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Cited by 155Vaccine Coverage and HesitancyMobile Health and mHealth ApplicationsICT in Developing Communities

Use of mobile phones for improving vaccination coverage among children living in rural hard-to-reach areas and urban streets of Bangladesh

Open access
Uddin, Md. Jasim, Shamsuzzaman, Md., Horng, Lily, Labrique, Alain, Vasudevan, Lavanya, Zeller, Kelsey, Chowdhury, Mridul, Larson, Charles P. +2 more·2016·Vaccine
DOI 10.1016/j.vaccine.2015.11.024PMC PMC4807732
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Abstract

In Bangladesh, full vaccination rates among children living in rural hard-to-reach areas and urban streets are low. We conducted a quasi-experimental pre-post study of a 12-month mobile phone intervention to improve vaccination among 0-11 months old children in rural hard-to-reach and urban street dweller areas. Software named "mTika" was employed within the existing public health system to electronically register each child's birth and remind mothers about upcoming vaccination dates with text messages. Android smart phones with mTika were provided to all health assistants/vaccinators and supervisors in intervention areas, while mothers used plain cell phones already owned by themselves or their families. Pre and post-intervention vaccination coverage was surveyed in intervention and control areas. Among children over 298 days old, full vaccination coverage actually decreased in control areas--rural baseline 65.9% to endline 55.2% and urban baseline 44.5% to endline 33.9%--while increasing in intervention areas from rural baseline 58.9% to endline 76*8%, difference +18.8% (95% CI 5.7-31.9) and urban baseline 40.7% to endline 57.1%, difference +16.5% (95% CI 3.9-29.0). Difference-in-difference (DID) estimates were +29.5% for rural intervention versus control areas and +27.1% for urban areas for full vaccination in children over 298 days old, and logistic regression adjusting for maternal education, mobile phone ownership, and sex of child showed intervention effect odds ratio (OR) of 3.8 (95% CI 1.5-9.2) in rural areas and 3.0 (95% CI 1.4-6.4) in urban areas. Among all age groups, intervention effects on age-appropriate vaccination coverage were positive: DIDs +13.1-30.5% and ORs 2.5-4.6 (p<0.001 in all comparisons). Qualitative data showed the intervention was well-accepted. Our study demonstrated that a mobile phone intervention can improve vaccination coverage in rural hard-to-reach and urban street dweller communities in Bangladesh. This small-scale successful demonstration should serve as an example to other low-income countries with high mobile phone usage.

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  • One-way mobile phone messaging was used by HCPs to remind mothers of clinic appointments, communicate test results from the clinic and give them information on PNC.

    “One-way mobile phone messaging was used by HCPs to remind mothers of clinic appointments, communicate test results from the clinic and to give them information on PNC [7, 13, 34–39].”

    From mHealth communication to strengthen postnatal care in rural areas: a systematic review (2019) · cites this paper as [39]

  • In rural Bangladesh, some mothers changed beliefs about PNC and consequently attended PNC clinics to have their children vaccinated in a timely manner.

    “In rural areas of Bangladesh, some mothers changed their beliefs about PNC and consequently attended PNC clinics to have their children vaccinated in a timely manner [39]”

    From mHealth communication to strengthen postnatal care in rural areas: a systematic review (2019) · cites this paper as [39]

  • In rural areas of Bangladesh, mobile phone messaging to track newborns due for vaccination led to timely vaccination of children, facilitating PNC.

    “With the use of mobile phone messaging to track newborns due for vaccination, there was timely vaccination of children in rural areas of Bangladesh – the messaging facilitated PNC [39].”

    From mHealth communication to strengthen postnatal care in rural areas: a systematic review (2019) · cites this paper as [39]

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Research works printed but not linked: 1

  1. [22]United Nations Foundation – mobile phones to help meet health needs in Brazil’s indigenous communities Available at: < http://www.unfoundation. org/news-and-media/press-releases/2011/info-as-care.html>

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Authors
Uddin, M. J., Shamsuzzaman, M., Horng, L., Labrique, A., Vasudevan, L., Zeller, K., Chowdhury, M., Larson, C. P., Bishai, D., & Alam, N.
Affiliations
  • International Centre for Diarrhoeal Disease Research (BD)
  • Stanford Medicine (US)
  • Johns Hopkins University (US)
  • Duke University (US)
  • University of British Columbia (CA)
Corresponding author
Uddin, Md. Jasim
ORCID
Venue
Vaccine
Publisher
Elsevier BV
Published
2016-01
Volume
34
Issue
2
Pages
276-283
ISSN
0264-410X (ISSN-L)
DOI
10.1016/j.vaccine.2015.11.024
PMC
PMC4807732
OpenAlex
W2173568466
Cited by
155
References
30
Citations by year
2026: 9 · 2025: 17 · 2024: 13 · 2023: 10 · 2022: 10 · 2021: 21 · 2020: 14 · 2019: 23 · 2018: 22 · 2017: 14 · 2016: 2
FWCI
15.74
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Vaccine (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
Grand Challenges Canada
Topics
  • Social Sciences › Health › Vaccine Coverage and Hesitancy
  • Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
  • Physical Sciences › Computer Science › Information Systems › ICT in Developing Communities
Keywords
mobile phone intervention, childhood vaccination coverage, SMS reminders, hard-to-reach populations, street dwellers, rural health, urban health, health information technology, Bangladesh
MeSH terms
Smartphone, Adult, Bangladesh, Cross-Sectional Studies, Female, Humans, Infant, Infant, Newborn, Male, Patient Acceptance of Health Care, Rural Population, Urban Population, Vaccination, Reminder Systems, Immunization Programs, Young Adult, Text Messaging, Non-Randomized Controlled Trials as Topic

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