Peer-reviewed article
Using mobile phone Re-call notification as a primary care practice to improve vaccination uptake for children under five in baghdad, Iraq, 2022.
Firas Jabbar, Kamal A Kadhim, Riyadh A Alhilfi, Faris Lami, Abdulaal Chitheer et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study tested whether calling parents on their mobile phones to remind them about overdue vaccinations would improve immunization rates for children under five in Baghdad, Iraq. Trained health staff made up to six phone calls over three months to caregivers of children who had missed vaccines. About 39% of the targeted children ultimately came to health centers and received their overdue vaccines, showing the approach can work within existing healthcare systems.
Key points
- Of 17,241 children identified as overdue for vaccines, 15,087 (87.4%) had valid mobile phone numbers that could be contacted
- Most caregivers who answered the phone (87.5%) agreed to schedule vaccination appointments
- 6,831 children attended clinics and received 13,386 overdue vaccine doses after the recall intervention
- This represented 39.4% coverage at the child level among the targeted defaulters
- The intervention was feasible and low-cost, using existing EPI staff and structures
Limitations
The study did not include a comparison group receiving no intervention, so we cannot determine how many children would have been vaccinated anyway without the phone calls. The study only measured short-term attendance at clinics and does not report longer-term immunization outcomes or whether children completed their full vaccination schedules.
Abstract
INTRODUCTION: Reminder and recall (RR) interventions are proven strategies for improving childhood immunization coverage. However, evidence on their feasibility and effectiveness in routine primary healthcare settings in Iraq is limited. This study evaluated a direct, person-to-person mobile phone recall intervention to improve vaccine uptake among children under five years of age in Baghdad Province in 2022. METHODS: The intervention was implemented in 50 Primary Healthcare Centers (PHCs) with the lowest routine immunization performance, including 20 centers in Karkh and 30 in Rusafa. Eligible participants were children under five years of age who were overdue for one or more vaccines in the national Expanded Programme on Immunization (EPI) schedule, excluding Bacillus Calmette-Guérin (BCG) vaccine administered at birth. Trained EPI staff contacted caregivers through direct telephone calls, with up to six biweekly attempts over a three-month period. Standardized data collection forms were used under supervision of the Directorate of Public Health. RESULTS: A total of 17,241 children (47.8% female) with 48,919 overdue vaccine doses were identified, of whom 15,087 (87.4%) had valid mobile phone numbers. Among these, 28,130 call attempts resulted in 10,061 caregiver responses. Most respondents (87.5%) agreed to schedule vaccination appointments. Ultimately, 6,831 children attended PHCs and received 13,386 overdue vaccine doses, corresponding to 39.4% child-level and 27.4% dose-level coverage among targeted defaulters. CONCLUSION: Direct cellphone-based recall interventions are feasible and operationally effective for improving routine childhood immunization in Iraq. As a low-cost strategy embedded within existing EPI structures, this approach has strong potential for scale-up in similar settings.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Direct mobile phone recall notifications: trained EPI staff made up to six biweekly telephone calls over three months to caregivers of children overdue for vaccines on the national Expanded Programme on Immunization schedule
- Population
- Children under five years old identified as overdue for one or more vaccines (excluding BCG) in 50 Primary Healthcare Centers in Baghdad with the lowest routine immunization performance (Karkh and Rusafa districts)
Key finding
39.4% of targeted children attended clinics and received vaccinations (child-level coverage)