Notice F1: Implementation of the WHO digital documentation of COVID-19 certificates: vaccination status (DDCC:VS) technical specifications

CommCare for Equitable COVID 19 Vaccine Delivery

Two Sentence Overview: 
CommCare for equitable COVID-19 vaccine delivery is an open-source digital solution to track and support every vaccine recipient before, during, and after the vaccination process. It has been implemented at scale in Somalia and Jamaica. Both experiences presented the opportunity to work with eGOV in the integration of CommCare and DIVOC to fulfill the data exchange needs of the WHO DDCC: VS technical guidance to easily generate vaccination certificates. Through this project, Dimagi will carefully document all details related to the integration of CommCare with DIVOC to generate vaccine certificates: updated data model, integration, and workflows, and will develop documentation on installation and deployment methods, quality assurance, testing, and product information in line with the shelf readiness framework to ensure the solution can be easily deployed with or without a Dimagi services team in a given country.
Executive Summary: 
In the past year, we’ve seen the globe undertake an unprecedented vaccination campaign to stem the spread of the COVID-19 pandemic. As vaccines have been delivered across the globe we have recognized the tremendous value of digital solutions in ensuring that doses are delivered equitably, effectively, and efficiently, so that governments are empowered with the data they need to track the progress of vaccination campaigns in their countries. In October 2020, Dimagi developed a digital solution to track individuals through every step of a multi-dose vaccination process, verify course completion, monitor for adverse events, and visualize the progress of vaccine delivery. This digital solution was built prior to the start of the campaign to ensure it could be customized for specific country deployments to match the speed of vaccine delivery. In March and April of 2021, the tool was rapidly deployed and scaled in both Jamaica and Somalia and has been used to record well over 1.5 million COVID-19 vaccine doses. With the publication of the WHO DDCC: VS technical guidance Dimagi has begun work with the support of UNICEF and the Jamaican Ministry of Health and Wellbeing to align its customized solution to the standards and integrate the solution with DIVOC to generate vaccine certificates. We are now actively leveraging funding opportunities to generalize updates made to the customized instance in Jamaica to update the template application and ensure they can fulfill the necessary data exchange needs. Dimagi’s objective is to respond to the call from the global community to provide vaccine certificates to recipients in a quick and easy manner. This investment will support the development of an integration guide between eGov’s DIVOC solution and CommCare and publish the code required to allow the two solutions to communicate. It will allow Dimagi to develop and publish comprehensive documentation on the template solution including documentation outlining the data models, the workflow details, the user personas, technical design, and integration steps to ensure that these efforts make the solutions easier and shelf-ready. Finally, updates made to these templates will be pushed to the live deployment in Somalia to ensure that when they are prepared to begin issuing vaccine certificates the solution has collected all relevant data, and can support the required workflows. The investment in this generic integration solution will enable end-users to build their own custom integrations, which is currently an elaborated task that requires software development time.
Consortium Team: 
Dimagi will prime this consortium, as Dimagi is the organization responsible for the development and maintenance of CommCare, an open-source, no-code platform that is the most widely used and scaled platform for equipping frontline workers in LMICs. Along with the development of the CommCare platform, Dimagi has a services team that has delivered projects in 130 countries across the globe. Our team’s experience with Ebola helped to rapidly design template applications for contact tracing, facility readiness assessment, port of entry screening, health worker in-service training/education. Generous and flexible funding allowed the services team to develop these apps, coordinate with other digital development organizations, and provide hands-on support to many countries and large organizations to adapt and deploy CommCare applications for COVID-19 response. Since March 2020 over 45,000 users across over 40 countries have used CommCare for COVID-19 response. A report by Johns Hopkins University determined it is one of the two most useful platforms for COVID-19 response. In October 2020, the team developed a new template application in preparation for upcoming vaccine campaigns. Dimagi’s digital solution supports our partners before, during, and after the vaccination and provides analytics and visualizations to monitor the progress of vaccine delivery. The solution has now been deployed and scaled nationally in both Jamaica and Somalia and Dimagi has received letters of support to potentially deploy the solution in Burkina Faso, Guatemala, and Mozambique. Dimagi’s services team will lead the work to further build on top of this template and will utilize an agile methodology approach with multiple sprints to accomplish the activities over the project in an organized and well-documented manner. In support of the goal of developing an integration guide, eGov, the developers of DIVOC, will also play a supporting role in this consortium. They will work on the documentation along with Dimagi and provide all necessary technical support and input to create documentation and processes that are particularly implementable in low and middle-income settings.
Project Description: 
Through the COVAX initiative, COVID-19 vaccine doses have been made available across the globe. To support that goal Dimagi has developed a ready to deploy solution to support vaccine delivery on its mature Global Good, CommCare. The solution has been customized, deployed, and scaled in both Somalia and Jamaica, and in order to deploy the solution, Dimagi’s services team has worked with the relevant government ministries to customize it and integrate it with third-party systems for vaccine appointment scheduling and certificate generation. In its current state, the template solution is ready to be deployed and customized to a local context but in order to do so, a Dimagi services team is required. The documentation on installation and deployment, quality assurance and testing, and product information, in general, is relatively limited. Additionally, as it pertains to functionality, the solution was developed prior to the development of the WHO DDCC: VS technical guidance and does not collect all data required for needed data exchanges. With the support of Digital Square, this project will complete the following activities: -Update workflows and fields to align with the WHO DDCC: VS technical guidance documentation to ensure it can fulfill the data exchange needs. (Months 1-2). -Develop and publish documentation on installation and deployment methods, quality assurance and testing, and product information in line with the shelf readiness framework. (Months 3-4). -Create an integration guide between CommCare and DIVOC to ensure the two systems can easily communicate to create vaccine certificates in line with WHO DDCC: VS guidance. (Month 5). -Create a generic framework to support custom integrations. This will be used to support the DIVOC integration but might be repurposed to support additional custom integrations in the future. (Month 6). Potential risks could include the rapid acceleration of the spread of the new COVID 19 Omicron variant in LMICs, as it could hamper the progress that vaccination campaigns have been achieving. In addition, fragile supply chain mechanisms for vaccines in low and middle-income countries might also represent a risk to this project.
Application Status: 
Approved - fully funded


Thank you for the submission. For the full technical application, in addition to general recommendations per the email, please also:

  • Note the list of in-scope/out-of-scope items and ensure the submission focuses on what is considered in scope, e.g., related to implementation activities.
  • Per the technical checklist, ensure there is alignment with the DDCC:VS technical guidance.

Thank you for a great application. Please elaborate on:

  1. It is not very clear on how the proposed activities align to the proposed scope in the concept note.
  2. Describe the use of standards and what information may need to be exchanged with other systems.

Thank you for your feedback, and we are happy to elaborate on the two questions. Is there a deadline to provide our answers, and is it okay to provide them in this comment box? 

Thank you for your questions. Please see our responses outlined below.

1. It is not clear on how the proposed activities align to the proposed scope in the concept note

Our throughout this project is to align the CommCare solution for COVID-19 vaccine delivery with the WHO DDCC:VS technical guidance and to ensure that it can be used by a wide audience and easily be integrated with tools that generate vaccine certificates (like DIVOC). 

With that in mind, we will update the CommCare template solution for vaccine delivery to align to the DDCC:VS technical guidance by adding additional workflows and data elements. The solution supports vaccinators before, during, and after delivering multiple doses of a COVID-19 vaccine and can be used to verify a vaccination event. That said, the solution needs to include new fields and workflows to align it with the DDCC:VS guidelines. 

Further, to ensure that the tool can be used by any group interested in deploying it, we'll develop and publish documentation on installation and deployment methods, quality assurance and testing, and product information in line with the shelf readiness framework. By creating this public facing documentation, we believe the tool can be adopted by a larger range of organizations. 

Finally, once the solution captures all information needed for a country to verify a vaccination event and has more documentation available, we next want to make it easier for groups to integrate it with solutions, like DIVOC, which can issue vaccine certificates. With that in mind, we'll build a generic framework to support custom integrations so that implementers can connect solutions without needing to write custom code. In addition, understanding that many in the vaccine delivery space have or are planning to adopt DIVOC as a tool to issue vaccine certificates, we will create a step-by-step integration guide for the two tools. 


2. Describe the use of standards and what information may need to be exchanged with other systems 

Through this project, Dimagi will align the CommCare Solution for COVID-19 vaccine delivery with the principles and elements proposed in the DDCC:VS core data set. With that in mind, implementers will easily be able to map the solution's data dictionary to the HL7 FHIR elements. 

Since CommCare is being used to verify vaccination events so that vaccine certificates can be generated, it will exchange the information described in table 10, 11, and 12 in Section 5 of the WHO Digital Documentation of COVID-19 Certification Vaccination Status guidance.