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[Positive impact on the Expanded Program on Immunization when sending call-back SMS through a Computerized

M Schlumberger, A Bamoko, T M Yaméogo

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    Sending SMS reminders via a Computerized Immunization Register (CIR) significantly improved vaccination timeliness and completeness in Burkina Faso's Expanded Program on Immunization (EPI). This digital approach enhances child health outcomes in sub-Saharan Africa.

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    Area of Science:

    • Public Health
    • Health Informatics
    • Vaccinology

    Background:

    • The Expanded Program on Immunization (EPI) in sub-Saharan Africa faces challenges in vaccination coverage and timeliness.
    • The impact of digital health interventions, specifically Computerized Immunization Registers (CIR) combined with SMS reminders, on EPI performance has not been previously studied in this region.

    Purpose of the Study:

    • To evaluate the effectiveness of a CIR system in conjunction with call-back SMS messages to parents on the quickness and completeness of EPI vaccinations.
    • To assess the impact of SMS reminders on parental adherence to immunization schedules in Burkina Faso.

    Main Methods:

    • A randomized controlled trial was conducted in a health center in Bobo Dioulasso, Burkina Faso.
    • Mothers with newborns were randomized to receive or not receive call-back SMS reminders before EPI sessions, facilitated by a Francophone CIR (Siloxane's Intervax ©).
    • Data on vaccination attendance and timeliness were collected and analyzed for children receiving SMS reminders versus those relying on traditional methods.

    Main Results:

    • Significant increases in vaccination coverage were observed at the second (p<0.001), third (p<0.001), and fourth (p<0.001) EPI sessions for children whose parents received SMS reminders.
    • SMS reminders were associated with significantly shorter quickness to attend the second (p=0.03) and third (p=0.02) EPI sessions.
    • Despite SMS reminders, some parents faced barriers including inability to be reached by phone, relocation to other vaccination centers, or neglect of sessions.

    Conclusions:

    • The use of a CIR with SMS call-back reminders demonstrably improves both the quickness and completeness of Expanded Program on Immunization services in sub-Saharan Africa.
    • Integrating official contact numbers within CIRs is crucial for emergency care and vaccination completion; CIRs should replace paper registers for efficient data management and reporting.
    • Health staff should implement telephone call-backs for under-immunized children and incorporate SMS reminders for pregnant women to enhance prenatal and tetanus vaccination completion.