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Innovations in communication technologies for measles supplemental immunization activities: lessons from Kenya
William B Mbabazi1, Collins W Tabu2, Caleb Chemirmir2
1American Red Cross International Response and Programs, PO Box 41275-00100, Nairobi, Kenya, Division of Vaccines and Immunization, Ministry of Health, PO Box 30016, Nairobi, Kenya, Kenya Red Cross, PO Box 40712-00100, Nairobi, Kenya, UNICEF East and Southern African Regional Office, United Nations Complex, Gigiri, PO Box 44145-00100, Nairobi, Kenya and Bill and Melinda Gates Foundation, PO Box 45335-00100 Nairobi, Kenya william.mbabazi@redcross.org.
Background:
To achieve a measles free world, effective communication must be part of all elimination plans. The choice of communication approaches must be evidence based, locally appropriate, interactive and community owned. In this article, we document the innovative approach of using house visits supported by a web-enabled mobile phone application to create a real-time platform for adaptive management of supplemental measles immunization days in Kenya.
Methods:
One thousand nine hundred and fifty-two Red Cross volunteers were recruited, trained and deployed to conduct house-to-house canvassing in 11 urban districts of Kenya. Three days before the campaigns, volunteers conducted house visits with a uniform approach and package of messages. All house visits were documented using a web-enabled mobile phone application (episurveyor®) that in real-time relayed information collected to all campaign management levels. During the campaigns, volunteers reported daily immunizations to their co-ordinators. Post-campaign house visits were also conducted within 4 days, to verify immunization of eligible children, assess information sources and detect adverse events following immunization.
Results:
Fifty-six per cent of the 164 643 households visited said that they had heard about the planned 2012 measles vaccination campaign 1-3 days before start dates. Twenty-five per cent of households were likely to miss the measles supplemental dose if they had not been reassured by the house visit. Pre- and post-campaign reasons for refusal showed that targeted communication reduced misconceptions, fear of injections and trust in herbal remedies. Daily reporting of immunizations using mobile phones informed changes in service delivery plans for better immunization coverage. House visits were more remembered (70%) as sources of information compared with traditional mass awareness channels like megaphones (41%) and radio (37%).
Conclusions:
In high-density settlements, house-to-house visits are easy and more penetrative compared with traditional media approaches. Using mobile phones to document campaign processes and outputs provides real time evidence for service delivery planning to improve immunization coverage.