Children fully vaccinated
Health service delivery points
Stronger together: Partners in Uganda
A bold and long-lasting partnership
Uganda has always been a special place for Shifo, as this was where the idea of SPT was birthed and first piloted. In 2013, Shifo began a collaboration with the Ministry of Health of Uganda (MoH) to implement and evaluate point-of-care electronic immunisation registry system in Mukono and Wakiso Districts. Assessments showed that point-of-care eHealth solutions are not timely in Uganda and cannot replace existing systems based on paper forms, because of lack of infrastructure in most health service delivery points (HSDP), lack of technical support structures at a district and facility levels, and high operating costs which are not sustainable for MoH.
Based on an external evaluation in Mukono District in 2018, we discovered that a Smart Paper Technology alternative offered a more sustainable and scalable solution. MoH decided to shift/retire existing system and use exclusively Smart Paper Technology in all the health facilities in Uganda, for immunisation and child growth monitoring programs. This was an important decision for bringing systems change and institutionalising Smart Paper Technology Solution in Uganda. And in 2019, MoH proposed to extend the capabilities of SPT to support entire RMNCH services, which consists of Family Planning, Antenatal, Delivery, Postnatal, Immunisation and Nutrition services.
We had always set our sights on having SPT utilised nationally, and in 2021 we took another step towards this goal. Going into the largest scale up work we have undertaken so far, we had earlier on realised that we could not copy and paste the how we develop the solution or how we implement as it was done in other countries like The Gambia because the magnitude of the scale is different. We had to change ourselves starting from the development to even how we finance and administrate this project.
Later on in the year, in November 2021 we also partnered long term with CordAid to build a solution with RBF and build on data use. An MoU was signed between Shifo and CordAid to enable that our partnership and work continues for the long term in Uganda.
What we have done
The following data use interventions are integrated across the health care chain.
At the community level, families with children 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 to help them know their performance and improve.
Decision-makers and planners at municipality levels review the performance of each health facility using the integrated dashboard.
In order to strengthen the Data use at central level we partnered with Karolinska University and we have enrolled and created a PHD plan for the first PhD student expected to be.
External Evaluation results
Data quality assessment based on WHO's data quality review toolkit indicated that data completeness, timeliness, and internal consistency was 100% and that data recording error was between 0.9-3.8%.
With Smart Paper Technology Solution, health workers spend less time on all stages of data management tasks with the biggest reduction in post-session data administration - 96%, and 49% and 85% during the service delivery.
Cost analysis showed that, when considering the monetary value of administration time reduction for frontline health workers over the course of five years, the Smart Paper Technology Solution would save around 2,072,752 USD compared to printing the existing HMIS forms. When the administration time was excluded from the analysis, the HMIS forms cost less (349,247 USD) compared with the Smart Paper Technology Solution (383,111 USD).
84% of processes essential to managing the intervention have been transferred to the existing health system structure. In most cases where these processes have been transferred, they have been performed in a way that is both accurate and sustainable. Remaining processes are planned to be fully transferred when the solution is scaled up at the national level.
Voices from Uganda
What health workers, governments and partners say about us.
MyChild External Evaluation Uganda
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