Effect of mobile phone text message reminders on improving completeness and timeliness of routine childhood vaccinations in North-West, Ethiopia: a study protocol for randomised controlled trial

Abstract

IntroductionNon-attendance and delay in vaccination schedules remain a big challenge to healthcare workers. With the continuous growth of mobile network coverage and exponential penetration of mobile devices in the developing world, adoption of short message service has been shown to increase attendance for health services by targeting participant characteristics such as forgetfulness. Therefore, the aim of this trial is to determine the effect of mobile text message reminders on completeness and timeliness of childhood vaccination in North-West, Ethiopia.Methods and analysisA two-arm, parallel, superiority, randomised controlled trial study will be employed. The study arms are the intervention group (text message reminders plus routine care) and the control group (routine care only). Mother–infant pairs will be randomised to one of the groups during enrolment. The trial will consider a sample size of 434 mother–infant pairs with 1:1 allocation ratio. Mothers assigned to the intervention group will receive text message reminder 1 day before the scheduled vaccination visit at 6 weeks, 10 weeks, 14 weeks and at 9 months. Initially, descriptive statistics will be computed. For the primary outcome log-binomial regression model will be used to identify associated factors, and relative risk with 95% CI will be reported. Primarily, iIntention-to-treat analysis principle will be applied. STATA V.14 software will be used for the analysis.Ethics and disseminationThis study obtained ethical approval from the University of Gondar Institutional Ethical Review Board. The trial findings on the effectiveness of mobile text message reminders in improving vaccination uptake will help to inform decision makers on the use of mobile health interventions in developing countries like Ethiopia. The scientific findings of the trial will also be published in reputable journals.Trial registration numberPACTR201901533237287.

<p>The Applicability of the Modified Technology Acceptance Model (TAM) on the Sustainable Adoption of eHealth Systems in Resource-Limited Settings</p>

“…2,3 Health technology applications, like hospital information system (HIS), electronic health record (EHR), mobile health (M-health), decision support system (DSS), electronic medical record system (EMR) and research/data collection systems (RCS) have a big value in different settings of the healthcare by reducing healthcare costs, advancing access for up-to-date information, enable quick access for patient records and improve communication between patient and healthcare providers. [4][5][6][7] Over the past decade, the practical implementation and integration of eHealth systems have been scaled drastically. Many developed nations are utilizing eHealth technologies and make a real difference in improving patient care, and the provision of efficient and effective healthcare services.…”

“…[17][18][19] All the previously deployed systems and the systems that are in progress have been implemented using a trial-and-error approach which is very expensive and unsuccessful. [5][6][7]20 Due to this, the implementation and diffusion of eHealth technology in Ethiopia is still in the embryonic stage. [21][22][23][24] Developing nations like Ethiopia, with limited resources to implement eHealth technology, needs an empirically validated model that supports to identify the main elements of the system implementation and user's behavioral intention to use eHealth technologies that can be used by executives for prior preparation.…”

“…17–19 All the previously deployed systems and the systems that are in progress have been implemented using a trial-and-error approach which is very expensive and unsuccessful. 5–7 , 20 Due to this, the implementation and diffusion of eHealth technology in Ethiopia is still in the embryonic stage. 21–24 …”

Acceptability, Barriers and Facilitators of Mobile Text Message Reminder System Implementation in Improving Child Vaccination: A Qualitative Study in Northwest Ethiopia

“…The trial was a one-year follow-up study conducted in northwest Ethiopia. 32 For the trial, a locally developed automated mobile text message reminder was developed and text message reminders were sent for each study participant in the intervention group one day before the due date of vaccination. The mobile text message reminders were developed and sent in Amharic and English languages for all consecutive vaccination appointments of infants.…”

Effect of Mobile Phone Text Message Reminders on the Completion and Timely Receipt of Routine Childhood Vaccinations: Superiority Randomized Controlled Trial in Northwest Ethiopia

“…This study applied a two-arm, parallel, superiority, individually randomized controlled trial design with a 1:1 allocation ratio. This trial followed a published study protocol that details the methods and approaches implemented in the trial [ 82 ]. This randomized controlled trial was conducted in the public health facilities (8 health centers and 1 comprehensive specialized hospital) of Gondar city, northwest Ethiopia between May 2019 and June 2020.…”