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Effect of Mobile Phone Text Messages Reminders on Uptake of Routine Immunization among Children in Pakistan-Study Protocol for a Randomized Clinical Trial

Kazi AM, Murtaza A, Kazi AN, Khurram Z, Hussain K and Ali SA

Introduction: Routine Immunization (RI) is considered one of the best public health interventions to decrease child morbidity and mortality. The RI coverage in Pakistan is still well below the desired level, leading to continued polio transmission, large measles outbreaks and thousands of deaths from vaccine-preventable illnesses. Different innovative and cost effective strategies are required to look into for enhancement in vaccination uptake and coverage. We plan to test the effectiveness of reminders to parents/caregivers on cell phones through short messaging system (SMS) in improving vaccine uptake and on-time routine immunization for children in Pakistan.
Methods and Analysis: A parallel-randomized controlled trial will be conducted to assess the effectiveness of short messaging service (SMS) text reminders on the mobile phones in improving the uptake and on-time vaccination for routine immunization in children at 6,10 and 14 weeks of age according to the EPI schedule in Pakistan. The trial consists of 300 children with allocation of parallel 1:1 to the SMS reminders or to standard care (control group). The intervention arm in addition to the standard counseling will receive four SMS reminders according to the language preference in the week that the enrolled child is due for routine immunization at 6, 10 and 14-week schedule. The primary outcome is to evaluate whether text reminders can improve uptake and on-time vaccination for routine immunization at 6, 10 and 14 weeks’ schedule. Assumptions used for calculating sample size are increase in coverage rate from 60% to 80%, power at 0.8, alpha error at 0.05 and allowing for 10% dropout.
Ethics and Dissemination: Study protocol and associated study instruments, will be submitted to the Aga Khan University’s Ethical Review Committee for approval before commencement of any study activities. Results will be disseminated to pediatric and public health communities in Pakistan through scientific meetings.