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The Gambia
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Children registered


Children fully vaccinated


Follow-up SMS sent

Stronger together: Partners in The Gambia

Scaling SPT to all regions

In 2016, Ministry of Health and Social Welfare in The Gambia signed a Memorandum of Understanding together with ActionAid International The Gambia and Shifo Foundation to establish a new form of Health Management Information System (HMIS) in The Gambia.

The intervention is implementing a novel hybrid paper-digital solution that collects, shares, stores and distributes data for the Expanded Programme for Immunisation (EPI) using Smart Paper Technology. The data is digitised and stored in an electronic register from which HMIS reports are generated and shared at health facility, regional and national level. The key stakeholders in the implementation project are Ministry of Health and Social Welfare The Gambia (MoHSW), ActionAid International The Gambia (AAITG), The Vaccine Alliance (GAVI), IKARE, Swedish Postcode Foundation (PKS), af Jochnick Foundation (af Jochnick) and Shifo Foundation (Shifo).

An external evaluation of data quality and operating costs of Smart Paper Technology (SPT) in The Gambia was conducted in 2018 when the solution was being used in 4 fixed and 14 outreach health service delivery points in Western Region 1 and Western Region 2. Based on the findings, the external evaluators recommended the scale-up of the solution in the two regions, which was subsequently agreed on by MoHSW, AAITG and Shifo. In July 2018, the scale-up of SPT was commenced in Western Regions 1 and 2 and the solution was scaled up in all health service delivery points.A further independent evaluation on the scale-up of the solution took place in 2019, and focussed on the themes of: Data quality; Data use; Administrative time efficiency; Total cost of ownership and transition of work processes; Perceptions and experiences.

After successful evaluation results, MOHSW decided to scale-up SPT to other remaining regions, starting from Central River Region. The Smart Paper Technology (SPT) Solution has been successfully integrated with DHIS2. By 2022, all 91 health service delivery points, which include public, private and not-for-profit clinics shifted to using SPT solution.

The Gambia has become the first country in Africa that have adopted SPT Solution for EPI at a national level and completely replaced the old and inefficient paper-based system.

What we have done

At the community level, families with children and women of childbearing age receive SMS messages one day before their visit reminding them about their due date to visit the facility.

Health workers receive their key performance indicators and develop strategies to improve coverage, equity and quality of immunisation services in the underperforming areas.

Automatically generated request forms are used by provincial medical stores to deliver vaccines and other supplies to each health facility.

Decision-makers and planners at regional and national levels review the performance of each health facility/area using the integrated dashboard and reports. The insights help decision-makers identify and close the gaps in health service delivery points

External Evaluation Results

The data quality assessment, based on WHO's data quality review toolkit, indicated that the data completeness, timeliness, internal and external consistency is 100%; the incidence of recording errors were 2%, and the data accuracy was 98%.

With Smart Paper Technology, the time spent on data administration per child fully vaccinated and receiving the required vitamin A and de-worming services were decreased by 59%.

The cost analysis indicated that Smart Paper Technology Solution cost only USD 364.51 more compared with printing the existing HMIS tools; USD 3,227.42 and USD2,862.91 respectively.

Three themes emerged from caregiver interviews: the usefulness of SMS reminders, the practical benefits of MyChild Solution for caregivers, and caregivers’ wishes related to immunisation activities overall. Themes emerging from stakeholder interviews included the easing of work by MyChild Solution for health workers and their supervisors, the suitability of MyChild Solution for the local context, the desire to scale-up the solution and include more service areas, the improved data quality the solution provides and additional issues for consideration moving forward. Based on the results of external evaluations, we are working with our partners to scale up the Smart Paper Technology solution.

Assessment of MyChild Solution in The Gambia
Quality of  data produced through SPT in The Gambia
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2019 Evaluation of the MyChilds Solution in The Gambia
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