A Digital Revolution in Immunization: Reaching Every Child in Sidama

Despite dedicated efforts, a significant coverage gap existed in Ethiopia’s Sidama region’s immunization program, with over 12% of children “zero-dose.” This was primarily caused by the absence of a tracking system at over 1,300 remote health care sites, leading to unreliable data and the inability to effectively monitor vaccination coverage and allocate resources. This systemic failure disproportionately affected vulnerable children in a rural and underserved area.

The Problem: A Crisis of Coverage and Data

Sidama Region lacked systematic tracking at more than 1,368 remote outreach sites, which constituted 66% of all health facilities. An early 2024 regional assessment revealed that key immunization coverage indicators, such as pentavalent and first dose measles vaccines, were significantly below national targets. This indicates a systemic failure to reach vulnerable populations. The root causes included inadequate tracking for mobile outreach, a lack of connection between health facilities and outreach programs, limited insight into service quality, and non-standardized data collection. Consequently, families in rural and underserved areas often missed out on opportunities to protect their children.

The Vaccine Data Capture: A Strategic Digital Solution

To address these challenges, the Sidama Regional Health Bureau, in collaboration with JSI’s Gates Foundation-funded Data Use Partnership (DUP) project, developed and implemented a DHIS2 v40.1-based solution for capturing outreach vaccination data in Sidama. This tool, integrated into all Expanded Program on Immunization regional maternal and child health systems, offers real-time mobile data entry via phones and tablets, geolocation, real-time monitoring facilitated through performance dashboards, and planning tools. This enables accurate recording, precise site mapping, and efficient resource allocation.

A pilot to test this innovation began November 2024 in four districts, with subsequent expansion to additional sites. A central component of this strategy was a comprehensive capacity strengthening program, which trained users and key stakeholders across districts in standardized protocols.

The Result: A Healthier Sidama, A Brighter Future

The vaccination data capture app substantially enhanced system performance and operational efficiency. It eliminated false reporting, providing a reliable evidence base, and optimized service delivery through improved vaccine monitoring, logistics management, and evidence-based resource allocation. The solution also introduced new performance indicators, improving outbreak prevention and rapid response capabilities by identifying accessibility gaps and monitoring real-time data.

Crucially, it established systematic tracking for 66% of previously unmonitored outreach sites, bringing unprecedented visibility to immunization efforts.

The vaccination data capture app, now fully owned and managed by Sidama’s regional health bureau, has expanded from 4 to 12 woredas, with plans for region-wide implementation within the current fiscal year. Sidama’s success has attracted national attention, leading to a country-wide scale-up by JSI and the Ministry of Health. The Oromia Regional Health Bureau is already implementing the initiative, and other regions are considering adoption to improve data reporting and replicate Sidama’s impact.

Future Implications and Global Replication

Sidama’s results prove that a strategic, data-driven approach can fundamentally transform immunization programming. By leveraging the DHIS2 platform and fostering multi-stakeholder collaboration, the solution didn’t just improve immunization coverage; it built a more resilient and transparent health care operating system. The success of this model, designed for easy replication, provides a clear path for other regions and countries grappling with similar “last-mile” challenges to achieve clarity across their immunization programs, enabling protection of the most vulnerable populations.