NCT03355989|Completed

Evaluation of Conditional Cash Transfers (CCTs) for Immunization

Testing the Effect of Mobile Conditional Cash Transfers (mCCTs) of Different Schedules and Amounts on Routine Childhood Immunization Coverage and Timeliness in Pakistan: A Randomized Control Trial.

Interactive Research and Development ClinicalTrials.gov

Compare

1 other identifier

IRD-IRB_2017_01_004

Study Type

interventional

Target

11,197

Locations

1 country

Sites

Timeline

RegisteredNov 2017

StartedNov 2017

CompletionApr 2020

Brief Summary

Like many developing countries, Pakistan faces a public health challenge of low and incomplete immunization rates of children, only 54% of children aged 12 to 24 months are fully immunized, which leaves children susceptible to vaccine-preventable diseases. The Expanded Program on Immunization (EPI) is a low-cost and effective health intervention, but the uptake is low, delayed, and completion rates are poor. Door-to-door campaigns can increase coverage, but are extremely expensive. Incentive-based approaches have been rigorously demonstrated to effectively increase take-up and completion rates of immunization, and there is substantial evidence that small incentives can have a large impact on the take up of preventative health behavior in general. There are two major constraints to scaling these findings, however. This study will attempt to find the most effective incentive design that helps increase the coverage of full immunization rates among children between the ages of 0 - 24 months in the city of Karachi, Pakistan. The study proposes to conduct a randomized control trial involving small conditional cash transfers (mCCTs) to determine the optimal CCT amount (high versus low), schedule (flat versus increasing) and design (lottery versus sure payment) that would lead to the highest increase in immunization rates. Interactive Research and Development's digital immunization registry will be used to enrol and randomize the study participants and generate CCTs disbursed through a mobile money transfer platform and mobile top - ups . The three year study will be conducted in Karachi, Pakistan enrolling a sample of 11,200 children, 0-2 years of age. The study aims to provide evidence regarding the most cost-effective way to structure incentives in terms of size, schedule, and design; and address the challenge of delivering small incentives in a way that is inexpensive, logistically simple, and not subject to leakage.

Trial Health

On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment

11,197

participants targeted

Target at P75+ for not_applicable

Timeline

Completed

Started Nov 2017

Typical duration for not_applicable

Geographic Reach

1 country

1 active site

Status

completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

2.4 years study duration

Study Start

First participant enrolled

November 6, 2017

Completed

16 days until next milestone

First Submitted

Initial submission to the registry

November 22, 2017

Completed

7 days until next milestone

First Posted

Study publicly available on registry

November 29, 2017

Completed

2.3 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

April 4, 2020

Completed

Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

April 4, 2020

Completed

Last Updated

July 29, 2020

Status Verified

July 1, 2020

Enrollment Period

2.4 years

First QC Date

November 22, 2017

Last Update Submit

July 27, 2020

Conditions

Immunization; Infection

Keywords

Conditional Cash TransferImmunization coverageImmunization reminder

Outcome Measures

Primary Outcomes (1)

Proportion of fully immunized children
This will be the proportion of Fully immunized children under two years of age. A fully immunized child (FIC) will be one who received the entire series of EPI recommended vaccines by 2 years of age: one dose of BCG, 3 doses of each OPV, Pentavalent \& PCV immunizations, and 2 doses of Measles vaccines. This is a commonly used indicator in WUENIC, DHS reports and EPI survey reports.
When the participants reach 2 years of age

Secondary Outcomes (5)

Penta3, Polio3, PCV3, or Measles1 coverage at 12 to 23 months
Children vaccinated between the age of 12 to 23 months
Penta3, Polio3, PCV3, or Measles1 coverage at 12 months
Children vaccinated by 12 months of age
Proportion of fully immunized children at 12 months
When the children enroled reach 12 months of age
Proportion timely receipt of vaccine doses.
Vaccination date within 4 weeks of the due date
Immunization system utilization (drop-out rate)
This will be noted for when the child exceeds two years of age and remains unvaccinated

Study Arms (12)

Low Flat Rate without Lottery

EXPERIMENTAL

The intervention consists of receiving a small cash incentive of $0.80 on every vaccine along with 3 SMS reminders before, at and after the due date. The incentive will be sent via mobile top - up.