Combining health datasets is helping polio vaccination efforts in Pakistan


Polio is one of the world’s most devastating diseases. It mainly affects children under the age of five and leads to lifelong paralysis in one in 200 cases. Amazing progress has been made in the fight against polio worldwide: According to UNICEF, 20,000 children in Pakistan were paralyzed by polio in 1994. By 2021, the number of new cases of paralysis had dropped to just one child. However, as long as only one child remains infected, all children are at risk.

Identifying and reaching unvaccinated children has been a challenge, but big data startups like Zenysis are making strides in partnership with Pakistani government partners.

Zenysis was part of Gavi’s INFUSE program, which connects high-impact innovation to the countries that need it most. Hasan explains that Gavi’s investment is vital for countries like Pakistan to improve healthcare budgets, but also to provide impetus and set targets for immunization programs.

Vaccination data is only useful if it is correct

Abid Hasan is project manager for Zenysis – a Gavi INFUSE pacesetter since 2017 – in Pakistan, and he explains the obstacles to a more effective immunization program in the country:

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“Data is like people: if datasets don’t communicate with each other, they don’t work well. Zenysis makes data and datasets speak.”

Community health workers employed under Pakistan’s polio eradication program and expanded immunization program are going door-to-door collecting immunization data, sometimes using spreadsheets, sometimes on paper, sometimes recording data via WhatsApp. It can be difficult to track families without an official address or mobile communities without a fixed address. With 14 million children who need a polio vaccine every two months, collecting accurate data is a daunting task.

A community health worker goes door-to-door to give children the oral polio vaccine during the August polio campaign.  She finds a newborn zero-dose child and enters this data in her register.  Photo credit: @SalmanMahar
A community health worker goes door-to-door to give children the oral polio vaccine during the August polio campaign. She finds a newborn zero-dose child and enters this data in her register.
Photo credit: @SalmanMahar

The resulting data can be imperfect, with duplication a particular challenge. This is where Zenysis’ platform comes in. Zenysis software integrates, dedeplicates, and harmonizes more than 20 siled datasets, including polio data, immunization records, and population data.

Combined, the data can be used much more effectively for analyzes and, above all, for on-site measures. The result? A new and improved vaccination plan personalized for each district of the vaccinator – known as a microplan.

Microplans help health workers target zero-dose children

The improved microplans provide health workers with detailed information about every child in a region, including immunization status, age and address. This information can be used to identify individual children and to highlight neighborhoods where there are clusters of unvaccinated (zero dose) children. This in turn means better use of time and energy and better outcomes for communities.

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Community health workers using Zenysis provided micromaps to identify homes with zero-dose children in high-risk areas of Karachi.  Photo credit: @SalmanMahar
Community health workers using Zenysis provided micromaps to identify homes with zero-dose children in high-risk areas of Karachi.
Photo credit: @SalmanMahar

The effect, Hasan explains, is evident in three key areas. “First, the new microplans give community health workers a real picture. Second, frontline workers now have a plan to follow and no longer use rich or inflated data that is difficult to implement. Third, this approach is measurable – when you achieve a goal, it goes into the system. With accurate data you can really see the impact.”

Health workers on the ground have seen the difference. Sadaf, a community polio health worker in Karachi, says: “Before the microplans, vaccinators received a long list of children with duplicate entries and it was extremely difficult to track them. After receiving these micro-plans, we can easily decide where to set up our counseling centers and mobilize children to systematically take them there for vaccination.”

The effect was impressive. As of January 2022, the Expanded Program on Immunization in the Sindh region has used the Zenysis platform to identify over 28,500 true zero-dose children in the region and vaccinate 12,724 of them using microschedules. From March to June this year, 3,854 zero-dose children were vaccinated using the new micro-plans in the regions where they were implemented.

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Gavi’s support was crucial in setting goals and driving change

Zenysis was part of Gavi’s INFUSE program, which connects high-impact innovation to the countries that need it most. Hasan explains that Gavi’s investment is vital for countries like Pakistan to improve healthcare budgets, but also to provide impetus and set targets for immunization programs.

Looking ahead, Zenysis is working closely with government partners to expand the platform and immunization approach across the province of Sindh, target other vaccine-preventable diseases, and improve government management capacity for tech platforms.

As Hasan says, “Not everyone is a data expert – but if you can go on a platform, go into a dashboard and see all your data in one workspace, then you can reach a zero-dose child and their family and they get vaccinated .”

And with every child vaccinated, we’re one step closer to a world where infection with wild polioviruses is a thing of the past.



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