Freedom Polio

ZMQ's solution is designed as a universal model based on the new strategy shift from fixed site immunisation to mobile vaccination strategies ("house-to-house" immunisation) in the final battles against polio and achieving higher rates of RI. Thus, it was important to integrate a platform with complete mobility tools for community health workers (CHWs) capable of doing on-the-ground activities. Also, the supervision-level health officers needed mobility tools integrated in the design of the solution for monitoring, decision making, and designing effective immunisation in villages and community areas.

To that end, the ZMQ team mapped every ground process in detail and developed a TLM (Technology Linked Model) for each process. All the connecting threads of every process modules were then weaved together. During the design, special attention was also given to making the tools simple to use, specially focusing the CHWs. It was important they could accomplish their complex tasks using a basic feature phone device; so, the project uses open source technology with a localisation option for region-specific adaptation. The solution is built on scalable PHP/MySQL, Json/XML, JavaScript, Python platform, and establishing network connectivity over CDMA and GSM networks with end tools developed and rendered using variety of open source mobile technologies like Android, Open Java (Polish Java or J2ME) and BREW and SMS Push/Pull technology. In short, it includes:

• A universal management information system (MIS) that carries the data, operations, and management of the polio management in the project districts. This includes information about the communities, households, families, children, and pregnant mothers in every block of the Freedom Polio pilot districts.
• The web-based MIS, which has a universal tracker for Supplementary Immunisation Day (SID) scheduling, done a day prior to the start of the polio round ("polio Sunday"). The scheduling is done online, and the Community Mobilization Coordinators (CMCs) can start conducting the immunisation process once the tracker is set to be "on". This backend system has a provision for designing scheduling of immunisation camps at different locations and regions.
• A web-based system in a specialised section form which can be assigned to the administrators and donors to monitor performance and see the operations and transactions, which is designed to help in evaluating the programme's success. It has a facility to monitor details such as the number of houses visited or the number of polio drops administered.
• A mobile application, which comprises a feature-phone-based Java application for the CMCs to do daily transactions during the polio round. One CMC can enter and manage data from 500 households. The data are also stored on the phone, and, on the first available connectivity, can be submitted on the server.
• A mobile application for block mobilisation coordinators (BMCs) and district mobilisation coordinators (DMCs) on tablets/Android/smartphone that enables the officers to monitor the activities of its subordinate officers. The application is a single window application for both BMC and DMC with different management, tracking, follow-up, and reporting modules. The toolkit also has a global positioning system (GPS) tool to map CMC areas to the level of each house see risk patterns based on location layout of CMC areas. The tool is designed to help the BMCs and DMCs design and prioritise future immunisation and other health services.

"Training of all tier staff in a large scale structured M-Health program is one of the most important components of the solution....A monthly training is conducted for CMCs in different Blocks and Districts. The BMC and DMC training is organized on bi-monthly basis."

Polio, Immunisation and Vaccines, Health.

ZMQ's solution was developed to serve the needs of CGPP's network of over 1,300 CMCs who conduct social mobilisation activities in high-risk areas to promote implementation and acceptance of the oral polio vaccine (OPV), supplementary immunisation activities (SIAs), and RI coverage. The CMCs also work with the Social Mobilization Network (SM-Net), which works with underserved communities in high-risk areas in coordination with district governments, the National Polio Surveillance Project (NPSP), and other partners. The project is implemented on the ground through three non-governmental organisation (NGO) partners: Project Concern International (PCI), Adventist Development and Relief Agency (ADRA), and Catholic Relief Services (CRS) in 56 Blocks of 13 high-risk districts in Uttar Pradesh and West Bengal. Annually, the project reaches more than 21 million children under 15 years old.