Reducing routine vaccination dropout rates: evaluating two interventions in three Kenyan districts, 2014

Area of Science:

• Public Health
• Global Health
• Pediatrics

Background:

• Vaccine-preventable diseases cause nearly 20% of annual deaths in children under 5 globally.
• Incomplete or delayed vaccination schedules contribute to preventable childhood mortality worldwide.
• Interventions are needed to reduce dropout rates in childhood vaccination programs.

Purpose of the Study:

• To evaluate the effectiveness of text message and sticker reminders in reducing vaccination dropout rates.
• To compare the impact of mobile phone text messages versus physical stickers on vaccination adherence.
• To identify factors associated with dropping out of the vaccination program.

Main Methods:

• A randomized controlled trial was conducted in three districts in Kenya.
• Health facilities were allocated to text message reminders, sticker reminders, or routine reminders (control).
• Children under 12 months were enrolled, and dropout was defined as missing the third pentavalent vaccine dose by two weeks.

Main Results:

• Text message reminders reduced dropout rates to 4%, compared to 17% in the control group.
• Sticker reminders showed no significant difference in dropout rates compared to controls (16% vs 17%).
• Lower caregiver education and longer distance to health facilities were associated with higher dropout odds.

Conclusions:

• Text message reminders are an effective strategy to decrease vaccination dropout rates in Kenya.
• The study recommends implementing text message reminders in routine immunization services.
• Targeted interventions may be necessary for caregivers with lower education or those living farther from facilities.