MGHD 2024

Background: Childhood immunization is critical for preventing diseases and reducing child mortality globally. Despite Rwanda's high initial coverage, many children miss subsequent vaccinations, posing health risks. Electronic Health Records (EHR) like District Health Information System (DHIS2) e-Tracker aim to improve immunization by tracking schedules and managing vaccine inventory. This study evaluates DHIS2 e-Tracker's effectiveness and compares it with KURA, an android- based EHR system, to understand their impact on immunization program efficiency and healthcare provider satisfaction in Rwanda. Methods: We used a mixed-method observational study to assess the operational efficiency of the DHIS2 e-Tracker and KURA application for immunization at the Remera Heath Center. This involved evaluating data completeness and accuracy through record review. Additionally, retrieval time and report comprehensiveness were analyzed. To assess user experience, we conducted a System Satisfaction, and System Usability Scale (SUS) survey with five healthcare providers responsible for immunization services. Open-ended questions further explored their experiences and challenges with the system. Results: Findings from the review of 145 child immunization records showed comparable retrieval rates using child’s ID (p=0.235) but significant differences using child’s name (p<0.001). e-Tracker had lower completeness across essential data fields compared to KURA. We found a 66.7% staff satisfaction on KURA and 60% on e-Tracker. Qualitative analysis highlighted user desires for automated reminders, comprehensive reporting capabilities, and improved data control and training opportunities for e-Tracker. Integration with Civil Registration and Vital Statistics (CRVS) was a notable strength of e-Tracker. Conclusion: Overall, while both systems showed strengths, improvements in feature functionality, reliability, and System Usability are critical in both KURA and e-Tracker for enhancing immunization program efficiency and user satisfaction in Rwanda.