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Automated phone call and text reminders for childhood immunisations (PRIMM): a randomised controlled trial in Nigeria

Osayame A Ekhaguere1, Rosena O Oluwafemi2, Bolaji Badejoko3

  • 1Neonatal-Perinatal Medicine, Department of Pediatrics, Indiana University, Indianapolis, Indiana, United States.

BMJ Global Health
|May 30, 2019
PubMed

Insights

Combined automated voice and text reminders improved childhood immunisation completion rates in rural Nigeria. This intervention enhanced timely delivery of essential vaccines, addressing a critical gap in child healthcare.

Area of Science:

  • Public Health
  • Global Health
  • Health Informatics

Background:

  • Sub-Saharan Africa faces high under-5 mortality, with vaccine-preventable diseases causing a significant proportion of deaths.
  • Existing text message reminders have shown limited success in improving immunisation completion in rural African settings, potentially due to low adult literacy.
  • The impact of combined automated voice and text reminders on immunisation completion in rural Sub-Saharan Africa remains largely unstudied.

Purpose of the Study:

  • To evaluate the feasibility and impact of combined automated voice and text message reminders on childhood immunisation completion rates in rural Nigeria.
  • To assess the timeliness of immunisation delivery within the intervention and control groups.

Main Methods:

  • A randomized controlled trial was conducted with 600 mother-baby dyads at Mother and Child Hospitals in Ondo State, Nigeria.
  • Participants were randomized to receive either combined automated call and text reminders or standard care for child immunisation.
  • Outcomes included completion of the third pentavalent vaccine (Penta-3) at 18 weeks, 12-month immunisation completion, and vaccination timeliness.
  • Feasibility was assessed by the proportion of reminders successfully received by participants.

Main Results:

  • Infants in the intervention group showed significantly higher rates of Penta-3 (84% vs. 78%) and measles vaccine (73% vs. 65%) completion.
  • Overall immunisation completion at 12 months was significantly improved in the intervention group (57% vs. 47%).
  • The intervention group also demonstrated improved timeliness for Penta-3, measles, and all scheduled immunisations within one week of the recommended date.
  • Feasibility was high, with 92% receiving verification reminders and 86% receiving at least one reminder during the study.

Conclusions:

  • Paired automated voice and text message reminders are a feasible and effective strategy to significantly improve childhood immunisation completion and timeliness in rural Sub-Saharan Africa.
  • This intervention offers a promising approach to overcome barriers to immunisation in low-resource settings.
Abstract

Keywords:
immunisationpaediatricspublic Healthrandomised control trialvaccines

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