Key challenges Deploying the web-based LIS across national sites surfaced both human and technical challenges. On the process side, we managed varied digital literacy levels and initial resistance to change among staff shifting away from legacy workflows. Technically, the primary hurdles involved interfacing with fragmented legacy laboratory analyzers and maintaining seamless web connectivity in areas with unstable infrastructure

The successful nationwide implementation of iEmdoo was driven by strong leadership from the Ministry of Health, close collaboration with the World Health Organization and other development partners, and active engagement of healthcare providers throughout the implementation process. The adoption of national policies standardized digital immunization workflows, comprehensive user training, and continuous technical support accelerated system uptake. Integration with national health information systems and the government interoperability platform (Tunduk) improved data exchange, reduced duplicate data entry, and strengthened the sustainability and scalability of the national immunization program.