Reimagining immunisation: A new chapter in health workforce training in Pakistan

We’re helping to transform how Pakistan trains its immunisation workforce through a new digital Learning Management System (LMS). Funded by Gavi, the Vaccine Alliance, and developed in collaboration with the Federal Directorate of Immunisation (FDI), with our technical support. It’s designed to make training more accessible, consistent, and responsive, especially for vaccinators and health staff serving hard-to-reach communities.

With over 16,000 vaccinators working across Pakistan’s diverse geography, delivering standardised, up-to-date training has long been a challenge. This LMS will strengthen the immunisation workforce by offering mobile-friendly, multilingual training content that supports digital health capacity building at scale.

Why digital immunisation training matters

Until recently, training for Pakistan’s immunisation professionals has taken place mainly through face-to-face sessions. While these remain valuable, they are often difficult to scale and not always accessible to health workers in remote or underserved regions. Many professionals lack access to up-to-date guidance on safe vaccine handling, new vaccine introductions, and effective service delivery practices.

By introducing a digital model, we aim to bridge these gaps. Every health worker, regardless of location, should have access to high-quality, engaging training that supports their professional development and strengthens Pakistan’s immunisation system overall.

Tackling the challenge of scale and standardisation

The absence of a centralised training system has made it difficult to maintain consistent quality across regions. Several key challenges currently hinder the effectiveness of immunisation training nationwide:

Outdated Training Content: Training materials often don't reflect the latest vaccines or cold chain management technologies.
Inconsistent Training Quality: A lack of centralised training units means training quality varies significantly from region to region.
Limited Digital Integration: Without digital tools, training cannot be flexible or engaging enough for today's fast-paced healthcare environment.
Accessibility Issues: Attending physical training sessions is often not feasible for vaccinators in remote areas due to poor infrastructure and logistical barriers.
Measuring Training Effectiveness: There is no system in place to track whether the training is actually making a difference.

This initiative aims to address these disparities by offering targeted, scalable training for all cadres involved in the Expanded Programme on Immunisation (EPI). These include vaccinators, cold chain technicians, female medical technicians, Lady Health Workers, surveillance officers, and both district and provincial immunisation managers. The LMS draws on World Health Organization (WHO) Mid-Level Manager training and Pakistan’s national immunisation guidance. It is designed to provide a comprehensive, locally relevant curriculum. Core modules include safe injection practices, adverse events following immunisation (AEFI) surveillance, community mobilisation, and supportive supervision. Learners will also be trained in planning and budgeting, warehouse procedures, and the use of Pakistan’s Logistics Management Information System (LMIS) and immunisation dashboards.

All content will be delivered in an interactive, mobile-optimised format, with multilingual support and integrated assessments to ensure that learning is accessible, measurable, and relevant.
The key features of LMS include:

1.    Competency-Based Training: The LMS will offer structured modules that focus on outcomes, ensuring that health workers develop the skills they need to perform their roles effectively, in line with international health standards.

2.    Interactive and Engaging Content: The LMS will make learning fun and impactful by using gamification, scenario-based quizzes and digital elements like mascots.

3.    Integration with National Systems: The platform will sync with systems like the NEIR (National Electronic Immunisation Registry) and EPI-MIS, enabling real-time progress tracking and aligning training with immunisation performance

4.    Offline Access: Recognising that internet access can be unreliable in some regions, the LMS will allow users to download content, complete modules offline and sync their progress once online.

5.    Mobile-friendly: Designed for mobile devices, the system ensures that vaccinators and managers can access training on smartphones or tablets, commonly available to health workers on location.

6.    Competency Testing: Each module will include built-in pre- and post-training assessments to track learning outcomes, identify skill gaps and support continuous professional development; integrated into central dashboards for monitoring.

Driving impact through reach, accountability and local ownership

From its launch in January 2025, we aim to reach at least 80% of the immunisation workforce by the end of 2025. To support this, the LMS will be embedded in national systems like the National Electronic Immunisation Registry (NEIR), with learners receiving certification that contributes to professional recognition and accountability.

A network of master trainers will scale delivery nationwide, supported by a national competency framework that sets out clear learning standards for all cadres.

Sustainability is a key focus. The system will be hosted on FDI’s existing digital infrastructure, allowing for a smooth transition to full government ownership. Regular updates will ensure that the platform remains relevant, incorporating new vaccines, emerging evidence, and evolving service delivery protocols. Multilingual access will support nationwide reach, including in rural and remote areas.

Towards more equitable immunisation services

Ultimately, this initiative is about improving the quality and equity of immunisation services. Digital tools can help us overcome geographic and resource barriers to training. By investing in the people who deliver vaccines, we’re contributing to stronger public health outcomes and helping Pakistan move towards universal health coverage.