Timor-Leste's health workers use digital tools to assess immunization coverage

The Ministry of Health has deployed 64 health workers who are conducting interviews with people using digital questionnaires, and the mobile application directly feeds the data into the Timor-Leste Health Information System (TLHIS), which is the national health management information system.

Real-time monitoring with the use of digital technologies can lead to more efficient data collection and analysis, and Timor-Leste's initiative to digitize the immunization coverage survey is a positive step forward. "Digital tools have the potential to fast-track processes," said Dr. Arvind Mathur, WHO Representative to Timor-Leste. "There will definitely be some challenges in the beginning, but these technologies will go a long way in strengthening the health systems," he added.

The survey in Timor-Leste has a two-pronged objective: to assess the coverage of the national integrated immunization campaign that took place from 12 January to 3 March 2023 and to assess the coverage of routine immunization during the years 2021 and 2022 when COVID-19 disrupted services. The TLHIS has ensured that all data from the Expanded Programme on Immunization (EPI), integrated campaign and the survey, is available on the same platform for analysis and decision making along with the other health information

The integrated campaign was a catch-up drive targeting children from 0 to 5 years with the Measles Rubella vaccine (MR), Oral Polio Vaccine (OPV), Pneumococcal vaccine (PCV), Vitamin A supplements, and deworming tablets. Preliminary data indicated that the campaign achieved over 95% coverage of the vaccines in all districts of Timor-Leste.

"It is commendable that the campaign has achieved the desired coverage, but we have to assess the data to ensure that we have an accurate picture," said Dr. Mathur. "The results of this ongoing survey will provide us with the true picture," he added.

Participants attend the two day workshop on conducting the survey, data collection and use of digital questionnaires in March 2023. Photo: WHO Timor-Leste/Emilia Moniz

The 64 health workers were trained by WHO Timor-Leste for data collection and the use of digital questionnaires. The WHO also collaborated with the Instituto Nacional da Estatística, the national institute of statistics in Timor-Leste, which helped in identifying 194 enumeration areas and mapping 5044 households across the country to conduct the survey. The trained health workers then visited homes, examined immunization records, and interviewed individuals, parents, or caregivers about the immunizations received, recording the responses on the digital questionnaire. The survey is now in its final leg, and WHO experts will conduct the final analysis in May 2023.

The use of digital tools to assess immunization coverage in Timor-Leste is a progressive step towards achieving more efficient data collection and analysis, which can strengthen the health system.

“We hope that this survey establishes a robust framework that can be utilized for conducting numerous surveys in various public health domains in the future,” said Dr. Mathur.