Strengthening paper health register systems: strategies from case studies in Ethiopia, Ghana, South Africa and Uganda

Paper registers are primarily used at the facility level, though they can serve as inputs to higher level reporting. Because they serve health providers, program administrators, and health management decision–makers, registers can sometimes fail to meet all stakeholder identified needs. ART – Antiretroviral treatment, FF – Family Folder, MoTeCH – Mobile Technology for Community Health, SR – Simplified Register, TB – Tuberculosis, WHO – World Health Organization *All case studies are publicly available at: http://technet–21.org/en/forums/case–studies–on–paper–immunization–registers. [...]implementing changes to these systems requires commitment of time and resources, and must be approached strategically to avoid system fatigue. [...]it is important to consider adjustments and updates to multiple aspects of the system. Many stakeholders—including funders, policymakers, public health officials, and health providers—can be a part of strengthening paper register systems to support accurate reporting, evidence–based decision–making, and improved patient care. 1 University of Washington, Strategic Analysis, Research and Training (START) Center, Seattle, WA, USA 2 University of Washington, Department of Epidemiology, Seattle, WA, USA 3 Bill and Melinda Gates Foundation, Vaccine Delivery Team, Seattle, WA, USA