The COVID-19 pandemic brought unprecedented challenges to healthcare systems worldwide, particularly in low and middle-income countries (LMICs). The urgent need to track infections, treatments, and immunisations spurred the rapid development and adoption of information technology (IT) systems that were previously not widely used in these settings. These systems played a crucial role in managing the pandemic and have left a lasting legacy on healthcare delivery in LMICs. This article explores the continued use of these technologies, examines successful implementations, and assesses their impact on saving lives, saving money, and saving time.
The Rise of IT Systems in Pandemic Response
Before the pandemic, many LMICs relied on paper-based systems for tracking health data, which were often inefficient, prone to errors, and lacked real-time accessibility. The pandemic exposed the limitations of these traditional methods and highlighted the need for robust IT systems to manage the crisis effectively. In addition to the need to track vaccinations, there was a need to track patient data, allocate resources effectively, and monitor treatment outcomes. Electronic health records (EHRs) have proven helpful in this regard, as they provide a digital platform for storing and managing patient records, which can be used to track vaccination history, identify people due for immunisation, and monitor treatment progress.
The implementation of IT systems during the pandemic enabled LMICs to:
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Track infections: Monitor the spread of the virus, identify hotspots, and implement targeted interventions. For example, Bangladesh developed a public COVID-19 dashboard to monitor cases’ spatial and temporal distribution in real-time. This dashboard helped raise awareness and inform public health interventions.
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Manage treatment: Track patient data, allocate resources effectively, and monitor treatment outcomes.
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Scale up immunisation: Register individuals, schedule appointments, track vaccine distribution, and monitor adverse events.
These systems provided real-time data for informed decision-making and effective public health responses.
Continued Use and Adaptation of IT Systems
While initially implemented for pandemic response, many IT systems have proven valuable beyond the immediate crisis. LMICs increasingly recognise these technologies’ potential to strengthen their healthcare systems and improve overall health outcomes. Gavi, the Vaccine Alliance, has played a crucial role in supporting the development and implementation of these IT systems in LMICs. Gavi’s mission is to save lives, reduce poverty, and protect the world against the threat of epidemics and pandemics. Since its establishment in 2000, Gavi has helped vaccinate more than 1.1 billion children in 78 countries, averting more than 18.8 million future deaths.
Vaccination Information Systems (VIS), for example, have transitioned from primarily tracking COVID-19 vaccinations to managing routine immunisation programs. These systems offer several benefits, including
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Systematic recording and collection of immunisation data: This leads to more accurate and complete records, essential for monitoring vaccination coverage and identifying gaps
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Easy access and retrieval of vaccination data: Healthcare providers can quickly access patient vaccination history, facilitating informed decision-making and personalised care
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Analysis, reporting, and facilitation of the use of vaccination data for public health decision-making: VIS can generate reports on vaccination coverage, identify high-risk populations, and support data-driven interventions
The transition from paper-based to electronic records through VIS can improve vaccination uptake rates and reduce morbidity and mortality associated with vaccine-preventable diseases. However, it’s important to acknowledge that the effectiveness of VIS in achieving these outcomes depends on various factors, including access to technology, healthcare worker training, and community engagement.
Examples of Successful Implementations
Several LMICs have successfully implemented IT systems to track infections, treatments, and immunisations, demonstrating their potential to save lives, money, and time. These successful implementations highlight the significant potential of IT systems to improve health outcomes and optimise healthcare delivery in LMICs. The following list summarises some notable examples
Bangladesh
Monitors cases’ spatial and temporal distribution in real-time, helping raise awareness and inform public health interventions.
India
Facilitates registration, appointment scheduling, vaccine distribution tracking, and the issuance of digital vaccine certificates.
Argentina
Supports vaccine registration, appointment scheduling, and the generation of digital vaccination certificates.
South Africa
Electronic Vaccination Data System (EVDS)
Enables registration, appointment scheduling, and vaccine distribution tracking, focusing on increasing vaccination rates among mothers and children.
Challenges and Limitations
While IT systems offer significant potential for improving healthcare in LMICs, their implementation is challenging. Some key limitations include
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Limited infrastructure: Many LMICs lack the necessary infrastructure, such as reliable internet connectivity and electricity supply, to support the widespread use of IT systems
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Data quality and interoperability: Ensuring data quality and interoperability between different systems can be challenging, particularly in settings with limited resources and technical expertise
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Privacy and security concerns: Protecting patient data and ensuring the security of IT systems are crucial considerations, especially in resource-constrained environments
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Digital literacy and training: Adequate training for healthcare workers and promoting digital literacy among the population are essential for the successful adoption and use of IT systems
Summary
The COVID-19 pandemic accelerated the adoption of IT systems in LMICs, and these technologies have proven their value in tracking infections, managing treatments, and scaling up immunisation efforts. While challenges remain, these systems’ continued use and adaptation hold significant promise for strengthening healthcare systems and improving health outcomes in LMICs. By addressing the limitations and investing in capacity building, LMICs can leverage the power of IT to save lives, money, and time, ultimately contributing to a healthier and more equitable future for all.
