In 2015, a Bass Connections project team analyzed the uptake of childhood vaccination services in Roatán, Honduras, and found that a barrier to rapidly identifying and reaching under-immunized children was the static paper-based vaccination record system. To address this issue, a 2017-18 Bass Connections project team developed mVax, a mobile health (mHealth) application for capturing and managing vaccination data.

Last spring, three members of the team, including Linh Bui ’20 (Computer Science and Global Health), Rob Steilberg ’18 (Computer Science) and Kate Watkins ’19 (Biology and History), received a Bass Connections Follow-on Student Research Award to update the app and share it more widely with healthcare providers in Roatán. The team worked with Clínica Esperanza, a low-cost provider of medical services in the area, to streamline the process of recording immunization data by improving record collection, access and storage. The group was mentored by Lavanya Vasudevan. Recently, they shared this update:

Developing and Sharing an mHealth App to Streamline the Vaccination Process in Roatán, Honduras

By Linh Bui ’20, Rob Steilberg ’18 and Kate Watkins ’19

Despite a national routine immunization program in Honduras, many children in Roatán (a small island off the northern coast of mainland Honduras) remain susceptible to vaccine-preventable diseases due to delays in, lack of access to, or refusal to accept vaccinations. The current Honduran vaccination record system is entirely paper-based, preventing rapid identification of and outreach to under-immunized or unimmunized children. Our project aimed to streamline the process of recording immunization data, thus enabling clinics to focus more time on vaccination delivery.

Our project began a year prior to arriving in Roatán with the design and initial development of mVax, a mobile Android application designed to record and export vaccination data for Clínica Esperanza, a local clinic in the Sandy Bay neighborhood of Roatán. The primary goal of the app was to improve child vaccine uptake in the migrant community of La Colonia, located near the clinic. The app is designed to help achieve this goal by decreasing the amount of time spent copying vaccination data to paper forms while maximizing the amount of time spent with patients and educating them on the importance of regular immunizations.

The application works by recording patient and vaccination data and providing a convenient way for exporting this data so that required vaccination form completion is easier and less time-consuming for the vaccinator. We implemented a powerful search algorithm for locating patients by a variety of search terms. We also designed and built a calendar widget for visualizing when patients were due for their next scheduled vaccinations, so that the clinic’s vaccinator could easily contact them and encourage retention rates among patients. Importantly, the app is bilingual for ease of use among both English- and Spanish-speaking people, and it provides live updating to a dedicated backend database, so that data is always correct across multiple devices.

Upon arriving in Roatán, we worked closely with the clinic’s vaccinator to observe vaccination appointments with young mothers and children from La Colonia. We fleshed out the final version of mVax, published it on the Google Play store and deployed the app within the clinic itself. This involved one-on-one teaching sessions with the clinic’s vaccinator along with follow-up observations to determine the effect of the app on the clinic’s vaccination workflow.

Our follow-on funds from Bass Connections allowed us to purchase updated tablets to finish developing the app and to ultimately donate them to the clinic for continued use after conclusion of our project. Additionally, we collected field surveys from mothers with children between the ages of 12 and 23 months using the tablets to facilitate secure data storage. By talking with diverse, local actors involved in delivering vaccines to children, including the vaccinator, community health workers and parents, we gained a holistic appreciation for the incentives and challenges of vaccinating children in a timely manner.

Today, the app has been fully developed and deployed. Clínica Esperanza continues to use the app to record their immunization events. Ultimately, future projects may investigate the efficacy of spreading the app to other clinics on Roatán or perhaps in other areas of Honduras, as well.

Learn More

• Learn more about this 2017-18 project team, which was part of a multiyear effort to evaluate and improve child vaccination rates in Honduras.
• Check out the 2018-19 project team that’s studying vaccine misinformation and its impact on vaccine uptake in Durham.
• Meet all of the 2018 Follow-on Student Research Award grantees.

Photos courtesy of Linh Bui, Rob Steilberg and Kate Watkins: Watkins and Bui in the field in Roatán; members of the mVax team in Roatán; mVax logo; Steilberg and Watkins at the Bass Connections Showcase in April 2018; Bui at the 2018 Triangle Global Health Annual Conference in Raleigh on September 27; Watkins and Bui in the field; Clínica Esperanza sign; Watkins and Bui in the field