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Effectiveness of Short Message Services Reminder on Childhood Immunization in Kadoma, Zimbabwe, 2013- A Randomized Controlled Trial1

DonewellBangure1, D Chirundu2, N T Gombe1, M. Tshimanga1, L. Takundwa1 1Department of Community Medicine, University of Zimbabwe, 2Kadoma City Council

Background: Globally, non-attendance for immunization appointments remains a challenge to healthcare providers. A review of the 2011 consolidated monthly return form (T5) for Kadoma City revealed that annual Oral Polio Vaccine, Pneumococcal, and Pentavalent coverage was 74% at six weeks, 84% at 10 weeks and 74% at 14 weeks against a district target of 90% for all antigens at six, 10 and 14 weeks. We investigated the effectiveness of short message service (SMS) reminders on immunization coverage in Kadoma City.

Methods: A randomized controlled trial was conducted among women who delivered and were resident in Kadoma City. In the intervention group, SMS reminders were sent at six, 10 and 14 weeks. In the non- intervention group, no message reminders were sent. All women in both groups received routine health education on immunization schedule for their children and were issued with immunization cards post- delivery. Data were analyzed using Epi-Info 7.

Results: A total of 304 participants were recruited, 152 intervention group and 152 non-intervention group. Immunization coverage was 97% for the intervention group and 82% for non-intervention group at six weeks (p<0.001). At 10 weeks, immunization coverage was 96% for the intervention group and 80% for the non-intervention group (p<0.001). At 14 weeks coverage was 95% for the intervention group and 75% for the non-intervention group (p<0.001).The respondents who received SMS reminders were 1.3 times more likely to have their children immunized at 14 weeks than those who did not receive the SMS reminders (p<0.001). The total cost including capturing data per SMS was US$0.41.

Conclusion: Immunization coverage in the intervention group was significantly higher than in non- intervention group. Based on this evidence we recommended the use of SMS reminders to increase immunization coverage in Kadoma City.

Key Words: Randomized Control Trial, Immunization, Kadoma

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