Background
Africa faces persistent challenges in immunization data capture, transmission, analysis, and use. Robust digital health systems are essential for improving immunization coverage and outcomes. Aligned with Uganda’s eHealth Strategy and the Immunization Agenda 2030, the Ministry of Health, the Academy at Infectious Diseases Institute, and Johnson & Johnson adapted Vxnaid—a tool previously used in Ebola and COVID-19 campaigns—to digitize routine immunization workflows in Uganda and document stakeholder experiences for future scale-up and sustainability.
Methods
Using a user-centered design approach, we conducted requirements gathering through stakeholder consultations, workflow mapping, and needs assessment. These informed iterative customization of Vxnaid to support digitalization of routine immunization. Core components include QR code child identification, real-time vaccine scheduling and referral, reporting, and caregiver engagement via automated voice calls for reminders and tracking of Adverse Events Following Immunization (AEFIs). After User Acceptance Testing, phased deployment followed with health worker training, tablet distribution, quality control, and routine supervision.
Results
By July 2025, 540 health workers and village health teams had been trained. Since deployment began in February 2025, the system has rolled out to 96 (62% of target) public and private facilities, registering 36,496 children. Key challenges included internet instability, digital literacy gaps, and the need for ongoing support. Policy engagement ensured alignment with national strategies, while community sensitization and user feedback shaped uptake and system improvements.
Conclusion
Initial deployment showed strong acceptance among health workers due to user-friendly design and integration into workflows. Vxnaid shows promise as a scalable, interoperable digital health solution. Its success underscores the importance of co-creation, policy alignment, and phased rollout. Addressing infrastructure barriers and building digital capacity are critical for sustainability.
Keywords: Routine immunization; Vxnaid; digitalization
