Abstract

BackgroundMobile-phone reminders have gained traction among policymakers as a way to improve childhood vaccination coverage and timeliness. However, there is limited evidence on the acceptability of mobile-phone reminders among patients and caregivers. This systematic review and meta-analysis aimed to evaluate the ownership of mobile-phone device and the willingness to receive mobile-phone reminders among mothers/caregivers utilizing routine childhood immunization services in Nigeria.MethodMEDLINE, Scopus, CINAHL, CNKI, AJOL (African Journal Online), and Web of Science were systematically searched for studies on the acceptability of mobile-phone reminders for routine immunization appointments among mothers/caregivers in Nigeria. Studies were assessed for methodological quality using the Newcastle Ottawa Scale and JBI critical appraisal checklists. Meta-analysis was conducted using random-effects model to generate pooled estimates (proportion) of mothers who owned at least one mobile phone and proportion of mothers willing to receive mobile-phone reminders.ResultsSixteen studies (13 cross-sectional and three interventional) involving a total of 9923 mothers across 15 states and the Federal Capital Territory Abuja met inclusion criteria. Pooled estimates showed that the proportion of mothers who owned at least one mobile phone was 96.4% (95% CI = 94.1–98.2%; I2 = 96.3%) while the proportion of mothers willing to receive mobile-phone reminders was 86.0% (95% CI = 79.8–91.3%, I2 = 98.4%). Most mothers preferred to receive text message reminders at least 24 h before the routine immunization appointment day, and in the morning hours. Approximately 52.8% of the mothers preferred to receive reminders in English, the country’s official language.ConclusionCurrent evidence suggests a high acceptability for mobile-phone reminder interventions to improve routine childhood immunization coverage and timeliness. Further studies, however, are needed to better understand unique regional preferences and assess the operational costs, long-term effects, and risks of this intervention.Systematic review protocol registrationPROSPERO CRD42021234183.

Highlights

  • Routine childhood immunization has been remarkably successful and cost-effective in preventing infectious diseases worldwide [1]

  • Pooled estimates showed that the proportion of mothers who owned at least one mobile phone was 96.4% while the proportion of mothers willing to receive mobile-phone reminders was 86.0%

  • Current evidence suggests a high acceptability for mobile-phone reminder interventions to improve routine childhood immunization coverage and timeliness

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Summary

Introduction

Routine childhood immunization has been remarkably successful and cost-effective in preventing infectious diseases worldwide [1]. A number of systematic reviews have synthesized the evidence on the effectiveness of mobile phone reminders on the uptake of immunization in low- and middle-income countries (LMICs) [13,14,15,16]. While all of these reviews suggest that phone reminders are generally effective, these exists a gap in our understanding of a key mechanism: acceptability. This systematic review and meta-analysis aimed to evaluate the ownership of mobile-phone device and the willingness to receive mobile-phone reminders among mothers/caregivers utilizing routine childhood immunization services in Nigeria

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