Parental Reminder Strategies and the Cost Implication for Improved Immunisation Outcomes: A Systematic Review and Meta-Analysis.

Abstract

Getting children vaccinated amidst prevailing barriers to immunisation has been challenging in both developed and developing countries. To address these problems, studies on parental reminder strategies were conducted to improve immunisation outcomes in children. These led to the development of different parental reminder interventions. This review systematically reviews different parental interventions and their cost implication for improved immunisations. Five online databases; Medline Complete, the Cumulative Index for Nursing and Allied Health Literature [CINAHL], Academic search premier, SPORTDiscus, and Health Source Nursing/Academic were searched using search terms. A total of 24 articles that met the inclusion criteria were included in this review. Studies that provided sufficient information were included for meta-analysis using Comprehensive Meta-Analysis version three, while narrative synthesis was used for the other studies. Results indicate that a heterogeneous and low-quality certainty of evidence on parental voice calls (OR 4.752, 95% CI 1.846–12.231, p = 0.001) exists in improving immunisation coverage. Regarding immunisation timeliness, a high-quality certainty of evidence on Short Message Services (SMS)-delivered health education messages (OR 2.711 95% CI 1.387–5.299, p = 0.004) had more effect on timely immunisation uptake. The average cost of SMS-delivered parental reminder interventions for improved immunisation outcomes was USD 0.50. The study concludes that mobile technology is a promising, cost-effective strategy for improved immunisation outcomes.