Leveraging Blockchain to Ensure Safe Vaccination Delivery in India

Rakkshet Singhaal, Programme Associate, Community Systems Foundation

In India, only 65% of children obtain full immunization during their first year of life, resulting in the deaths of over a million children each year. However, significant strides have been made to achieve full immunization coverage. In order to reach the goal, the government of India recognizes the need to expand data access and the involvement of key state partners to improve vaccination programmes nationwide. [1]

To accelerate immunization coverage and expand cold chain management, the Biotechnology Industry Research Assistance Council (BIRAC), a non-profit public sector enterprise set up by the Department of Biotechnology Government of India, initiated the Immunization Data: Innovating for Action (lDlA) project. In partnership with Community Systems Foundation’s (CSF) technical partner Avalon Information Systems Pvt Ltd, BIRAC sought to utilize the blockchain to enable more transparent and accurate end-to-end tracking in the supply chain. Digitization of antigens and medical equipment records would allow BIRAC to track assets from production to delivery or use by end-users.

Project Objectives

The key objective of this lDlA was to develop a digital platform to visualize and analyze triangulated immunization data. The platform was conceived to enhance the performance of the immunization program by leveraging blockchain technology through the triangulation of data available through the Reproductive and Child Health (RCH) Programme, India Health Management Information System (HMIS), and Electronic Vaccine Intelligence Network (eVIN).

Avalon sought to create a proof of concept HealthChain. Establishing a HealthChain built with blockchain technology would allow for a decentralized and distributed vaccination ledger that is immutable and unhackable. 

The intention of this work was to eventually link it to IndiaChain, which is one of the world’s largest blockchain projects that seek to integrate all public records across the country. This would allow child immunization schedules to be triangulated to improve vaccine delivery micro-planning. 

HealthChain Dashboard

In addition, a HealthChain dashboard was planned to focus on three key use-cases that were affecting the immunization sector:

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Data Triangulation

The triangulation of data through blockchain aimed to highlight seven different cases scenario at the indicator level:

1. Whether the coverage of antigen matches consumption, so that the analysis regarding optimum utilization/over-reporting/high wastage can be understood;
2. Whether the utilization of antigen matches with children due for that antigen;
3. Whether the children covered under the immunization program match those with due targets;
4. Whether the availability of antigen matches the children due for that antigen for a better analysis of stock-outs;
5. The availability of ANMs for delivery of outreach immunization services;
6. The delivery of immunization services in areas catered by vacant sub-health centers; and,
7. The discrepancy of reported administrative coverages in RCH and HMIS portals.

Challenges and Next Steps

Due to constraints and project limitations, ultimately Avalon was unable to implement blockchain technology.  Instead, Avalon leveraged the Data For All toolkit and applied an open-source software to manage incoming data from RCH, HMIS, and even to present a holistic picture of full immunization. 

The project generated significant lessons learned, along with a clear conceptual understanding of how blockchain can be applied in critical, and cross-cutting areas such as immunization.  No doubt that these lessons learned will one day position public health planners with timely and complete data to ensure that no child is left behind in the world’s biggest immunization program.

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[1] See more: https://www.unicef.org/india/what-we-do/immunization 
​[2] See more: https://www.businessinsider.in/what-is-indiachain-a-blockchain-system-that-could-soon-be-the-heart-of-governance-in-india/articleshow/64676670.cms  ​