JMIR Publications

ABSTRACT

Background:

Electronic immunisation registers (EIRs) have been promoted as health system strengthening tools that, if used effectively, can lead to greater efficiency and improvements in vaccination coverage. Several low-and-middle-income countries (LMICs) introduced EIRs for COVID-19 vaccination and are now integrating them for routine immunisation.

Objective:

This paper describes the protocol used to evaluate the implementation of an EIR in Lao PDR, that started in 2022, to identify opportunities to improve implementation, scale-up and sustainability in the country.

Methods:

To evaluate the implementation of the EIR in Lao PDR, we will 1) map the EIR workflow process; 2) examine EIR user and stakeholder perspectives; and 3) assess the EIR data quality. Data will be collected and analysed through a mixed methods approach. This will involve a document review, observation of workflows in health facilities, health facility user surveys, key informant interviews with decision-makers, and an assessment of immunisation data quality. This protocol paper details the methods for each of these. The evidence generated will be triangulated to identify the strengths and weaknesses of the early implementation phase of the EIR, facilitators and barriers to implementation, and whether the introduction of the EIR has improved immunisation data processes and quality compared with paper-based processes.

Results:

Data collection occurred between April and August 2024. Data analysis is ongoing, with results expected to be shared with study stakeholders in late-2024.

Conclusions:

This early evaluation will contribute to developing a roadmap for the nationwide strengthening and sustainability of the EIR, based on challenges and lessons learned, potentially streamlining further implementation efforts and enabling more effective use of the EIR. This paper presents a methodology for evaluating EIR implementation, which can be replicated in other LMICs implementing EIRs.