Implementation of Mobile Phone Reminder System to Improve Immunisation Uptake in Abakaliki, Southeast, Nigeria: Its Feasibility and Acceptability

Background: Reminder systems are effective ways to improve childhood immunisation coverage, but the feasibility of its implementation in rural health facilities in Nigeria has not been adequately evaluated. This study, therefore, determined the feasibility and acceptability of childhood immunisation reminder implementation in rural health facilities in Southeast Nigeria.

Materials and Methods: This is a descriptive-analytical report of a non-randomized control study in rural health facilities in Abakaliki, Nigeria. Mile-Four and St. Vincent hospitals in Ebonyi and Izzi Local Government Areas (LGA) of Ebonyi State respectively were selected purposively. Mile-Four was assigned the phone reminder/recall intervention group and St. Vincent as a control group. The sample size was determined using the formula for comparing two proportions. Caregiver-child pair was recruited in the health facilities and enrolled into the two groups during the infants’ BCG or Pentavalent vaccines 1 immunisation visit and followed till the final scheduled immunisation visit for each child. Data were collected using questionnaire, proforma and checklist. Statistical Package for Social Science (SPSS) version 22.0 was used for analysis. Ethical approval was obtained from the Research and Ethics Committee (REC) of the Federal Teaching Hospital Abakaliki (FETHA), Nigeria.

Results: A total of 290 caregiver-child pairs (145 in each group) participated in the study. All caregivers had access to their own mobile phone or that belonging to a spouse. All the caregivers (100%) in intervention group showed willingness to record their phone numbers and receive immunisation reminders and recalls while 95.2% and 96.6% of the respondents in the control group showed willingness to record their phone numbers and receive reminders and recalls respectively. Out of the 495 reminders and recalls made, 84.4% (418) went through and were answered by recipients. Appointment compliance rate in the intervention group was 91.7%, 91.7% and 91.1% for 6th, 10th and 14th week respectively when compared with 95.9%, 93.1% and 77.9% for 6th, 10th and 14th week respectively in the control group, a difference that was significant in the 14th week (p=0.04)

Conclusion: Mobile phone reminder (interventions) to improve compliance and uptake of routine childhood immunisations are feasible in rural health facilities in Nigeria. Further research to test the potential for scale up in urban setting is recommended.