this girl doesn’t look right. The moment I spoke English to him in baby talk, he burst out crying and I rescued him back to his mother’s tender hold.
It’s been almost three weeks since I started as the new Project Manager at VaxTrac and I’ve already been halfway around the world. As we stepped off the plane in Cotonou, Benin into that warm, muggy, mango-scented air, it felt a lot like coming home.
No stranger to West Africa, I recently completed two stints in the Peace Corps, first in Mali as a health volunteer (unfortunately we were evacuated following the coup d’etat there last year in 2012), then followed with a nine month Peace Corps Response position in Burkina Faso working as a Country Coordinator for the Stomp Out Malaria Initiative. So I guess you could say I’m pretty familiar by now with Ministry Meetings that have at least 3 coffee breaks and trainings that must include official certificates for each and every participant and reimbursements for gas for motos. Nonetheless, each new project is always a new and exciting experience and my time with VaxTrac has been no exception.
I am coming to VaxTrac with several years of public health and project management experience, as well as a passion for innovative and sustainable solutions to international development, but also a high level of enthusiasm for new adventures, meeting new people, drinking great coffee, eating good food, and helping to make the world a little bit closer. This is basically what happened during my first trip to Benin (minus the great coffee, but nescafe has a special place in my heart too).
We arrived late Thursday evening, exhausted but excited and after checking in at our hotel (running water AND electricity! A big step up from my Peace Corps accommodations), we hit the town with our Beninese coordinator Fidele Marc for a meet and greet dinner. We struggled out of our cozy beds bright and early the next morning to present our project expansion plan to the Ministry of Health and receive their feedback. The meeting was mostly productive, everyone was very supportive, and good comments were made all around. After the meeting, we headed to Porto-Novo for lunch and a visit to two of our clinic sites so we could see VaxTrac in action. We were warmly welcomed by the clinic staffs and mothers who had brought their infants to be vaccinated and everyone was pretty excited to show us the finger print scanner. We spent some time talking with the staff about issues they were experiencing with the software and any improvements they thought we could make. It was great to hear their experiences and it was so cool to see how excited they were about making the shift from paper records to something more efficient.
Saturday, we headed to our VaxTrac office, where Fidele is based, to meet with our technicians. We had a great meeting, did some problem solving, and when we wrapped things up there was a palpable sense of excitement about the future of VaxTrac in Benin and I couldn’t wait to get back to DC and start working on our plans. BUT, our short trip wasn’t over quite yet. We headed to the scenic town of Ouidah for a working lunch on the beach, definitely one of Benin’s major selling points. Ouidah was once one of the biggest slave ports in West Africa and while it has some major touristic appeal, it is also home to some more sobering attractions like the Door of No Return and the Slave History Museum.
Back in Cotonou, we participated in the local Happy Hour culture at an American bar, where of course, we ran into some Peace Corps Benin Volunteers enjoying a brief respite from village-life. It seemed so strange to be heading to the airport to fly back home when I felt like I should be staying with these volunteers, maybe going to an ex-pat grocery store to stock up on staples like nutella and lentils to take back to site. But then I thought about all the amazing work that we’re doing at VaxTrac and the opportunities we’ve been given to scale up our project and I realized that for now at least, my place is on the other side of the world at a desk in DC, making sure that our trips to Benin are time well spent so that we’re maximizing our capacity to have a lasting impact on the people and places with whom we work. Plus, I know that we’ll be back.
So as we say in Mali, kan ben sooni (see you soon)!
We’ve added a new major release of our immunization tracking software.
Here are some screenshots from our newest version: