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Use of mobile phones for improving vaccination coverage among children living in rural hard-to-reach areas and urban streets of Bangladesh.

Publication ,  Journal Article
Uddin, MJ; Shamsuzzaman, M; Horng, L; Labrique, A; Vasudevan, L; Zeller, K; Chowdhury, M; Larson, CP; Bishai, D; Alam, N
Published in: Vaccine
January 2016

In Bangladesh, full vaccination rates among children living in rural hard-to-reach areas and urban streets are low. We conducted a quasi-experimental pre-post study of a 12-month mobile phone intervention to improve vaccination among 0-11 months old children in rural hard-to-reach and urban street dweller areas. Software named "mTika" was employed within the existing public health system to electronically register each child's birth and remind mothers about upcoming vaccination dates with text messages. Android smart phones with mTika were provided to all health assistants/vaccinators and supervisors in intervention areas, while mothers used plain cell phones already owned by themselves or their families. Pre and post-intervention vaccination coverage was surveyed in intervention and control areas. Among children over 298 days old, full vaccination coverage actually decreased in control areas--rural baseline 65.9% to endline 55.2% and urban baseline 44.5% to endline 33.9%--while increasing in intervention areas from rural baseline 58.9% to endline 76*8%, difference +18.8% (95% CI 5.7-31.9) and urban baseline 40.7% to endline 57.1%, difference +16.5% (95% CI 3.9-29.0). Difference-in-difference (DID) estimates were +29.5% for rural intervention versus control areas and +27.1% for urban areas for full vaccination in children over 298 days old, and logistic regression adjusting for maternal education, mobile phone ownership, and sex of child showed intervention effect odds ratio (OR) of 3.8 (95% CI 1.5-9.2) in rural areas and 3.0 (95% CI 1.4-6.4) in urban areas. Among all age groups, intervention effects on age-appropriate vaccination coverage were positive: DIDs +13.1-30.5% and ORs 2.5-4.6 (p<0.001 in all comparisons). Qualitative data showed the intervention was well-accepted. Our study demonstrated that a mobile phone intervention can improve vaccination coverage in rural hard-to-reach and urban street dweller communities in Bangladesh. This small-scale successful demonstration should serve as an example to other low-income countries with high mobile phone usage.

Duke Scholars

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Published In

Vaccine

DOI

EISSN

1873-2518

ISSN

0264-410X

Publication Date

January 2016

Volume

34

Issue

2

Start / End Page

276 / 283

Related Subject Headings

  • Young Adult
  • Virology
  • Vaccination
  • Urban Population
  • Text Messaging
  • Smartphone
  • Rural Population
  • Reminder Systems
  • Patient Acceptance of Health Care
  • Non-Randomized Controlled Trials as Topic
 

Citation

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Uddin, M. J., Shamsuzzaman, M., Horng, L., Labrique, A., Vasudevan, L., Zeller, K., … Alam, N. (2016). Use of mobile phones for improving vaccination coverage among children living in rural hard-to-reach areas and urban streets of Bangladesh. Vaccine, 34(2), 276–283. https://doi.org/10.1016/j.vaccine.2015.11.024
Uddin, Md Jasim, Md Shamsuzzaman, Lily Horng, Alain Labrique, Lavanya Vasudevan, Kelsey Zeller, Mridul Chowdhury, Charles P. Larson, David Bishai, and Nurul Alam. “Use of mobile phones for improving vaccination coverage among children living in rural hard-to-reach areas and urban streets of Bangladesh.Vaccine 34, no. 2 (January 2016): 276–83. https://doi.org/10.1016/j.vaccine.2015.11.024.
Uddin MJ, Shamsuzzaman M, Horng L, Labrique A, Vasudevan L, Zeller K, et al. Use of mobile phones for improving vaccination coverage among children living in rural hard-to-reach areas and urban streets of Bangladesh. Vaccine. 2016 Jan;34(2):276–83.
Uddin, Md Jasim, et al. “Use of mobile phones for improving vaccination coverage among children living in rural hard-to-reach areas and urban streets of Bangladesh.Vaccine, vol. 34, no. 2, Jan. 2016, pp. 276–83. Epmc, doi:10.1016/j.vaccine.2015.11.024.
Uddin MJ, Shamsuzzaman M, Horng L, Labrique A, Vasudevan L, Zeller K, Chowdhury M, Larson CP, Bishai D, Alam N. Use of mobile phones for improving vaccination coverage among children living in rural hard-to-reach areas and urban streets of Bangladesh. Vaccine. 2016 Jan;34(2):276–283.
Journal cover image

Published In

Vaccine

DOI

EISSN

1873-2518

ISSN

0264-410X

Publication Date

January 2016

Volume

34

Issue

2

Start / End Page

276 / 283

Related Subject Headings

  • Young Adult
  • Virology
  • Vaccination
  • Urban Population
  • Text Messaging
  • Smartphone
  • Rural Population
  • Reminder Systems
  • Patient Acceptance of Health Care
  • Non-Randomized Controlled Trials as Topic