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Overview
The Pregnant Women and Birth Registry (PWBR) is a digital health initiative designed to ensure that every mother and child enters the immunization system from birth. Developed by IRD and integrated with the Zindagi Mehfooz Electronic Immunization Registry (ZM-EIR), PWBR registers pregnant women and newborns at health facilities in high-risk areas, generating a digital immunization identity that links them to vaccinators for timely birth and routine vaccines. This system strengthens maternal and child health, eliminates zero-dose children, and enhances routine immunization delivery in urban, polio-endemic communities.
Impact Data
37821
newborns registered
97 percent
newborns received OPV0 (birth dose of polio vaccine)
115,836
Total PWBR visits
76070
Enrolments
39766
Follow ups
Our Partners
- Expanded Programme on Immunization (EPI) Sindh
- Health Department Sindh
The need
The need
High maternal and child mortality
Pakistan has one of the highest maternal, fetal and child mortality rates globally.
One in five children unregistered at birth
Without birth registration, newborns remain invisible to health systems and miss critical services, including vaccines.
Marginalized communities at highest risk
In Super High-Risk Union Councils (SHRUCs) — characterized by poor health infrastructure, socio-economic deprivation and recurrent polio transmission — mothers and babies are most likely to remain unregistered and unimmunized.
Zero-dose challenge
Children who do not receive any vaccines are at highest risk of death and disease, and contribute to ongoing outbreaks of polio and other vaccine-preventable illnesses.
Our approach: Pilot - Technical Assistance -Delivery
IRD, in partnership with EPI Sindh and Zindagi Mehfooz, developed the PWBR to systematically register pregnant women and newborns, and connect them to immunization services.
- Digital enrollment at birth facilities: Pregnant women and newborns are registered at 16 high case load birthing facilities.
- Integrated with ZM-EIR: Each mother and newborn receives a unique digital EPI identity linked to the provincial immunization registry, ensuring follow-up for OPV0, BCG and subsequent routine vaccines.
- Real-time linkage to vaccinators: Data is shared with facility and catchment vaccinators, enabling immediate connection to immunization services and reducing missed birth doses.
- Strengthening health systems: PWBR supports birth registration, reduces zero-dose children, and establishes a coordinated mechanism for monitoring maternal and child vaccination.
Our partners
PDI has a nationwide footprint, focusing on districts identified by the national STH survey— 47 at-risk districts requiring annual deworming.
The Drivers Behind Our Impact
The Drivers Behind Our Impact
Early entry into the health system
Registers mothers and babies before or at birth, enabling immediate access to vaccination.
Eliminating zero-dose children
Ensures no newborn is missed for OPV0, BCG or routine immunization.
Digital tracking and accountability
Integrated with ZM-EIR for real-time tracking, follow-up and data-driven planning.
Focused on high-risk geographies
Targets SHRUCs with persistent polio transmission and low immunization coverage.
Scalable and replicable
A digital model that can be extended to other districts and provinces to strengthen maternal and child health systems.