Customised m-health messages boost immunisation coverage in underserved areas: study.

Karachi -- Results from a randomised controlled trial spanning over 3,300 households in rural and urban areas of Sindh have highlighted the usefulness of SMS and voice campaigns, targeted at parents and caregivers of infants, in increasing vaccine coverage in underserved areas.

Sindh has one of the lowest rates of routine immunisation in Pakistan with seven out of ten children at risk of contracting preventable, and often fatal, diseases such as diphtheria, pertussis and hepatitis B. Since 97 per cent of the province's population owns a mobile phone, text and voice messages represent an accessible and low-cost means to promote access to lifesaving vaccines in line with targets under Goal 3 of the sustainable development goals.

The Paigham-e-Sehat, a message of health, study saw researchers from Aga Khan University and the University of British Columbia partner with digital health and telecommunications specialists to develop a variety of mobile campaigns containing targeted messages on immunisation for rural and urban audiences in the province. The study found that automated messages, delivered through an interactive voice response (IVR) system, delivered a 26 per cent increase in vaccine coverage, substantially higher than three other interventions and a control group which did not show a statistically significant increase in immunization uptake.

Local insights were incorporated in the study's design through the help of focus groups. The focus groups showed that Sindhi was the language of choice for citizens in interior Sindh while text messages in Roman Urdu (Urdu written in English) would be more effective for those living in Karachi. Since only a fifth of all households enrolled in the study had access to a smartphone, text messages were written with feature phones in mind.

Health messages also reflected local views on the most effective content for the audience. These ranged from information on the health benefits of vaccines, religious considerations (vaccinations are compulsory for those undertaking Hajj and Umrah) to warnings on the adverse effects of avoiding immunization.

These messages were then delivered through four different mediums to generate evidence on the most effective means to boost demand for routine immunisation. Participants in the study were divided into the following intervention arms which received:

1. A one-way series of SMS messages providing information on the benefits of immunisation.

2. An interactive sequence...