Research Projects

Teeko: A mHealth App Helping Improve Routine Immunization


The immunization rate in Pakistan’s Sindh province declined from 37 percent in 2006-2007 to 29 percent in 2012-2013 despite a large number of vaccinators being employed under the immunization programme. Lack of transparency, accountability and effective monitoring by the government, insufficient visits to villages by vaccinators and inadequate efforts at creating routine immunization awareness are contributing factors for the declining rates.


The Aga Khan University (AKU) in collaboration with the Sindh government’s Expanded Programme on Immunization is conducting a research project titled, “Improving Routine Immunization Coverage through Health Systems Strengthening” to boost routine immunization coverage in the Tando Mohammad Khan (TMK) district of the Sindh province. AKDN eHRC is supporting the project by designing, developing and implementing Teeko, an android-based application and a web portal to assist with vaccinator and immunization tracking and monitoring.


Teeko, meaning vaccination in the local language, provides real-time data on a vaccinator’s field movements through GPS tracking and on the number of children being immunized. Vaccinators can also check vaccine stock availability at their respective health facilities through the app. A GPS tracking system built into the web portal allows district health officers and supervisory staff to remotely monitor vaccinators’ activities and movements. The portal keeps a record of registered children’s vaccinations and routine immunization coverage reports. A SMS panel is used to send text messages to parents of registered children about upcoming vaccinations. Vaccinators and lady health workers are also informed about meetings and schedules. The aim is to have a strengthened immunization programme through increased transparency, accountability and monitoring.


The application has been tested in the field and the intervention was well-received by the end-users in TMK. Additionally, immunization-related SMS/robocalls and health sessions have also been administered which have helped raise awareness in the community on the importance of routine immunizations. The application has been endorsed by the Government of Sindh for a potential rollout in Sindh.




“The result was a jump in routine immunization from 15-19 percent surveyed for different vaccines to 49-84 percent as reported by independent monitoring”, said Dr Shehla Zaidi, Associate Professor, Women and Child Health Division, AKU, who is leading this project.


Funded by Global Alliance for Vaccines and Immunizations, the project initiated in January 2015 and will conclude in 2017. The mHealth component of the project, led by AKDN eHRC, began in October 2015 and will be implemented over a period of 15 months.


AKDN eHRC has developed this video to create awareness of immunizations. When conducting health sessions in the community, vaccinators show this video to parents to help increase their knowledge and help them understand the importance of immunizations.