Effect of Mobile Phone Reminders and Recalls on Pentavalent Vaccines Drop-out Rate among Caregivers Accessing Childhood Immunisation Services in a Developing City, Southeast Nigeria

Abstract

Background: Immunisation drop-out rate measures the effectiveness of the immunisation programme. When drop-outs exceed 10 percent it indicates a problem of utilisation of services. Receipt of vaccines at the recommended ages and intervals will ensure that children are adequately protected from target diseases at all times. Immunisation reminder and recall (RR) systems are cost-effective methods of improving adherence to recommended immunisation schedules. This study, therefore, determined the effect of immunisation reminders and recalls on reducing pentavalent vaccination drop-outs in Abakaliki.
 Materials and Methods: This is a quasi-experimental study among caregivers of infants in rural health facilities in Abakaliki, Nigeria. Mile-Four and St. Vincent hospitals in Izzi and Ebonyi Local Government Areas (LGA) of Ebonyi State were selected purposively. Mile-Four was assigned the phone reminder/recall intervention group and St. Vincent as a control group. The sample size was determined using the formula for comparing two proportions. Caregiver-child pair was enrolled into the two groups during the infants’ BCG or Pentavalent vaccines 1 immunisation visit and followed till the final scheduled immunisation visit for each child. Data were collected using questionnaire forms, proforma and checklist. Statistical Package for Social Science (SPSS) version 22.0 was used for analysis. Ethical approval was obtained from the Research and Ethics Committee (REC) of the Federal Teaching Hospital Abakaliki (FETHA), Nigeria. 
 Results: The mean age of respondents were 26.6 ±4.9 years and 27.1±4.2 years in the intervention and control groups respectively. Thirty five point seven percent (35.7%) of infants dropped out of pentavalent vaccinnation 3 in pre-intervention phase when compared with 5.5% post-intervention. This difference in their proportions was found statistically significant (p<0.01). In the control group, 47.7% dropped out of pentavalent vaccination 3 at the beginning of the study when compared with 22.1% at the end of the study, a difference that was statistically significant (p=0.02). Out of 145 infants who received pentavalent vaccines 1 in both groups, 137 (94.5%) infants received pentavalent vaccines 3 in the intervention group while 113 (77.9%) infants received pentavalent vaccines 3 in the control group. Far distance to health facility predicted immunisation drop-out in the control group. It is 2.8 times more likely to cause immunisation drop-out than near distance to health facility. No predictor was found in the intervention group.
 Conclusion: Mobile phone reminders and recall has proven very effective in reducing pentavalent vaccines drop-out rate in Abakaliki. Implementation of immunisation reminders and recall systems are therefore recommended in immunisation clinics in developing countries especially in Nigeria for improved immunisation coverage in order to achieve Sustainable Developmental Goal 3 (SDG 3).