Globally, vaccine preventable diseases are responsible for nearly 20% of deaths annually
among children <5 years old. Worldwide, many children dropout from the vaccination
program, are vaccinated late, or incompletely vaccinated. In Kenya while significant
strides has been made by increasing DPT 3 coverage from 63% in 2000 to 81% in 2007,
dropout rates still remain high with 27% of the districts in Kenya having >10% dropout
rates in 2012.Th effectiveness of text messaging and sticker reminders to reduce
dropouts from the vaccination program was evaluated. The evaluation was conducted in
three selected districts in Kenya: Machakos, Langata and Njoro. Three health facilities
were selected in each district, and randomly allocated to send text messages or provide
stickers reminding parents to bring their children for second and third dose of
pentavalent vaccine, or to the control group (routine reminder) with next appointment
date indicated on the well-child booklet. Children aged <12 months presenting for their
first dose of pentavalent vaccine were enrolled. A dropout was defined as not returning
for vaccination ≥2 weeks after scheduled date for third dose of pentavalent vaccine.
Dropout rate was calculated as a percentage of the difference between first and third
pentavalent dose. A total of 1,116 children were enrolled; 372 in each intervention and
372 controls between February and October 2014. Median age was 45 days old (range:
31-99 days), and 574 (51%) were male. There were 136 (12%) dropouts. Thirteen (4%)
children dropped out among those who received text messages, 60 (16%) among who
received sticker reminders, and 63 (17%) among the controls. Having a caregiver with
below secondary education [Odds Ratio (OR) 1.8, 95% Confidence Interval (CI) 1.1-
3.2], and residing >5km from health facility (OR 1.6, CI 1.0-2.7) were associated with
higher odds of dropping out. Those who received text messages were less likely to drop
out compared to controls (OR 0.2, CI 0.04-0.8). There was no statistical difference in
dropout rates between those who received stickers and controls (OR 0.9, CI 0.5-1.6). the
study found Text message reminders to be effective in reducing vaccination dropout
rates in Kenya, low education level and distance >5km from facilities were associated
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with missed vaccination. The study recommends the adoption of SMS reminders in
routine childhood vaccination services in Kenya and strengthening of outreach services
to cover hard to reach areas.