Text message reminders to improve the timeliness of birth dose vaccine administration among newborns in an urban informal settlement in Kenya

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BACKGROUND: We evaluated the effectiveness of text message reminders on the timely administration of birth dose vaccines among newborns in Viwandani urban informal settlement in Nairobi County, Kenya. METHODS: In a pilot stepped-wedge cluster-randomized trial, we sequentially randomized pregnant women to receive text message reminders or routine care. Three standardized text messages were sent notifying pregnant women to take their newborn for vaccination at birth during the intervention period. No text messages were sent during the control period but vaccinations were provided as standard practice in Kenya. The primary outcome was timely administration of birth dose vaccines-oral polio vaccine (OPV 0) and Bacillus Calmette-Guerin (BCG) administered at birth or within 2 weeks of birth. RESULTS: Among 491 newborns (355 intervention period versus 136 control period), timely administration of birth dose vaccines during the respective intervention and control periods were as follows: OPV 0 only (93.0% vs. 80.9%), BCG only (92.7% vs. 81.6%), and OPV 0 or BCG (92.1% vs. 77.9%). Timeliness of birth dose vaccine administration showed a borderline improvement in the intervention period than the control period: OPV 0 only (adjusted RR [aRR] 1.16, 95% CI: 1.00-1.35), BCG only (aRR 1.14, 95% CI: 0.98-1.33), and both OPV 0 and BCG (aRR 1.19, 95% CI: 1.00-1.43). CONCLUSION: This trial showed that text message reminders can improve the timely administration of birth dose vaccines among newborns in an urban informal settlement and can be used as an additional tool for improving the timeliness of administering vaccines in such settings.

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