Thank you, Manisha for your initial feedback on this proposal. I would take some time in adding more details regarding the proposal on the attachments in the next few days. In regard to the clarifications that you needed, the M&E system that I propose is digital based where all details of community members targeted for immunization will be documented, and their details entered in registers. This actually already happens in government facilities where they usually obtain the immunization services. But there are gaps in two aspects; (1) The facility immunization register is only able to identify immunization defaulters of previously attending members that have defaulted. If a member has never attended the facility and is defaulting, they cannot be tracked or identified (2) The immunization register indicates the attendance rates for immunization services by each member already registered and will highlight any defaulting members. Because this process is manual and is done on a hardcopy register, the process of follow-up of defaulters becomes cumbersome and often impossible to undertake especially since contacts details are not provided which means it is not possible to directly reach out to defaulters using reminders.
Hence, an M&E system would address both of these challenges in that the system will target the community and record all persons targeted for immunization services and their details captured. Secondly, the functionalities of the system will allow immunization defaulters to be highlighted and the details of the defaulters (such as village, household names, telephone) sent to the community health volunteer in charge of the area who will then do follow up and ensure the defaulter resumes immunization services. By sending sms reminder of details of the defaulters to the community health worker instead to the defaulter themselves means we can significantly reduce non-delivery of reminders when targeted to defaulters which through experience has proved unreliable due to factors such as; illiteracy levels, poverty (inability to afford a cellphone), switched off cellphones and largely due to constant change of contact telephone numbers even for those with cellphones.