Challenges Identified: Digital literacy gaps among healthcare workers. Internet connectivity issues in rural PHCs. Lack of standardised unique identifiers for immunisation records. Low literacy among caregivers, limiting the effectiveness of SMS reminders.

Lessons Learned: Early stakeholder engagement fosters government ownership and scale-up readiness. Healthcare workers adapt quickly when given structured training and mentoring. Community Volunteers are indispensable for identifying defaulters and building trust. Technical support and blended digital-human approaches (e.g., Documentation Associates) are critical in low-connectivity settings.Standardised unique immunisation IDs are urgently needed to integrate fragmented records into a national database. Planned AI-Driven Upgrade - Building on the success of the pilot, ADIS will be enhanced with AI-driven features to improve efficiency, equity, and scalability:1.Predictive Analytics: AI models to forecast vaccine demand, identify high-risk zero-dose clusters, and guide vaccine stock planning. 2.Geospatial Mapping: Real-time mapping of immunisation coverage and zero-dose hotspots to optimise outreach strategies. 3.AI-Powered Chatbots: Interactive support in multiple local languages to engage caregivers, fathers, and community influencers with tailored health messages.4.Interactive Voice Response (IVR) & USSD Codes: Ensures inclusion of caregivers without smartphones or literacy skills.5.Data Quality Assurance: Automated error detection to reduce duplication and improve consistency of immunisation records.6. Integration with NHMIS: Seamless connection to NPHCDA’s national data system for harmonised reporting and decision-making.Policy Recommendations - 1.National Scale-Up of Electronic Immunisation Registers (EIRs) a.Institutionalise EIRs across all PHCs using the ADIS model. b.Integrate EIRs with antenatal care and birth registration systems for automatic newborn enrollment.2.Adopt a Unique Immunisation Identifier System: Collaborate with relevant stakeholders to develop and deploy a national unique ID for immunization tracking. This is essential for ensuring accurate, centralised, and interoperable tracking of children's vaccination records across facilities, LGAs and States, thereby eliminating duplication, improving defaulter follow-up, and enabling effective national planning.3.Strengthen Community Engagement Structures. a.Formalise the role of Community Volunteers (CVs) in immunisation programs. b.Provide incentives and digital tools to support outreach and defaulter tracking. c.Institutionalize digitalized defaulter tracking and zero-dose identification. 4.Invest in Digital Infrastructure and Offline Functionality. a.Equip PHCs with solar-powered devices and offline-capable EIR apps. b.Ensure consistent internet access through partnerships with telecom providers. 5.Enhance Capacity Building and Support Systems. a.Institutionalise regular training and refresher programs for healthcare workers and CVs. b.Establish state-level technical support hubs for digital health tools. 6.Support AI Integration: Endorse and support the development of the ADIS AI version upgrade. This will enable a data-driven, proactive approach to public health interventions, moving beyond reactive measures. 7.Leverage AI and Local Languages for Caregiver Engagement: Integrate voice-based reminders and AI-powered translation in local languages to improve caregiver comprehension and response.