Globally, every year 40% of children’s births are unregistered. Because of this they have no legal recognition, are in danger of underage labor, trafficking, prostitution. Most important, they do not exist for purposes of immunization—especially in under-served populations and emergency situation. Follow-up immunizations are a challenge as many are born outside hospitals and rarely seek medical attention, leading to systemic risk to infections. Several barriers to birth registration exist.
The objective is to create and implement an electronic system that simultaneously registers births in 72 hours and vaccination records for all children less than 5 years of age using a smartphone, through a community healthcare worker (CHW).
We will digitize birth and vaccination records that is currently paper-based and by overcoming the hurdle that had previously rendered similar initiatives unsuccessful, because of lack of means, access or initiative of parents to give birth in hospitals and/or visit county civil registration office (CCRO) for birth registration of their children. Instead, we bring registration from centralized location directly to the door of the parents, while also working with government officers to verify eligibility of children by taking digital copies of parents’ identity cards, document and issue birth notification electronically directly to the government in real time. We propose to integrate birth registration and vaccination records, through the use of Nokia Data Gathering (NDG) system, a free, open source software platform on a mobile phone prototype we recently pilot tested in Kwale County Kenya. Through use of trained village CHWs, with enhanced mobility using motorcycle “bodaboda” we will digitize BR and vaccination records (VR) of ~ 5, 000 children, creating a first basis of electronic vaccination records.
The project builds on a number of existing foundations. First mobile phones are ubiquitous in Kenya1. Over 85% of Kenyan adults have mobile phones. Also, the use of mobile phones as a platform technology in other sectors is accepted3. We have recently conducted a survey on BR process, identified factors limiting registration and identified ~60,000 children in 5 sites (Lukore, Mangawani, Kinango, Dzombo, and Kikoneni) from ~15,780 households are in need of BR. Together with Nokia Corporation and the Kenyan government we created a prototype electronic system for BR, based on NDG software, which duplicates the official form used by the District Civil Registration Office (DCRO) and automatically upload data to a server. Based on our previous survey, we identified CHWs in each site who helps mothers to deliver babies both at home and hospital. Upon delivery of the newborn the CHW issue birth notification to the government (paper based). To increase BR and institute electronic medical vaccination record, a sample of households from one pilot location (Mwangani with 8,886 population in 1,206 households) will be defined at the start of Phase 1: Birth and vaccination pilot registration of 0-5 years old children (~ 5000 children) will be conducted. A rapid assessment of the intervention will be carried out for 12 months and data analyzed. Benchmark: 1) Training of CHWs in the use of mobile phone to data, and 2) Sensitization of the community on the benefits of BR and VR. A successful BR and VR intervention in Mwangani location can be scaled up in the whole Kwale County in the subsequent phase of the project. If successful the project can be scaled up across the country. The electronic system will enable issuance of birth notification in real time to government and create reliable VR. Who is involved: Nokia Corporation will provide in-kind support of phones and NDG platform. Kenyatta University, a collaborating institution will provide expertise on rapid assessment of project performance. Experts from Nagoya University, Suffolk University and university of Massachusetts Medical School will serve as collaborators in software design, trials and data management.