Mobile phone messages offer unique opportunities to boost immunisation in children —Study

Experts in a new study have proved that sending reminder text messages to mothers of infants on routine childhood immunisation can promote full and timely completion of routine childhood immunisation in Nigeria.

The study said sending reminder text messages can increase especially the rate and completion of measles and yellow fever immunisations, which till date have been very low from previous surveys.

Professor Oladimeji Oladepo, the principal investigator of this study, entitled ‘Mobile phone reminder messages for uptake and completion of basic childhood immunisations by mothers in six geopolitical zones’ presented its findings at a dissemination workshop in Ibadan.

It was supported with funds from the Bill & Melinda Gates Foundation

According to the study, the level of adherence to keeping timely routine immunisation appointment dates and completion of all immunisation was greater in the intervention group compared with the control with different completion rates by vaccines.

Completion BCG jumped from 41.1 per cent in the control group to 77.7 per cent in the intervention group. Completed measles coverage was 55.3 per cent in the intervention group unlike 26.8 per cent in the control group. Also, completed yellow fever coverage jumped from 23.9 per cent in the control group to 75.9 per cent in the intervention group.

The 10-month intervention study involved 3,500 consenting mothers of infants aged between zero and two months with at least one mobile phone randomly selected from primary health centres in six geopolitical zones of Nigeria, including the Federal Capital Territory.

Two rural local government areas from each state, including the Federal Capital Territory, were randomly selected and assigned to the intervention and control groups.

Messages that focused on issues such as the benefits of timely and full completion of immunisation as well as the consequences of non-completion of basic routine immunisation were sent three times in a week between 7.00 am and 7.15 am for 10 months to mothers of infants and their significant others in the intervention group.

Professor Oladepo said: “Several strategies implemented to promote routine immunisation uptake and its timely completion in Nigeria have yielded limited success thus necessitating new innovative approaches.

“One potential approach is the use of reminder text messages through mobile phones in mobilising mothers of infants in rural areas considering lower immunisation coverage and high level of phone ownership.

“The study is saying that using phone technology to promote full and timely uptake of vaccination by women in the rural areas work if it is done well and in the people’s own language and at they wanted it.”

The expert, however, said there was the need to scale up the study to build a national body of evidence with wider geographic spread and integrating data generated into a national database.

They also recommended exploring text messaging as a viable alternate channel of communication for increasing childhood immunisation coverage as well as the integrating m-health strategy into existing national immunisation policy.

Director, Primary Health care, Ganju Local Government, Bauchi state, Mr Idris Muhammed, stated the mobile phone reminders messages is a welcome development that will help track defaulters.

Mr Muhammed said that Nigeria currently spends a lot of money on supplementary immunisation to bridge gaps identified in routine immunisation

He, however, declared that the use of mobile phone reminders messages will be cheaper in tracking defaulting mothers and to increase public awareness on the importance of immunisation and its completion at the expected time.

In Nigeria, although full and timely completion of all childhood immunisations are one of the important goals of the Nigerian immunisation programme, trends in the immunisation coverage has consistently remained low with wide disparities between and within regions especially in rural areas.

Data from the Nigerian National Demographic Health Survey (NDHS) published in 2014 showed that 27 per cent, 29 per cent and 21 per cent of children aged 12 to 23 months were not immunised in 2003, 2008 and 2013 respectively.

The proportion of the fully vaccinated children as at first birthday in Nigeria has never reached 30 per cent in the last three consecutive national surveys.