Improving the timeliness of administering birth dose vaccines using a digital platform in Nairobi slums., ChanjoBora

Vaccine preventable diseases still contribute substantially to child mortality in sub-Saharan Africa. Delays in administering vaccines within the recommended age group increase the risk of infection because of a prolonged potential exposure to vaccine-preventable diseases. Birth dose vaccines are administered late, due to fragmented systems of delivery, recording and communication between maternal health and child health services. Understanding these deficiencies presents opportunities for improving timely vaccinations at birth.
Objective: The main aim of this study was to assess the effectiveness of community health volunteers (CHVs) and healthcare workers using an electronic immunization registry consisting of a digital platform, web-based database and health text messages to improve timeliness of administering birth dose vaccines such as Bacille Calmette Guerin (BCG) and Oral Polio Vaccine (OPV) in Nairobi slums.

Methodology: Through a cross-sectional stepped wedge design, the intervention consisting of interaction between CHVs, pregnant women and healthcare workers using a digital platform linked to a central registry was implemented in eight villages in Viwandani (a site for the Nairobi Health and Demographic Surveillance System). CHVs or healthcare workers were to register pregnant women at home or health facility and automatically send tailored text messages from a central server, encouraging timely vaccination uptake. The project tested the feasibility of CHVs or healthcare workers using the platform and the effectiveness including cost-effectiveness of the intervention. Interviews were conducted with women with infants at baseline and the introduction of the intervention into clusters (villages) to measure the effect of the intervention on timeliness of birth dose vaccines.
Duration and budget: The duration of the project was 18 months and the total budget will be USD 100,000.
Conclusion: The expected findings generated from this study included the feasibility and effectiveness of using the digital platform for improving timely vaccinations and these was used to inform the design of a large trial in other settings. Within the larger trial we had hoped to also measure the impact of the intervention on infant survival. The digital platform was customized based on recommendations from this study to include additional features such as health sensitization videos.