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Effects of Community Health Nurse-Led Intervention on Childhood Routine Immunization Completion in Primary Health Care Centers in Ibadan, Nigeria

Sunday, 6th of March 2016

This is the second article to appear from Africa this year showing an impact of cellphone reminders on routine completion rates. Are there more experiences waiting for publication?

Effects of Community Health Nurse-Led Intervention on Childhood Routine Immunization Completion in Primary Health Care Centers in Ibadan, Nigeria

V. B. Brown, O. A. Oluwatosin, J. O. Akinyemi, A. A. Adeyemo

 

Journal of Community Health

http://www.ncbi.nlm.nih.gov/pubmed/26395786

 

Abstract below; full text is available to journal subscribers.

 

Immunization coverage of vulnerable children is often sub-optimal in many low- and middle-income countries. The use of a reminder/recall (R/R) system has been one of the strategies shown to be effective in improving immunization rates. In the resent study, we evaluated the effect

of R/R and Primary Health Care Immunization Providers Training (PHCIPT) intervention on routine immunization completion among 595 infants in Ibadan, Nigeria. The design was a group randomized controlled trial with Local Government Area (LGA) being the unit of randomization. Four randomly selected LGAs were randomized to receive a cellphone R/R only (A), a PHCIPT only (B); combined R/R and PHCIPT (C) intervention or serve as a control group (D). Children aged 0–12 weeks were consecutively recruited into each group and followed up for 12

months. The primary outcome measure was routine immunization completion at 12 months of age. At the study endpoint, immunization completion rates were: group A, 98.6%; group B, 70%; group C, 97.3

%; and group D, 57.3%. Compared to the control group, the cellphone R/R group was 72% (RR 1.72, 95% CI 1.50–1.98) and the combined RR/PHCIPT group 70% (RR 1.70, 95% CI 1.47–1.95) more likely to complete immunization. In contrast, immunization completion in the PHCIPT group was marginally different from the control group (RR 1.22, 95% CI 1.03–1.45). These findings remained robust to adjustment for potential predictors of immunization completion as covariates. In conclusion, cellphone reminder/recall was effective in improving immunization completion in this Nigerian setting. Its use is recommended for large scale implementation.