{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T14:50:09Z","timestamp":1785855009938,"version":"3.56.0"},"reference-count":64,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Res Protoc"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Electronic immunization registers (EIRs) can strengthen immunization systems and, if used effectively, can lead to greater efficiency and improvements in vaccination coverage. Several low- and middle-income countries introduced EIRs for COVID-19 vaccination and are now integrating them for routine immunization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aims to describe the protocol used to evaluate the implementation of an EIR in the Lao People\u2019s Democratic Republic in 2022. In addition, it seeks to identify opportunities to improve implementation, scale-up, and sustainability in the country.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>To evaluate the implementation of the EIR in the Lao People\u2019s Democratic Republic, we will (1) map the EIR workflow process, (2) examine EIR user and stakeholder perspectives, and (3) assess the EIR data quality. Data will be collected and analyzed through a mixed methods approach. This evaluation will involve a document review, observation of workflows in health facilities, health facility user surveys, key informant interviews with decision makers, and an assessment of immunization data quality. This protocol details the methods for each of these components. The evidence generated will be triangulated to identify the strengths and weaknesses of the early implementation phase of the EIR, facilitators of and barriers to the implementation, and whether the introduction of the EIR has improved immunization data processes and quality compared with paper-based processes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Data collection took place between April 2024 and August 2024. Data analysis is currently ongoing, with results expected to be shared with study stakeholders in October 2024.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This early evaluation will contribute to developing a road map for the nationwide strengthening and sustainability of the EIR based on challenges and lessons learned, potentially streamlining further implementation efforts and enabling more effective use of the EIR. This paper presents a methodology for evaluating EIR implementation that can be replicated in other low- and middle-income countries implementing EIRs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>International Registered Report Identifier (IRRID)<\/jats:title>\n                    <jats:p>DERR1-10.2196\/65663<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2196\/65663","type":"journal-article","created":{"date-parts":[[2025,5,12]],"date-time":"2025-05-12T12:25:07Z","timestamp":1747052707000},"page":"e65663","source":"Crossref","is-referenced-by-count":3,"title":["Strengthening Immunization Data: Protocol for the Evaluation of an Electronic Immunization Register"],"prefix":"10.2196","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5453-070X","authenticated-orcid":false,"given":"Meru","family":"Sheel","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3529-0445","authenticated-orcid":false,"given":"Cyra","family":"Patel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0040-6679","authenticated-orcid":false,"given":"Gemma","family":"Saravanos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-3484-6520","authenticated-orcid":false,"given":"Michelle","family":"Lynch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-2467-841X","authenticated-orcid":false,"given":"Adeline","family":"Tinessia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-9287-6637","authenticated-orcid":false,"given":"Niramonh","family":"Chanlivong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-4268-6527","authenticated-orcid":false,"given":"Mathida","family":"Thongseng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3280-5658","authenticated-orcid":false,"given":"Praveena","family":"Gunaratnam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8955-9104","authenticated-orcid":false,"given":"Chansay","family":"Pathammavong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kongxay","family":"Phounphenghack","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-9236-5634","authenticated-orcid":false,"given":"Yongjoon","family":"Park","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sisouveth","family":"Norasingh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-5185-802X","authenticated-orcid":false,"given":"Dheeraj","family":"Bhatt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4532-272X","authenticated-orcid":false,"given":"Nyambat","family":"Batmunkh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcela","family":"Contreras","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7324-9198","authenticated-orcid":false,"given":"M. Carolina","family":"Danovaro-Holliday","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2025,6,19]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)00850-X"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2020.05.003"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1080\/21645515.2023.2199656"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7144a2"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.4103\/jfmpc.jfmpc_1102_21"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1016\/s2214-109x(23)00603-4"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.3390\/vaccines12020168"},{"key":"ref8","unstructured":"Assessing country readiness for COVID-19 vaccines: first insights from the assessment rolloutThe World Bank202132021-03-24https:\/\/documents1.worldbank.org\/curated\/en\/467291615997445437\/pdf\/Assessing-Country-Readiness-for-COVID-19-Vaccines-First-Insights-from-the-Assessment-Rollout.pdf"},{"key":"ref9","unstructured":"Global strategy on digital health 2020-2025World Health Organization20212024-04-11https:\/\/iris.who.int\/bitstream\/handle\/10665\/344249\/9789240020924-eng.pdf"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.9745\/ghsp-d-21-00804"},{"key":"ref11","unstructured":"Designing and implementing an immunisation information system: a handbook for those involved in the design, implementation or management of immunisation information systemsEuropean Centre for Disease Prevention and Control2018112024-04-22https:\/\/www.ecdc.europa.eu\/sites\/default\/files\/documents\/designing-implementing-immunisation-information-system_0.pdf"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.2196\/32455"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1097\/PHH.0000000000000069"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2020.04.071"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1097\/PHH.0000000000000100"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.11604\/pamj.supp.2020.35.1.17804"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2023.03.051"},{"key":"ref18","unstructured":"Immunization agenda 2030: a global strategy to leave no one behindWorld Health Organization20202021-05-26https:\/\/www.who.int\/teams\/immunization-vaccines-and-biologicals\/strategies\/ia2030"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2021.12.048"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.9745\/GHSP-D-23-00161"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2023.03.059"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1136\/bmjmed-2022-000403"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1003992"},{"key":"ref24","unstructured":"Vaccination and immunization in the digital ageJMIR Publications2024-04-22https:\/\/publichealth.jmir.org\/themes\/623-vaccination-and-immunization-in-the-digital-age"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijmedinf.2022.104974"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2023.04.007"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2023.1106548"},{"key":"ref28","unstructured":"Evaluating the impact of electronic Immunization Registries (eIR) and electronic Logistics Management Information Systems (eLMIS) in four low- and middle-income countries: main insights from the cross-country analysis in Guinea, Honduras, Rwanda, and TanzaniaImmunization Economics202352025-05-29https:\/\/www.technet-21.org\/en\/resources\/report\/evaluating-the-impact-of-eir-and-elmis-in-four-low-and-middle-income-countries"},{"key":"ref29","author":"Danovaro-Holliday, M","year":"2022","journal-title":"-"},{"key":"ref30","unstructured":"Electronic immunization registry: practical considerations for planning, development, implementation and evaluationPan American Health Organization20182024-02-01https:\/\/iris.paho.org\/handle\/10665.2\/34865"},{"key":"ref31","unstructured":"BodwellGVaccinology in Latin America: a resource for immunization managersSabin Vaccine Institute20191112024-06-13https:\/\/www.sabin.org\/resources\/vaccinology-in-latin-america-a-resource-for-immunization-managers\/"},{"key":"ref32","unstructured":"Immunization essentials: a practical field guideUSAID2025-05-26https:\/\/knowledge.unicef.org\/resource\/immunization-essentials-practical-field-guide"},{"key":"ref33","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-021-06633-8"},{"key":"ref34","unstructured":"Immunization data: evidence for action: a realist review of what works to improve data use for immunization: evidence from low- and middle-income countriesPATH, Pan American Health Organization20192025-05-29https:\/\/media.path.org\/documents\/PATH_IDEA_WhitePaper_R6_pages_0JAQOBP.pdf"},{"key":"ref35","doi-asserted-by":"publisher","DOI":"10.21037\/mhealth.2017.06.03"},{"key":"ref36","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijmedinf.2021.104413"},{"key":"ref37","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-016-3549-0"},{"key":"ref38","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2017.11.023"},{"key":"ref39","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD008145.pub4"},{"key":"ref40","doi-asserted-by":"publisher","DOI":"10.1016\/s2589-7500(23)00134-6"},{"key":"ref41","unstructured":"Landscape analysis of health information systems and data tools for identifying, reaching, and monitoring zero-dose and under-immunized children: global-level report of findingsZero-Dose Learning Hub2025-05-26https:\/\/zdlh.gavi.org\/resources\/landscape-analysis-health-information-systems-and-data-tools-identifying-reaching-and"},{"key":"ref42","unstructured":"Morbidity and Mortality Weekly Report. Updated guidelines for evaluating public health surveillance systems: recommendations from the guidelines working groupCenters for Disease Control and Prevention2024-05-23https:\/\/www.cdc.gov\/mmwr\/preview\/mmwrhtml\/rr5013a1.htm"},{"key":"ref43","doi-asserted-by":"publisher","DOI":"10.26633\/RPSP.2019.28"},{"key":"ref44","unstructured":"WHO\/UNICEF estimates of national immunization coverage, 2023 revisionWorld Health Organization and the United Nations Children\u2019s Fund (UNICEF)2025-05-29https:\/\/worldhealthorg.shinyapps.io\/wuenic-trends\/"},{"key":"ref45","unstructured":"Health sector reform strategy and framework till 2025 [Lao PDR]Lao People\u2019s Democratic Republic Ministry of Health (MoH)20162025-05-29https:\/\/data.laos.opendevelopmentmekong.net\/library_record\/health-sector-reform-strategy-and-framework-till-2025-lao-pdr"},{"key":"ref46","unstructured":"Design - DHIS2 documentationDHIS2 Team2024-04-22https:\/\/docs.dhis2.org\/en\/implement\/health\/immunization\/eir-immunization-eregistry\/design.html"},{"key":"ref47","unstructured":"A data action framework - data to support the immunisation agenda 2030: a global strategy to leave no one behindImmunization Agenda 20302023-12-22https:\/\/www.immunizationagenda2030.org\/images\/documents\/IA2030_Data_Action_Framework_-_FINAL_format_210630.pdf"},{"key":"ref48","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2019.103208"},{"key":"ref49","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"ref50","doi-asserted-by":"publisher","DOI":"10.9745\/ghsp-d-22-00555"},{"key":"ref51","unstructured":"Immunization information system data quality practices to monitor and evaluate data at restAmerican Immunization Registry Association20182025-05-29https:\/\/repository.immregistries.org\/files\/resources\/5c002cbde216d\/aira_dq_guide_data_at_rest_-_final.pdf"},{"key":"ref52","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(24)00078-1"},{"key":"ref53","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2018-000807"},{"key":"ref54","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2020.09.017"},{"key":"ref55","doi-asserted-by":"publisher","DOI":"10.11604\/pamj.supp.2021.40.1.17313"},{"key":"ref56","doi-asserted-by":"publisher","DOI":"10.9745\/ghsp-d-19-00024"},{"key":"ref57","doi-asserted-by":"publisher","DOI":"10.7189\/jogh.12.04090"},{"key":"ref58","unstructured":"Lao People Democratic Republic Digital Health Strategy 2023-2027World Health Organization20232024-06-06https:\/\/extranet.who.int\/countryplanningcycles\/planning-cycle-files\/lao-people-democratic-republic-digital-health-strategy-2023-2027"},{"key":"ref59","unstructured":"FastLWaugamanAFighting Ebola with information: learning from the use of data, information, and digital technologies in the West Africa Ebola outbreak responseUSAID20172021-10-01https:\/\/www.usaid.gov\/sites\/default\/files\/documents\/15396\/FightingEbolaWithInformation.pdf"},{"key":"ref60","doi-asserted-by":"publisher","DOI":"10.1186\/s43058-020-00022-8"},{"issue":"5-6","key":"ref61","first-page":"453","volume":"35","author":"Danovaro-Holliday, MC","year":"2014","journal-title":"Rev Panam Salud Publica"},{"key":"ref62","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-021-06559-1"},{"key":"ref63","doi-asserted-by":"publisher","DOI":"10.2147\/JMDH.S104807"},{"key":"ref64","author":"Roller, M","year":"2015","journal-title":"Applied Qualitative Research Design: A Total Quality Framework Approach"}],"container-title":["JMIR Research Protocols"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.researchprotocols.org\/2025\/1\/e65663","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T13:58:40Z","timestamp":1785851920000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.researchprotocols.org\/2025\/1\/e65663"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,19]]},"references-count":64,"URL":"https:\/\/doi.org\/10.2196\/65663","relation":{"has-preprint":[{"id-type":"doi","id":"10.2196\/preprints.65663","asserted-by":"object"}]},"ISSN":["1929-0748"],"issn-type":[{"value":"1929-0748","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,19]]}}}