Global System for Mobile Communication (GSM) based Tracking: Scaling up low-cost technology to improve workforce monitoring for improved geographic coverage of immunization services

The rapid and vast proliferation of mobile technology has revolutionized the ability of health systems to achieve better outcomes, including improved geographic monitoring of immunization services. Expanded access to new technologies including Global Information System (GIS), and online mapping tools (e.g. Google Maps) has enabled more detailed maps and satellite images for demarcation and identification of priority areas during routine and large-scale mass immunization activities. We have leveraged these technologies to deploy a unique, cost-efficient and powerful tool for monitoring workforce and undertaking assessments of geographic coverage of immunization services. This session will outline our experience of piloting and scaling up a GSM-based Geographic Information Systems (GIS) tracking service in a low middle income setting. We will elaborate upon our experiences of piloting the technology in 2013, across 2 rural districts in Sindh province, Pakistan, tracking 20 vaccinators during a polio supplementary immunization campaign for 3 days. We will highlight the tracking mechanism and the positive results (in terms of improved attendance and geographic mobility of vaccinators) that enabled us to garner support from the Government and GAVI, for eventual scale-up of the system in 2016. Currently, the system is being used to track over 2000 government vaccinators, linked to 1,138 health facilities across 27 districts of the province. In addition to explaining the processes leading to scale-up, we will also highlight the advantages of the GSM tracking over GPS technology including the ability to track through regular mobile SIMS, no requirement for data connectivity or smartphones and preservation of phone battery life. The session will also highlight the impact and how real time tracking information is converted to actionable data for supervisors, ensuring effective monitoring and coverage of all target areas, specifically remote geographical pockets that remain unreached by immunization services.