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The Use of Mobile Health Technology in Promoting Infant Vaccine Adherence – A Health Technology Assessment

      Objectives

      Persistently stubborn infant mortality rates across the world have prompted the use of mobile technologies to assist in vaccine adherence. This systematic review attempts to assess the efficacy of a mobile phone technology in delivering timely infant immunization reminders and ensuring compliance and follow-up rates.

      Methods

      Studies were identified based on pre-specified criteria from two journals (BMJ and Lancet) and three databases (PUBMED, Google Scholar and Cochrane). The articles were screened for PICO (Population, Intervention, Control and Outcome) parameters and subsequently shortlisted when they included the desired target population, namely infants and mothers and used the methodology of Randomized Controlled Trials (RCTs). Biases on account of dropouts, selection and blinding methods were taken into consideration. Risk ratios were analyzed for the review using a forest plot and bias graphs.

      Results

      A total of 71 studies were identified based on results of which 3 duplicates were excluded. Of the 68, 25 were screened for PICO parameters and eventually of the 22 full-text articles reviewed. 6 were RCTs and qualified as relevant for the Health Technology Assessment. The studies, published between 1996 and 2014, recorded the participation of 5999 infants and mothers across 5 clinic based interventions and 1 province-based intervention. A risk ratio of 0.67 indicates that the mobile-based intervention is 45% more effective than the control, suggesting the former to be a crucial measure to improve outcome measures such as timeliness of immunization and increased infant vaccine awareness.

      Conclusions

      Our analysis suggests that the use of mobile technologies could marginally improve compliance in the intervention groups, even if they do not affect the overall immunization rates. The evidence also shows that incorporating this scheme into an existing health system requires a small investment that could potentially result in sizeable gains in reducing infant and neonatal mortality and morbidity, particularly in resource-limited settings.