Mobile Nudges to Increase Early Vaccination Coverage in Rural Areas

NCT03797950 | Completed

• 1 other identifier: GHS-ERC008/07/18
• Study Type: interventional
• Target: 260
• Locations: 1 country
• Sites: 1

Brief Summary

Despite major progress made in vaccination coverage overall, timeliness of vaccines remains a key concern in many settings. At the same time, access to mobile phones has increased rapidly, offering new opportunities to track and deliver health services. This research project uses these newly available mobile phone networks to simultaneously address two of the biggest bottlenecks in vaccine delivery: timely documentation of births, and lack of maternal effort or access to get essential vaccines. To increase documentation, investigators will train volunteers in each community to report new births via mobile phone to a central coordinator, and send small monetary rewards via mobile phone to volunteers for this reporting. To increase vaccination coverage, investigators will send reminder messages directly to mothers, and will also test small monetary rewards to volunteers and to mothers as an incentive to complete recommended vaccinations. The designs to provide vaccination encouragement will be tested through a small community randomized controlled trial in 15 selected villages in Ghana's Northern region. The primary outcome for the pilot study will be the percentage of children who received both the polio birth dose (OPV0) vaccination within two weeks of life (14 days) and the BCG vaccination within the first four weeks (28 days) of life.

Conditions

Immunization Coverage

Keywords

OPV; BCG; vaccine delivery; mhealth; incentives

Outcome Measures

Primary Outcomes (1)

• Full on time early vaccination coverage (OPV0 and BCG)

  Percentage of infants born during study who received both BCG and OPV0 vaccinations on time (OPV0 within first 2 weeks of life and BCG within first month of life)

  First month of life

Secondary Outcomes (2)

• On time BCG coverage

  First month of life

• On time OPV coverage

  First two weeks of life (14 days)

Other Outcomes (1)

• Birth documentation and reporting coverage

  First month of life

Study Arms (3)

Control

NO INTERVENTION

No active intervention

Voice Reminder (Group A)

EXPERIMENTAL

Community-appointed volunteers will document births in the community and will receive small monetary rewards via "mobile money" for all documented births. Enrolled women will receive reminders via mobile phone to highlight the importance of early vaccinations for newborns. Messages will recommend that women take their newborns to get the BCG and Polio0 vaccine as soon as possible after birth (within the first two weeks of life for Polio0 and within the first month for BCG). Information on where and when these vaccines will be available in the woman's community will be provided.

Behavioral: Voice Reminder (Group A)

Cash Incentive (Group B)

EXPERIMENTAL

Community-appointed volunteers will document births in the community and will receive small monetary rewards via "mobile money" for all documented births. Volunteers will encourage enrolled women to seek early vaccination for their newborns. Messages will recommend that women take their newborns to get the BCG and Polio0 vaccine as soon as possible after birth (within the first two weeks of life for Polio0 and within the first month for BCG). Volunteers will provide information on where and when these vaccines will be available in the woman's community. Volunteers and enrolled women will receive small monetary rewards via "mobile money" for receiving OPV0 and BCG vaccinations on time.

Behavioral: Cash Incentive (Group B)

Interventions

Voice Reminder (Group A) BEHAVIORAL

Woman with a recent delivery will be contacted via mobile phone by a central study staff member to encourage them to vaccinate their newborn with OPV0 and BCG, and information on where and when vaccines are available in this community will be provided. Community volunteers will receive small incentives for documenting births in the community.

Voice Reminder (Group A)

Cash Incentive (Group B) BEHAVIORAL

Mobile phone based monetary incentives will be provided to community volunteers and to women with a recent delivery who vaccinate newborns with OPV0 and BCG on time. Community volunteers will receive small incentives for documenting births in the community.

Cash Incentive (Group B)

Eligibility Criteria

• Gender Eligibility Details: Woman who have recently given birth
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• Women who have given birth to a live-born, surviving infant in the last two weeks (14 days) and reside in the community.

You may not qualify if:

• Women who do not reside in the community.
• Women whose newborn has passed away.

Sponsors & Collaborators

• Swiss Tropical & Public Health Institute: lead
• Innovations for Poverty Action: collaborator

Study Sites (1)

Innovations for Poverty Action

Tamale, Karaga, Ghana

Location

Related Publications (2)

• Levine G, Salifu A, Mohammed I, Fink G. Mobile nudges and financial incentives to improve coverage of timely neonatal vaccination in rural areas (GEVaP trial): A 3-armed cluster randomized controlled trial in Northern Ghana. PLoS One. 2021 May 19;16(5):e0247485. doi: 10.1371/journal.pone.0247485. eCollection 2021.

  PMID: 34010312 DERIVED

• Palmer MJ, Henschke N, Bergman H, Villanueva G, Maayan N, Tamrat T, Mehl GL, Glenton C, Lewin S, Fonhus MS, Free C. Targeted client communication via mobile devices for improving maternal, neonatal, and child health. Cochrane Database Syst Rev. 2020 Jul 14;8(8):CD013679. doi: 10.1002/14651858.CD013679.

  PMID: 32813276 DERIVED

Study Officials

• Guenther Fink, PhD

  Swiss Institute for Tropical and Public Health

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: November 7, 2018
• First Posted: January 9, 2019
• Study Start: November 1, 2018
• Primary Completion: July 9, 2019
• Study Completion: July 9, 2019
• Last Updated: March 3, 2020

Record last verified: 2020-03

Data Sharing

• IPD Sharing: Will not share

Locations

GH (1)