Short message service (SMS) reminders for childhood immunisation in low-income and middle-income countries: a systematic review and meta-analysis

Abstract

IntroductionChildhood vaccine delivery services in the low- and middle-income countries (LMIC) are struggling to reach every child with lifesaving vaccines. Short message service (SMS) reminders have demonstrated positive impact on a number of attrition-prone healthcare delivery services. We aimed to evaluate the effectiveness of SMS reminders in improving immunisation coverage and timeliness in LMICs.MethodsPubMed, Embase, Scopus, Cochrane CENTRAL, CINAHL, CNKI, PsycINFO and Web of Science including grey literatures and Google Scholar were systematically searched for randomised controlled trials (RCTs) and non-RCTs that evaluated the effect of SMS reminders on childhood immunisation and timeliness in LMICs. Risk of bias was assessed using the Cochrane Risk of Bias 2.0 assessment tool for RCTs and Cochrane Risk of Bias in Non-randomised Studies of Interventions tool for non-RCTs. Meta-analysis was conducted using random-effects models to generate pooled estimates of risk ratio (RR).Results18 studies, 13 RCTs and 5 non-RCTs involving 32 712 infants (17 135 in intervention groups and 15 577 in control groups) from 11 LMICs met inclusion criteria. Pooled estimates showed that SMS reminders significantly improved childhood immunisation coverage (RR=1.16; 95% CI: 1.10 to 1.21; I2=90.4%). Meta-analysis of 12 included studies involving 25 257 infants showed that SMS reminders significantly improved timely receipt of childhood vaccines (RR=1.21; 95% CI: 1.12 to 1.30; I2=87.3%). Subgroup analysis showed that SMS reminders are significantly more effective in raising childhood immunisation coverage in lower middle-income and low-income countries than in upper middle-income countries (p<0.001) and sending more than two SMS reminders significantly improves timely receipt of childhood vaccines than one or two SMS reminders (p=0.040).ConclusionCurrent evidence from LMICs, although with significant heterogeneity, suggests that SMS reminders can contribute to achieving high and timely childhood immunisation coverage.PROSPERO registration numberCRD42021225843.

Examining enablers of vaccine hesitancy toward routine childhood and adolescent vaccination in Malawi

“…It boosts local confidence in healthcare services including vaccination. Also, integrating a Short Message Service (SMS) reminder system will go a long way in addressing the vaccination schedule problems identified among caregivers (i.e., for those who have mobile devices) [ 36 , 37 ].…”

“…It boosts local confidence in healthcare services including vaccination. Also, integrating a Short Message Service (SMS) reminder system will go a long way in addressing the vaccination schedule problems identified among caregivers (i.e., for those who have mobile devices) [36,37]. Vaccine hesitancy, particularly for HPV, is prevalent among some Malawian communities regardless of their cultural or religious affiliations.…”

Behavioural Science-Informed Strategies for Increasing COVID-19 Vaccine Uptake in Children and Youth

“…Reminders for the next vaccine dose and recall for missed vaccination have also demonstrated impact. 29,[44][45][46][47][48][49] Personalized reminders focused on children, youth, parents, or providers have been shown to be effective. 17,49,50 In a vaccine registry, reminders can be sent directly to individuals who have received one COVID-19 vaccine dose to prompt individuals when they are due for their second dose.…”

Small mobile conditional cash transfers (mCCTs) of different amounts, schedules and design to improve routine childhood immunization coverage and timeliness of children aged 0-23 months in Pakistan: An open label multi-arm randomized controlled trial

“…Recent meta-analyses of SMS reminders in LMICs found reminders on their own significantly improve immunization coverage and timeliness. 21 They provide both a benchmark against which to measure mCCTs, and have the potential to enhance the effectiveness of mCCTs by reminding caregivers of their next payment. 14 …”