Iterative Design of an Immunization Information System in Pakistan

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Abstract
Routine early age child immunization is one of the most cost-effective public health interventions. The use of Information and Communication Technology (ICT) tools such as Immunization Information Systems (IIS) to improve efficiency of vaccination programs has shown mixed but encouraging results in terms of success. The objective of this paper is to present evidence of Evaccs -- a successfully deployed smartphone based vaccinator monitoring app, discuss the need to create a smartphone enabled IIS (called Har Zindagi -- every life matters) that can store digital records of every child, discuss various design and implementation features of Har Zindagi's android application, and present findings of the usability testing performed on the Har Zindagi android app. Given that the vaccinators are non tech-savvy, and the real estate on a smartphone is limited, this application was particularly designed to allow easy record entry process, and smoothen the workflow. This paper builds upon previous work on user interface design for low-literate users, and identifies techniques to iteratively design interfaces with government employees, who may be uncomfortable with giving usability feedback due to fear of repercussions or might have different field reality when compared to their supervisors and policy makers.

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