Strengthening Immunisation Data Systems: a mixed-method evaluation of the Lao Electronic Immunisation Registry

The Lao People’s Democratic Republic introduced an Electronic Immunisation Registry (EIR) for routine immunisation in 2022. This mixed-methods study evaluated the EIR’s implementation to inform its optimisation and use. Data were collected (April–June 2024) using document review, health facility surveys, interviews, workflow observations and data quality assessments. Data were analysed separately and then triangulated to develop recommendations. Among 26 healthcare workers, perceptions were largely positive and all found the EIR easy to use. However, the perceived effect of the EIR on workload was mixed, and training was largely considered insufficient (17/26, 65.4%). Eighteen stakeholder interviews highlighted strong EIR uptake, improved ability to generate reports and identification of under-immunised children, but persistent data gaps, limited data use, staff shortages, reliance on development partners, and the need for stronger government ownership and a long-term roadmap. Data quality assessment of 849,055 vaccination events showed high levels of missing or invalid data. Only 12.46% and 13.45% of births were registered in the EIR within 3 and 7 days, respectively. This evaluation demonstrated that EIR implementation is feasible and acceptable, but barriers, particularly workforce capacity and capability, digital infrastructure, governance, and financing, must be addressed to realise its potential to increase vaccination coverage.