advanced search

<< Back To Home

Improving hepatitis B birth dose in rural Lao People´s Democratic Republic through the use of mobile phones to facilitate communication

Wednesday, 2nd of November 2016

Vaccine, Volume 34, Issue 47, 11 November 2016, Pages 5777–5784

Improving hepatitis B birth dose in rural Lao People´s Democratic Republic through the use of mobile phones to facilitate communication

Anonh Xeuatvongsa, MD, PhDa, ,

Siddhartha Sankar Datta, MD, MPHb, ,

Edna Moturi, MBBSc, d, 1, , ,

Kathleen Wannemuehler, PhDc, ,

Phanmanisone Philakong, MDb, ,

Viengnakhone Vongxay, MD, MPHe, ,

Vansy Vilayvone, MD, MPHe, ,

Minal K. Patel, MDc, ,

a National Immunization Program, Mother and Child Health Center, Lao People´s Democratic Republic Ministry of Health, Simuang Road, Vientiane, Lao Democratic People´s Republic

b WHO Representative Office in Laos, 125 Saphanthong Road, Unit 5, Ban Saphanthongtai, Sisattanak District, Vientiane, Lao Democratic People´s Republic

c Global Immunization Division, Centers for Disease Control and Prevention, 1600 Clifton Road, NE, Atlanta, GA 30329, United States

d Epidemic Intelligence Service, Centers for Disease Control and Prevention, 1600 Clifton Road, NE, Atlanta, GA 30329, United States

e Faculty of Postgraduate Studies, University of Health Sciences, Lao People´s Democratic Republic Ministry of Health, Samsenthai Road, Vientiane Capital, Lao Democratic People´s Republic

Received 25 June 2016, Revised 25 September 2016, Accepted 28 September 2016, Available online 11 October 2016

Abstract below; full text is available to journal subscribers.

Background

Hepatitis B vaccine birth dose (HepB-BD) was introduced in Lao People´s Democratic Republic to prevent perinatal hepatitis B virus transmission in 2008; high coverage is challenging since only 38% of births occur in a health facility. Healthcare workers report being unaware of home births and thus unable to conduct timely postnatal care (PNC) home visits. A quasi-experimental pilot study was conducted wherein mobile phones and phone credits were provided to village health volunteers (VHV) and healthcare workers (HCWs) to assess whether this could improve HepB-BD administration, as well as birth notification and increase home visits.

Methods

From April to September 2014, VHVs and HCWs in four selected intervention districts were trained, supervised, received outreach per diem for conducting home visits, and received mobile phones and phone credits. In three comparison districts, VHVs and HCWs were trained, supervised, and received outreach per diem for conducting home visits. A post-study survey compared HepB-BD coverage among children born during the study and children born one year before. HCWs and VHVs were interviewed about the study.

Findings

Among intervention districts, 463 study children and 406 pre-study children were enrolled in the survey; in comparison districts, 347 study children and 309 pre-study children were enrolled. In both arms, there was a significant improvement in the proportion of children reportedly receiving a PNC home visit (intervention p < 0.0001, comparison p = 0.04). The median difference in village level HepB-BD coverage (study cohort minus pre-study cohort), was 57% (interquartile range [IQR] 32–88%, p < 0.0001) in intervention districts, compared with 20% (IQR 0–50%, p < 0.0001) in comparison districts. The improvement in the intervention districts was greater than in the comparison districts (p = 0.0009).

Conclusion

Our findings suggest that the provision of phones and phone credits might be one important factor for increasing coverage. However, reasons for improvement in both arms are multifactorial and discussed.