Strong immunization programs rely not only on vaccines and logistics but also on a skilled, accountable workforce. Yet in many health systems, performance management remains fragmented, paper-based, or poorly integrated into decision-making (WHO, 2016). Prior to the digitization initiative launched in 2025, appraisal processes within Cameroon’s Expanded Programme on Immunization (EPI) were costly, slow, and unable to generate the real-time insights needed to strengthen workforce performance.
To address this gap, the Solina team supported the Cameroon EPI under the GAVI EPI Cameroon Leadership Management and Coordination (LMC) project to develop a digitised Performance Management System (PMS) to modernise staff appraisal and improve accountability across the program. Built within the existing Microsoft 365 ecosystem using Power Apps, SharePoint, and Power BI, the system provides a cost-free and sustainable platform for tracking workforce performance and supporting data-driven leadership decisions.
Designing a System that Works for Public Health Programs
The PMS was developed through a structured five-step process: framework design, tool customization, testing, capacity building, and national rollout. As part of the design phase, the team mapped 63 general performance indicators and 189 technical metrics across 11 central and 5 regional EPI departments, ensuring the system captured the full scope of program responsibilities.
The platform was designed to include role-specific appraisal forms, automated reviewer–reviewee matching, bilingual functionality (English and French), and real-time dashboards that allow both staff and program leadership to track progress and identify performance gaps.
Because the system is integrated into the EPI’s existing digital ecosystem, it avoids costly licensing requirements while maintaining data security and interoperability.
From Pilot to National Rollout
Following development, the platform was initially tested with 20 EPI staff. User feedback from the pilot helped refine the system’s functionality, usability, and the relevance of performance metrics. Results showed that 100% of participants rated the platform as good or excellent for ease of use and expressed satisfaction with its features, confirming strong acceptance among program staff.
To ensure sustainability, the project also focused on institutional capacity. 8 Human Resource and data management staff were trained on system configuration, analytics, and troubleshooting, enabling the EPI to maintain and manage the platform independently.
The system was subsequently rolled out across all ten regions of Cameroon and the central EPI level by the Q4 2025 performance appraisal cycle. Completion rates for performance reviews ranged widely across regions from 80% to 100%, providing leadership with unprecedented visibility into workforce performance nationwide.
Strengthening Accountability and Decision-Making
The digitized PMS has transformed how staff performance data is generated and used within the program. Personalized dashboards now allow staff to track their own appraisal progress and performance indicators, while leadership dashboards provide program managers with actionable insights to guide supervision, coaching, and capacity building.
The platform has also delivered clear efficiency gains. By replacing the previous appraisal system, the new PMS eliminated approximately US$1,380 in annual licensing costs of the previous platform, demonstrating how digital innovation can improve program management while reducing financial burden.
Beyond cost savings, the system has fostered a stronger culture of accountability and transparency within the EPI. Performance data can now be reviewed in real time, enabling managers to quickly identify gaps and support staff where improvements are needed.
A Model for Scalable and Sustainable Workforce Strengthening
Cameroon’s experience demonstrates how locally driven digital innovation can modernize performance management in public health systems. By aligning the platform with the EPI’s existing Microsoft 365 infrastructure, engaging staff through iterative co-design, and training internal HR and data management teams to configure, manage, and troubleshoot the system, the program has ensured that the PMS can be maintained and adapted internally without external dependence.
The EPI plans to institutionalize the platform as part of its routine performance appraisal cycle, using the dashboards to inform supervision, coaching, and capacity-building priorities across departments and regions. This integration into existing workflows positions the PMS as a sustainable and scalable model for strengthening workforce governance across immunization programs and broader health systems in Africa.
The innovation has also attracted broader interest across the public health community. The work was presented at the 4th International Conference on Public Health in Africa (CPHIA 2025), held from 22–25 October 2025 in Durban, South Africa, where it contributed to discussions on digital innovation and workforce strengthening in African health systems. The conference convened policymakers, researchers, and public health leaders from across the continent to showcase African-led solutions for stronger and more resilient health systems.
As countries continue to invest in stronger health systems, Cameroon’s digital PMS demonstrates how practical, cost-effective digital tools can strengthen accountability, support data-driven management, and help build a more capable and high-performing public health workforce.
Reference
World Health Organization. (2016). Global strategy on human resources for health: Workforce 2030. World Health Organization. https://www.who.int/publications/i/item/9789241511131
