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Use of mobile phones for improving vaccination coverage among children living in rural hard-to-reach areas and urban streets of Bangladesh
Open accessAbstract
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 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 the citing paper
“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 the citing paper
“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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Metadata
- 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)
- 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
- green
- www.ncbi.nlm.nih.gov
- 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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