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Kayode-Alabi TF, Ibraheem RM, Alabi KO, Bolakale AO, Ernest SK. Mobile phone call reminders to improve oral rehydration salt and zinc adherence for acute diarrhea in children: a single-center, randomized controlled trial. BMC Health Serv Res 2024; 24:1036. [PMID: 39242528 PMCID: PMC11380190 DOI: 10.1186/s12913-024-11507-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2024] [Accepted: 08/28/2024] [Indexed: 09/09/2024] Open
Abstract
BACKGROUND Low-osmolarity oral rehydration salt (ORS) and zinc therapy effectively manage diarrhea in children under five years of age, offering both short- and long-term benefits. Despite this, caregivers' adherence to ORS and zinc is often unsatisfactory due to factors such as forgetfulness, resolution of symptoms, and underestimation of the disease's severity. This study assessed the effect of mobile call reminders on ORS and zinc tablet adherence among children with acute diarrhea in a secondary-level health facility in Kwara State, Nigeria. METHODS Using an open-label, randomized controlled trial design, this study compared caregiver-child pairs with acute diarrhea aged 6-59 months who received standard instructions (SI) alone (control group) and an intervention group (IG) who received SI plus phone call reminders on days three and seven of zinc sulfate therapy. All participants used a pictorial diary to track loose/watery stools and ORS and zinc tablet treatments for ten days. The primary outcome measures were independent and combined adherence to ORS and zinc therapy. The secondary outcomes were independent and combined adherence scores, defined as the percentage of times the ORS was given post-diarrhea and the percentage of prescribed zinc tablets administered out of ten. RESULTS A total of 364/400 mother-child pairs completed the study. The percentage of mothers with full adherence in the intervention group was 82.5% for ORS, 72.1% for zinc, and 58.5% for combined use, compared to 78.8%, 60.8%, and 43.6%, respectively, in the control group. The odds of full adherence to ORS and zinc were 1.6 and 1.7 times higher among intervention mothers [ORS: OR = 1.561, 95% CI = 0.939-2.598, P = 0.085; zinc: OR = 1.671, 95% CI = 1.076-2.593, P = 0.022], and 1.8 times higher for combined use according to WHO guidelines [OR = 1.818, 95% CI = 1.200-2.754, P = 0.005]. The mean adherence scores for the intervention group were higher than those for the control group by 4.1% (95% CI = 0.60-7.60) for ORS, 7.3% (95% CI = 3.74-10.86) for zinc, and 5.7% (95% CI = 3.23-8.17) for the combined treatment. CONCLUSION Phone reminders can effectively improve consistency of home treatment administered by caregivers for children under five years old. TRIAL REGISTRATION The study was registered retrospectively (17/3/2023) with the Pan African Clinical Trial Registry (PACTR202301560735856).
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Affiliation(s)
| | - Rasheedat Mobolaji Ibraheem
- Department of Paediatrics and Child Health, University of Ilorin & University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | | | - Aishat Oluwatoyin Bolakale
- Department of Paediatrics and Child Health, University of Ilorin & University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | - Samuel Kolade Ernest
- Department of Paediatrics and Child Health, University of Ilorin & University of Ilorin Teaching Hospital, Ilorin, Nigeria
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Misago N, Habonimana D, Ciza R, Ndayizeye JP, Kimaro JKA. A digitalized program to improve antenatal health care in a rural setting in North-Western Burundi: Early evidence-based lessons. PLOS DIGITAL HEALTH 2023; 2:e0000133. [PMID: 37068064 PMCID: PMC10109494 DOI: 10.1371/journal.pdig.0000133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 03/13/2023] [Indexed: 04/18/2023]
Abstract
In Burundi, the north-western region continues to grapple with the lowest level of antenatal care (ANC) attendance rate which is constantly about half the national average of 49% ANC4 coverage. Despite a dearth of empirical evidence to understand the determinants of this suboptimal attendance of ANC, widespread evidence informs that women forget scheduled ANC appointments. We designed and tested a digital intervention that uses a reminder model aimed at increasing the number of women who attend at least 4 ANC visits in this region. We enrolled a cohort of 132 pregnant women who were followed until childbirth using a single arm pre- and post-test design. The digital model builds on the collaboration between midwives or nurses, community health workers (CHWs), and pregnant women who are centrally connected through regular automated communications generated by the cPanel of the digital intervention. In addition to ANC attendances, we nested a cross-sectional survey to understand mothers' perceptions and acceptability of the digital intervention using the acceptability framework by Sekhon et al. (2017). Descriptive analyses were performed to observe the trend in ANC attendance and logistic regressions fitted to seize determinants affecting mothers' acceptability of the intervention. Of 132 enrolled pregnant women, 1 (0.76%) dropped out. From a baseline of 23%, nearly 73.7% of mothers attended their subsequent ANC visits after the start of the intervention. From the third month of intervention, about 80% of mothers constantly attended ANC appointments; which corresponds to greater than 200% increase from the baseline. Findings showed that 96.2% of mothers expressed satisfaction, 77.1% positively reacted to automated reminders (attitudes), 70.2% expressed willingness to participate, and 86.3% had the ability to actively participate to the intervention. Conversely, half of mothers confirmed that participation to this programme somewhat affected their time management. A key learning is that digital interventions have a lot of promise to improve pregnancy monitoring in rural settings. However, the overall user acceptability was low especially among mothers lacking personal mobile phone.
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Affiliation(s)
- Nadine Misago
- Health Healing Network Burundi, Santé Maternelle et Néonatale, Bujumbura, Burundi
| | - Desire Habonimana
- Centre de Recherche Universitaire en Santé (CURSA), Department of Community Medicine, Faculty of Medicine, University of Burundi, Bujumbura, 5190, Burundi
| | - Roger Ciza
- Health Healing Network Burundi, Santé Maternelle et Néonatale, Bujumbura, Burundi
| | - Jean Paul Ndayizeye
- Department of Community Medicine, University of Global Health Equity, Butaro, Rwanda
| | - Joyce Kevin Abalo Kimaro
- East African Market Driven and People Centred Integration, Incubator for Integration and Development in East Africa, Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH, East Africa Community, Arusha, Tanzania
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Mahachi K, Kessels J, Boateng K, Jean Baptiste AE, Mitula P, Ekeman E, Nic Lochlainn L, Rosewell A, Sodha SV, Abela-Ridder B, Gabrielli AF. Zero- or missed-dose children in Nigeria: Contributing factors and interventions to overcome immunization service delivery challenges. Vaccine 2022; 40:5433-5444. [PMID: 35973864 PMCID: PMC9485449 DOI: 10.1016/j.vaccine.2022.07.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 06/11/2022] [Accepted: 07/24/2022] [Indexed: 11/28/2022]
Abstract
'Zero-dose' refers to a person who does not receive a single dose of any vaccine in the routine national immunization schedule, while 'missed dose' refers to a person who does not complete the schedule. These peopleremain vulnerable to vaccine-preventable diseases, and are often already disadvantaged due to poverty, conflict, and lack of access to basic health services. Globally, more 22.7 million children are estimated to be zero- or missed-dose, of which an estimated 3.1 million (∼14 %) reside in Nigeria.We conducted a scoping review tosynthesize recent literature on risk factors and interventions for zero- and missed-dosechildren in Nigeria. Our search identified 127 papers, including research into risk factors only (n = 66); interventions only (n = 34); both risk factors and interventions (n = 18); and publications that made recommendations only (n = 9). The most frequently reported factors influencing childhood vaccine uptake were maternal factors (n = 77), particularly maternal education (n = 22) and access to ante- and perinatal care (n = 19); heterogeneity between different types of communities - including location, region, wealth, religion, population composition, and other challenges (n = 50); access to vaccination, i.e., proximity of facilities with vaccines and vaccinators (n = 37); and awareness about immunization - including safety, efficacy, importance, and schedules (n = 18).Literature assessing implementation of interventions was more scattered, and heavily skewed towards vaccination campaigns and polio eradication efforts. Major evidence gaps exist in how to deliver effective and sustainable routine childhood immunization. Overall, further work is needed to operationalise the learnings from these studies, e.g. through applying findings to Nigeria's next review of vaccination plans, and using this summary as a basis for further investigation and specific recommendations on effective interventions.
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Affiliation(s)
- Kurayi Mahachi
- College of Public Health, University of Iowa, Iowa City, Iowa, United States
| | | | - Kofi Boateng
- Nigeria Country Office, World Health Organization, Abuja, Nigeria
| | | | - Pamela Mitula
- Inter-Country Support Team, Regional Office for Africa, World Health Organization, Ouagadougou, Burkina Faso
| | - Ebru Ekeman
- Department of Immunization, Vaccines and Biologicals (IVB), World Health Organization, Geneva, Switzerland
| | - Laura Nic Lochlainn
- Department of Immunization, Vaccines and Biologicals (IVB), World Health Organization, Geneva, Switzerland
| | - Alexander Rosewell
- Department of Immunization, Vaccines and Biologicals (IVB), World Health Organization, Geneva, Switzerland
| | - Samir V Sodha
- Department of Immunization, Vaccines and Biologicals (IVB), World Health Organization, Geneva, Switzerland
| | - Bernadette Abela-Ridder
- Department of Control of Neglected Tropical Diseases (NTD), World Health Organization, Geneva, Switzerland
| | - Albis Francesco Gabrielli
- Department of Control of Neglected Tropical Diseases (NTD), World Health Organization, Geneva, Switzerland.
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Eze P, Agu SA, Agu UJ, Acharya Y. Acceptability of mobile-phone reminders for routine childhood vaccination appointments in Nigeria - a systematic review and meta-analysis. BMC Health Serv Res 2021; 21:1276. [PMID: 34836531 PMCID: PMC8627092 DOI: 10.1186/s12913-021-07296-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 10/29/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mobile-phone reminders have gained traction among policymakers as a way to improve childhood vaccination coverage and timeliness. However, there is limited evidence on the acceptability of mobile-phone reminders among patients and caregivers. This systematic review and meta-analysis aimed to evaluate the ownership of mobile-phone device and the willingness to receive mobile-phone reminders among mothers/caregivers utilizing routine childhood immunization services in Nigeria. METHOD MEDLINE, Scopus, CINAHL, CNKI, AJOL (African Journal Online), and Web of Science were systematically searched for studies on the acceptability of mobile-phone reminders for routine immunization appointments among mothers/caregivers in Nigeria. Studies were assessed for methodological quality using the Newcastle Ottawa Scale and JBI critical appraisal checklists. Meta-analysis was conducted using random-effects model to generate pooled estimates (proportion) of mothers who owned at least one mobile phone and proportion of mothers willing to receive mobile-phone reminders. RESULTS Sixteen studies (13 cross-sectional and three interventional) involving a total of 9923 mothers across 15 states and the Federal Capital Territory Abuja met inclusion criteria. Pooled estimates showed that the proportion of mothers who owned at least one mobile phone was 96.4% (95% CI = 94.1-98.2%; I2 = 96.3%) while the proportion of mothers willing to receive mobile-phone reminders was 86.0% (95% CI = 79.8-91.3%, I2 = 98.4%). Most mothers preferred to receive text message reminders at least 24 h before the routine immunization appointment day, and in the morning hours. Approximately 52.8% of the mothers preferred to receive reminders in English, the country's official language. CONCLUSION Current evidence suggests a high acceptability for mobile-phone reminder interventions to improve routine childhood immunization coverage and timeliness. Further studies, however, are needed to better understand unique regional preferences and assess the operational costs, long-term effects, and risks of this intervention. SYSTEMATIC REVIEW PROTOCOL REGISTRATION PROSPERO CRD42021234183.
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Affiliation(s)
- Paul Eze
- Department of Health Policy and Administration, Pennsylvania State University, University Park, PA 16802 USA
| | - Sergius Alex Agu
- Department of Paediatrics, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria
| | - Ujunwa Justina Agu
- Department of Paediatrics, Enugu State University Teaching Hospital, Parklane, Enugu, Nigeria
| | - Yubraj Acharya
- Department of Health Policy and Administration, Pennsylvania State University, University Park, PA 16802 USA
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Ibraheem RM, Bello AO, Ibrahim OR, Garba BI, Aliu R, Abdulkadir MB, Hashim R, Ibrahim LM, Mohammed SS, Sambo AH, Ahmed G, Akintola MA. Willingness of Mothers to Receive Reminders for Routine Vaccination Appointments in Northern Nigeria: A Multi-Centre Cross-Sectional Study. J Trop Pediatr 2021; 67:6377122. [PMID: 34580717 DOI: 10.1093/tropej/fmab085] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Routine vaccination, a cost-effective means of preventing deadly childhood disease, has a low coverage in Nigeria. The study assessed the willingness of mothers to receive reminder messages for routine vaccination appointments in Northern Nigeria. METHODS A multi-centre cross-sectional study involving at least 363 mother-infant pairs per centre from five states in Northern Nigeria. Data collected include the socio-demographic details, responses on parental phone ownership, mothers' willingness to receive reminders for immunization appointments and the reminder type characteristics. Data analysis was done with SPSS. RESULTS Of the 1952 mother-infant pairs, ownership of at least one household phone was 97.7%. In total, 1613 (82.6%) mothers were willing to receive reminders. A majority (62.2%) of mothers preferred phone calls. A day before the vaccination appointment was the preferred timing (78.1%), and the predominant communication language was the local language for each region.The odds of being willing to receive reminders were 3.1 times, 2.6 times and 1.8 times higher in those with no formal education, primary education and secondary education, respectively, compared with mothers with tertiary education, each p < 0.05. Mothers who delivered at home were significantly less likely to want reminder messages (p = 0.03). CONCLUSION Eight of 10 women in Northern Nigeria are willing to receive a reminder for their child. The predominant mode of reminder preferred is phone calls using the local language. Deployment of mobile phone reminders strategy in Northern Nigeria as a means to improve vaccination uptake is feasible. The institution of this strategy can be in collaboration with service providers.
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Affiliation(s)
- Rasheedat Mobolaji Ibraheem
- Department of Paediatrics & Child Health, University of Ilorin and University of Ilorin Teaching Hospital, Ilorin, Kwara State PMB 1515, Nigeria
| | - Afeez Oyesola Bello
- Department of Paediatrics, Federal Medical Centre, Bida, Niger State 912231, PMB 14, Nigeria
| | - Olayinka Rasheed Ibrahim
- Department of Paediatrics, Federal Medical Centre, Katsina, Katsina State 820241, PMB 2121, Nigeria
| | - Bilkisu Ilah Garba
- Department of Paediatrics, Usmanu Danfodiyo University Teaching Hospital, Sokoto 840103, PMB 2370, Nigeria
| | - Rasaki Aliu
- Department of Paediatrics, Gombe State University/Federal Teaching Hospital, Gombe 760222, PMB. 0037, Nigeria
| | - Mohammed Baba Abdulkadir
- Department of Paediatrics & Child Health, University of Ilorin and University of Ilorin Teaching Hospital, Ilorin, Kwara State PMB 1515, Nigeria
| | - Rabiu Hashim
- Department of Paediatrics, Ahmad Sani Yariman Bakura Specialist Hospital, Gusau, Zamfara State 860231, Nigeria
| | - Lawal Magaji Ibrahim
- Department of Paediatrics, Federal Medical Centre, Katsina, Katsina State 820241, PMB 2121, Nigeria
| | | | - Amina Hannatu Sambo
- Department of Paediatrics, Ahmad Sani Yariman Bakura Specialist Hospital, Gusau, Zamfara State 860231, Nigeria
| | - Grace Ahmed
- Department of Paediatrics, Federal Medical Centre, Bida, Niger State 912231, PMB 14, Nigeria
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Mekonnen ZA, Gelaye KA, Were MC, Tilahun B. Acceptability, Barriers and Facilitators of Mobile Text Message Reminder System Implementation in Improving Child Vaccination: A Qualitative Study in Northwest Ethiopia. J Multidiscip Healthc 2021; 14:605-616. [PMID: 33727823 PMCID: PMC7955748 DOI: 10.2147/jmdh.s298167] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 02/23/2021] [Indexed: 12/31/2022] Open
Abstract
Background Mobile phone text message-based mHealth interventions have shown promise in improving health service delivery. Despite the promising findings at a small scale and few contexts, implementing new technologies as part of changes to health care services is inherently challenging. Though there is a potential to introduce mHealth initiatives to health systems of developing countries, existing evidence on the barriers and facilitators of implementation in different contexts is not adequate. Therefore, this study aimed to explore the acceptability, barriers and facilitators of implementing mobile text message reminder system for child vaccination in Ethiopia. Methods This study applied a phenomenological study design. The study was conducted in north-west, Ethiopia between July 28 and August 19, 2020. A total of 23 participants were purposively selected for the in-depth and key informant interviews. We used an interview guide to collect data and audio-records of interviews were transcribed verbatim. Coding was done to identify patterns and thematic analysis was conducted using ATLAS ti7 software. Results The findings indicated that mothers were receptive to mobile text message reminders for their child’s vaccination. Low mobile phone ownership, access to mobile network, access to electricity and illiteracy among the target population were identified as barriers that would affect implementation. Confidentiality and security-related issues are not barriers to implementation of text message reminders for child vaccination service. Facilitators for implementation include stakeholder collaboration, providing orientation/training to users, and willingness to pay by clients. Conclusion In this study, using mobile phone text message reminders for child vaccination services are acceptable by clients. Barriers identified were related to inadequate ICT infrastructure and other technical issues. Addressing the potential barriers and leveraging the existing opportunities could optimize the implementation in resource-limited settings. Before actual implementation, program implementers should also consider providing orientation to users on the proposed mHealth program.
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Affiliation(s)
- Zeleke Abebaw Mekonnen
- Department of Health Informatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.,Health System Directorate, Federal Ministry of Health, Addis Ababa, Ethiopia
| | - Kassahun Alemu Gelaye
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Martin C Were
- Department of Biomedical Informatics, Vanderbilt Medical Center, Nashville, TN, 37232, USA
| | - Binyam Tilahun
- Department of Health Informatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Osei E, Mashamba-Thompson TP. Mobile health applications for disease screening and treatment support in low-and middle-income countries: A narrative review. Heliyon 2021; 7:e06639. [PMID: 33869857 PMCID: PMC8035664 DOI: 10.1016/j.heliyon.2021.e06639] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 11/15/2020] [Accepted: 03/26/2021] [Indexed: 12/12/2022] Open
Abstract
The advances in mobile technologies and applications are driving the transformation in health services delivery globally. Mobile phone penetration is increasing exponentially in low-and middle-income countries, hence using mobile phones for healthcare services could reach more people in resource-limited settings than the traditional forms of healthcare provision. The review presents recent literature on facilitators and barriers of implementing mHealth for disease screening and treatment support in low-and middle-income countries. We searched for relevant literature from the following electronic databases: MEDLINE; CINAHL with full text via EBSCOhost; Science Direct; PubMed; Google Scholar and Web of Science using the keywords for relevant studies. We searched for published studies from 2015 to August 2020 with no language limitations. A total of 721 articles identified, 125 articles met the inclusion criteria and were included in the qualitative synthesis. The review demonstrates relevant facilitators for the implementation of mHealth, which includes knowledge, attitudes, and perceptions of stakeholders on the use of mHealth and the performance of mHealth for disease diagnosis in low and-middle-income countries. Barriers and challenges hindering the implementation of mHealth applications were also identified. We proposed a framework for improving the implementation of mHealth for disease screening and treatment support in low-and middle-income countries.
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Affiliation(s)
- Ernest Osei
- Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Tivani P. Mashamba-Thompson
- Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
- Faculty of Health Sciences, University of Pretoria, Prinshof Campus, Pretoria, South Africa
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Ehlman DC, Magoola J, Tanifum P, Wallace AS, Behumbiize P, Mayanja R, Luzze H, Yukich J, Daniels D, Mugenyi K, Baryarama F, Ayebazibwe N, Conklin L. Evaluating a Mobile Phone-Delivered Text Message Reminder Intervention to Reduce Infant Vaccination Dropout in Arua, Uganda: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2021; 10:e17262. [PMID: 33625372 PMCID: PMC7946592 DOI: 10.2196/17262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 06/11/2020] [Accepted: 12/30/2020] [Indexed: 11/25/2022] Open
Abstract
Background Globally, suboptimal vaccine coverage is a public health concern. According to Uganda’s 2016 Demographic and Health Survey, only 49% of 12- to 23-month-old children received all recommended vaccinations by 12 months of age. Innovative ways are needed to increase coverage, reduce dropout, and increase awareness among caregivers to bring children for timely vaccination. Objective This study evaluates a personalized, automated caregiver mobile phone–delivered text message reminder intervention to reduce the proportion of children who start but do not complete the vaccination series for children aged 12 months and younger in select health facilities in Arua district. Methods A two-arm, multicenter, parallel group randomized controlled trial was conducted in four health facilities providing vaccination services in and around the town of Arua. Caregivers of children between 6 weeks and 6 months of age at the time of their first dose of pentavalent vaccine (Penta1; containing diphtheria, tetanus, pertussis, hepatitis B, and Haemophilus influenzae type b antigens) were recruited and interviewed. All participants received the standard of care, defined as the health worker providing child vaccination home-based records to caregivers as available and providing verbal instruction of when to return for the next visit. At the end of each day, caregivers and their children were randomized by computer either to receive or not receive personalized, automated text message reminders for their subsequent vaccination visits according to the national schedule. Text message reminders for Penta2 were sent 2 days before, on the day of, and 2 days after the scheduled vaccination visit. Reminders for Penta3 and the measles-containing vaccine were sent on the scheduled day of vaccination and 5 and 7 days after the scheduled day. Study personnel conducted postintervention follow-up interviews with participants at the health facilities during the children’s measles-containing vaccine visit. In addition, focus group discussions were conducted to assess caregiver acceptability of the intervention, economic data were collected to evaluate the incremental costs and cost-effectiveness of the intervention, and health facility record review forms were completed to capture service delivery process indicators. Results Of the 3485 screened participants, 1961 were enrolled from a sample size of 1962. Enrollment concluded in August 2016. Follow-up interviews of study participants, including data extraction from the children’s vaccination cards, data extraction from the health facility immunization registers, completion of the health facility record review forms, and focus group discussions were completed by December 2017. The results are expected to be released in 2021. Conclusions Prompting health-seeking behavior with reminders has been shown to improve health intervention uptake. Mobile phone ownership continues to grow in Uganda, so their use in vaccination interventions such as this study is logical and should be evaluated with scientifically rigorous study designs. Trial Registration ClinicalTrials.gov NCT04177485; https://clinicaltrials.gov/ct2/show/NCT04177485 International Registered Report Identifier (IRRID) DERR1-10.2196/17262
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Affiliation(s)
- Daniel C Ehlman
- Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | | | - Patricia Tanifum
- Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Aaron S Wallace
- Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | | | | | - Henry Luzze
- Uganda National Expanded Program on Immunization, Ministry of Health, Kampala, Uganda
| | - Joshua Yukich
- Department of Tropical Medicine, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, United States
| | - Danni Daniels
- Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | | | | | | | - Laura Conklin
- Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, United States
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Mekonnen ZA, Gelaye KA, Were MC, Tilahun B. Mothers intention and preference to use mobile phone text message reminders for child vaccination in Northwest Ethiopia. BMJ Health Care Inform 2021; 28:e100193. [PMID: 33608258 PMCID: PMC7898827 DOI: 10.1136/bmjhci-2020-100193] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 12/29/2020] [Accepted: 02/03/2021] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVES With the unprecedented penetration of mobile devices in the developing world, mHealth applications are being leveraged for different health domains. Among the different factors that affect the use of mHealth interventions is the intention and preference of end-users to use the system. This study aimed to assess mother's intention and preference to use text message reminders for vaccination in Ethiopia. METHODS A cross-sectional study was conducted among 460 mothers selected through a systematic random sampling technique. Initially, descriptive statistics were computed. Binary logistic regression analysis was also used to assess factors associated with the outcome variable. RESULTS In this study, of the 456 mothers included for analysis, 360 (78.9%) of mothers have intention to use text message reminders for vaccination. Of these, 270 (75%) wanted to receive the reminders a day before the vaccination due date. Mothers aged 35 years or more (AOR=0.35; 95% CI: 0.15 to 0.83), secondary education and above (AOR=4.43; 95% CI: 2.05 to 9.58), duration of mobile phone use (AOR=3.63; 95% CI: 1.66 to 7.94), perceived usefulness (AOR=6.37; 95% CI: 3.13 to 12.98) and perceived ease of use (AOR=3.85; 95% CI: 2.06 to 7.18) were predictors of intention to use text messages for vaccination. CONCLUSION In conclusion, majority of mothers have the intention to use text message reminders for child vaccination. Mother's age, education, duration of mobile phone use, perceived usefulness and perceived ease of use were associated with intention of mothers to use text messages for vaccination. Considering these predictors and user's preferences before developing and testing text message reminder systems is recommended.
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Affiliation(s)
- Zeleke Abebaw Mekonnen
- Department of Health Informatics, Institute of Public Health,College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Kassahun Alemu Gelaye
- Department of Epidemiology and Biostatistics, Institute of Public Health,College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Martin C Were
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Binyam Tilahun
- Department of Health Informatics, Institute of Public Health,College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Nigerian rural mothers' knowledge of routine childhood immunizations and attitudes about use of reminder text messages for promoting timely completion. J Public Health Policy 2019; 40:459-477. [PMID: 31427672 PMCID: PMC7771534 DOI: 10.1057/s41271-019-00180-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Mothers' poor knowledge and attitudes about routine immunization impede childhood immunization completion. This study assessed mothers' knowledge in rural communities about routine immunization and acceptability of mobile phone reminder text messages as an intervention for improving uptake and timely completion of routine immunization. The study adopted a descriptive cross-sectional design among 3440 consenting mothers of infants in six randomly selected Nigerian states and in the Federal Capital Territory (FCT). We used a Focus Group Discussion guide and validated questionnaire to collect data; we analysed data using a thematic approach and descriptive statistics. Respondents' ages were 26.7 ± 5.5 years. Knowledge of routine immunization was poor; attitudinal disposition was positive. Most (90.5%) indicated willingness to accept reminder text messages for routine immunization and 91.5% opined that mobile phones can be effective in providing such information. Mothers' willingness to accept the use of SMS reminder text messages for promoting routine immunization completion requires well-designed and culture-sensitive persuasive messages.
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Kebede AS, Ajayi IO, Arowojolu AO. Effect of enhanced reminders on postnatal clinic attendance in Addis Ababa, Ethiopia: a cluster randomized controlled trial. Glob Health Action 2019; 12:1609297. [PMID: 31124401 PMCID: PMC6534243 DOI: 10.1080/16549716.2019.1609297] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Background: Failure to attend maternal health services is an intractable challenge for the health-care system in low- and middle-income countries. The use of technology for reminding patients about their appointments has been demonstrated to be an effective (future) tool toward increased health care services utilization in developing countries, such as Ethiopia. Objective: We aimed to investigate the effect of enhanced reminders on postnatal care attendance versus usual care (notification of an appointment at discharge). Methods: The study was a cluster randomized controlled trial: out of eligible 86 health centers, 16 health centers in Addis Ababa (AA) were randomized to either the intervention (8) or the control (8) groups; with a total of 350 mothers equally randomized into each arm. Mothers in the intervention group received the SMS (short message service) or a voice call reminder at 48 and 24 hours before the due postnatal appointment, whereas the control group received only the usual notification of appointments provided by health professionals at discharge from the ward following delivery. We recruited participants on wards after delivery at discharge and followed them up to 6 weeks. This study's primary outcome was postnatal visit compliance. Our assessment consisted of a two-level bivariate and a multivariate ordinal logistic regression analysis. Results: The majority (97.7%) of the participants completed the study; 173(98.9%) of women in the intervention group and 169 (96.5%) of women in the control group. There was a statistically significant difference in postnatal care (PNC) compliance among women who were in the intervention versus the control group (p-value = 0.005). Higher odds of postnatal compliance was observed among the intervention group (AOR:2.98, 95% CI 1.51-5.8). Conclusions: Mobile phone reminders were effective in terms of enhancing adherence to PNC appointments. This indicates integration of mobile phone reminders in postnatal care could improve postnatal appointment compliance.
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Affiliation(s)
- Abraham Sahilemichael Kebede
- a Pan Africa University Life and Earth Sciences Institute (Including Health and Agriculture) , University of Ibadan , Ibadan , Nigeria
| | - IkeOluwapo O Ajayi
- b Department of Epidemiology and Medical Statistics, Faculty of Public Health , College of Medicine, University of Ibadan , Ibadan , Nigeria
| | - Ayodele O Arowojolu
- c Department of Obstetrics and Gynecology, Faculty of Clinical Medicine , College of Medicine, University of Ibadan , Ibadan , Nigeria
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Mathew JL, Vashishtha VM, Nimbalkar S. Mobile Phone Technology Based Incentives to Enhance Routine Childhood Immunization. Indian Pediatr 2018. [PMID: 30218517 DOI: 10.1007/s13312-018-1360-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Tran BX, Nguyen QN, Dang AK, Vu GT, Hoang VQ, La PV, Hoang DA, Van Dam N, Vuong TT, Nguyen LH, Le HT, Latkin CA, Ho CS, Ho RC. Acceptability of and willingness to pay for using a smartphone-based vaccination application in a Vietnamese cohort. Patient Prefer Adherence 2018; 12:2583-2591. [PMID: 30584282 PMCID: PMC6287420 DOI: 10.2147/ppa.s185129] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The increasing accessibility of smartphone in Vietnam shows potential in using smartphone applications for vaccination management to improve compliance. However, the acceptability and financial feasibility of using this application in Vietnam have not yet been understood. This study measured the general perception of and willingness to pay (WTP) for using smartphone-based vaccination management applications and their associated factors in Vietnam. SUBJECTS AND METHODS A cross-sectional study was conducted between March and April 2016 in an urban vaccination clinic at the Hanoi Medical University in Vietnam. Convenience sampling was used to recruit 429 adult participants who had received vaccinations or whose children were vaccinated. Sociodemographic characteristics and the acceptability of and WTP for using smartphone-based vaccination management applications were evaluated. RESULTS Among participants who used smartphone applications, 5% were aware of existing vaccination management applications, of whom 57.9% had previously used the applications. About 69.6% of participants believed that the applications were necessary, 93.7% of them were also willing to use the applications, and 79.1% were willing to pay 92.7 thousand Vietnamese dong (VND) for the applications on average. Participants who were older, unemployed, earned more household income, and having knowledge about functions and benefits of vaccination were less likely to use the vaccination applications. Participants who brought their children to get vaccinated at younger age and with higher level of education were willing to pay more for vaccination applications. CONCLUSION High levels of acceptability of, willingness to use, and WTP for smartphone-based vaccination management applications among Vietnamese participants are reported. Increased education and awareness about the benefits of vaccination and vaccination management applications through community health workers might increase the feasibility of implementing such applications and perception toward their usage among young adult smartphone users. In addition, building a stronger relationship with health care providers at hospitals might improve the application's visibility and adoption.
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Affiliation(s)
- Bach Xuan Tran
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam,
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA,
| | - Quang N Nguyen
- Université Claude Bernard Lyon 1, Villeurbanne 69100, France
- Center of Excellence in Evidence-based Medicine, Nguyen Tat Thanh University, Ho Chi Minh City 700000, Vietnam
| | - Anh Kim Dang
- Institute for Global Health Innovations, Duy Tan University, Da Nang 550000, Vietnam
| | - Giang Thu Vu
- Center of Excellence in Evidence-based Medicine, Nguyen Tat Thanh University, Ho Chi Minh City 700000, Vietnam
| | - Vuong Quan Hoang
- Centre for Interdisciplinary Social Research, Thanh Tay University, Hanoi, Vietnam
| | | | | | - Nhue Van Dam
- Faculty of Graduate Studies, National Economics University, Hanoi, Vietnam
| | | | - Long Hoang Nguyen
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City 700000, Vietnam
| | - Huong Thi Le
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam,
| | - Carl A Latkin
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA,
| | - Cyrus Sh Ho
- Department of Psychological Medicine, National University Hospital, Singapore 119074, Singapore
| | - Roger Cm Ho
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City 700000, Vietnam
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119074, Singapore
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