mTika

In rural Bangladesh, vaccination services are provided by Government and NGO Community Health Workers (CHWs). However, some key challenges exist in the current system and process. About 80% of new-born children are not immunized on time, thus getting exposed to many childhood ailments and even death, according to a Johns Hopkins University study. Two of the key reasons identified are lack of awareness about the importance of timely vaccination and simple forgetfulness on the part of household members. Presently, the Government of Bangladesh runs Expanded Programme on Immunization (EPI) camps to provide vaccination, and announces camp schedules via public loudspeaker announcements in neighbourhoods around the camp. As these announcements aren’t targeted and cannot practically reach everyone, people visit the EPI camps randomly. As a result, scheduled babies and infants miss their vaccination due to a lack of information and unscheduled babies get overdosed at times due to large crowds at the camps. Moreover, the vaccination service delivery record-keeping of the Bangladesh government is paper-based, whereby the vaccination workers maintain records in manual register books, and they aggregate information at the end of each month. This mechanism makes it very difficult to track vaccination compliance and subsequently to take targeted, individual-based measures to ensure compliance.

mTika automates the vaccination workflow for CHWs. It allows for digitization of log-books for record keeping of vaccinations and reduces multiple entries and logistical hassles of transferring data between paper registers. Automated vaccination schedules are generated through our app for vaccination workers. Additionally, our system automatically generates reminder SMS in both Bengali and English languages for mothers to take their children to immunization camps on the day of vaccination. SMS can also be sent out in mass announcements to all eligible households in a locality in advance of an EPI camp at the press of a button. Furthermore, mPower has developed dashboards for health worker supervisors on which they can track the performance of CHWs in real-time.
When a mother or child visits a vaccination camp, they are registered via the app. mTika app also has provisions for pregnant mothers to send “Birth SMS” which will register the new born child in the Child Register. Through the “Vaccination schedules”, an automated report gets generated for any missed appointments, on the basis of which health workers can take targeted interventions. The app also allows front-line health workers to send messages to beneficiaries on camp day for vaccination. Health workers can view which beneficiaries have vaccines due through color coded flags and this results in proactive engagement and increased timely vaccination rate in rural Bangladesh.

Because of the smartphone-based registration and Unique ID of each household/child, the CHWs and supervisors can easily search and identify those who have missed their vaccination and make targeted interventions for high-risk cases. All these allow for a holistic and closely monitored vaccination service delivery ecosystem.

Since the OpenSRP-based mTika system was developed using Bangladesh government health workers, and with formal buy-in by the Ministry of Health serving as the steward of the project, there is possibility for further scale-up and adoption of the mTika platform within Bangladesh. Furthermore, the system is aligned with the priorities and goals of the Vision 2020 strategic goals of the Directorate General of Health Services (DGHS) SDG Plan. Thus far, the mTika platform has been deployed among frontline health workers in Bangladesh and with the national push for digitization, its coverage could be raised potentially to all the 27,000 Government CHWs in the country.

Since 2013, mPower has piloted the vaccination solution under “mTIKA” branding in two different pilots in collaboration with UNICEF, Johns Hopkins University Global mHealth Initiative and ICDDR Bangladesh close partnership with the Bangladesh Ministry of Health and Family Welfare. Upon completion, the pilots demonstrated positive change in immunization coverage due to the introduction of mTIKA system.