Impact of mobile phone delivered reminders and unconditional incentives on measles-containing vaccine timeliness and coverage

A randomised controlled trial in western Kenya

Bibliographic Data

ID21880028
AuthorsEunice Wangeci Kagucia (0000-0002-4481-8889, Johns Hopkins University, corresponding author), Benard Ochieng (0000-0002-8591-5845, Kenya Medical Research Institute), Joyce Were (0000-0002-3344-7226, Kenya Medical Research Institute), Kyla Hayford (0000-0002-9872-2313, Johns Hopkins University), David Obor (0000-0002-2852-6368, Kenya Medical Research Institute), Katherine L O'Brien (Johns Hopkins University), Dustin G Gibson (0000-0002-9073-3376, Johns Hopkins University)
Year2021
Volume6
Issue1
Pagese003357
Publication date2021-01-01
Open AccessYes
TypeARTICLE
VenueBMJ Global Health (JOURNAL)
Journal identifiersISSN: 2059-7908 • E-ISSN: 2059-7908
PublisherBMJ (PUBLISHER • GB)
DOI10.1136/bmjgh-2020-003357
PMID33509838
OpenAlexW3125965183
LanguageEN
Citations received7
References cited38

INTRODUCTION: Short message service (SMS) reminders coupled with a small monetary incentive conditioned on prompt vaccination have been shown to improve first-dose measles-containing vaccine (MCV1) uptake. We assessed whether SMS reminders and unconditional monetary incentives-more amenable to programmatic implementation-can improve MCV1 uptake in Kenya. METHODS: Caregivers of eligible infants aged 6-8 months were enrolled into an individually randomised controlled trial and assigned to receive either: no intervention (control), two SMS reminders (SMS) sent 3 days, and 1 day before the scheduled MCV1 date, or SMS reminders coupled with a Kenya Shilling (KES) 150 incentive (SMS +150 KES) sent 3 days before the scheduled MCV1 date. Study staff conducted a household follow-up visit at age 12 months to ascertain vaccination status. Log-binomial regression was used to estimate the relative and absolute difference in MCV1 timely coverage (by age 10 months), the primary outcome. RESULTS: Between 6 December 2016 and 31 March 2017, 179 infants were enrolled into each of the three study arms. Follow-up visits were completed between 19 April 2017 and 8 October 2017 for control (n=170), SMS (n=157) and SMS + 150 KES (n=158) children. MCV1 timely coverage was 68% among control arm infants compared with 78% in each intervention arm. This represented a non-statistically significant increase in the SMS arm (adjusted relative risk 1.13; 95% CI 0.99 to 1.30; p=0.070; adjusted risk difference 9.2%; 95% CI: -0.6 to 19.0%; p=0.066), but a statistically significant increase in the SMS + 150 KES arm (1.16; 95% CI 1.01 to 1.32; p=0.035; 10.6%; 95% CI 0.8 to 20.3%; p=0.034). CONCLUSION: These findings suggest that the effect of SMS reminders coupled with a small unconditional monetary incentive on MCV1 uptake is comparable to that of SMS reminders alone, limiting their utility. Further studies in the absence of unexpected supply-side constraints are needed. TRIAL REGISTRATION NUMBER: NCT02904642

Economics · Environmental health · Family medicine · Incentive · Measles · Mobile phone · Phone · Randomized controlled trial · Telecommunications · Vaccination · Computer Science · Immune responses and vaccinations · Medicine · Mobile Health and mHealth Applications · Vaccine Coverage and Hesitancy · Internal Medicine · Pediatrics · Virology

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