Mobile phone alerts to boost vaccination coverage in Odisha

Banking on the familiarity of scratch cards and mobile phones, health officials in Odisha are mulling a pilot project where parents of a newborn can subscribe to regular vaccination updates via SMS and voice alerts to keep them on track with India's routine immunisation programme.

Christened the "Baby Health Card", the scratch card entitles couples in the overwhelmingly rural state, where nearly two-fifths of its 44 million population are tribals or scheduled castes, to register their children with the alert service to receive timely updates on the forthcoming vaccination schedule as per India's Universal Immunisation Programme (UIP).

The UIP enables vaccination of children against six preventable diseases: tuberculosis, diphtheria, pertussis, tetanus, poliomyelitis and measles. The central government has decided to introduce three new childhood vaccines in the programme, including vaccines against rotavirus, rubella, polio (injectable).

"Though immunisation coverage has been increasingly consistent over the last few years, we want to strengthen the level of awareness and adherence among the parents who have had new issues.

"Since mobile phones are extensively used by the present generation, we hope to tap into the technology to ensure couples are following the UIP schedule and bringing their children for routine immunisation (RI) camps," Indira Rath, deputy director of immunisation, health and family welfare department, Odisha, told IANS.

Rath was speaking on the sidelines of a consultation workshop here on "Media and Public Health with special focus on RI" organised by UNICEF India, George Institute for Global Health and Oxford University.

"We are scouting and tying up with sponsors gradually to start the pilot early next year," she said.

According to the last District Level Household and Facility Survey (DLHS 2007-2008), full immunisation (FI) coverage has increased from 53.5 percent (DLHS 2002-2004) to 62.4 percent.

Sustained efforts through the innovative alternate vaccine delivery system (AVDS) such as roping in autorickshaw drivers to deliver vaccines and supplies (dubbed the Immunisation Express) have proved crucial to boost the programme in the last couple of years, said Rath.

However, getting parents synced to the routine vaccinations is still a chink in the armour against infant mortality. But Rath hopes the gap can be bridged through the interactive voice response (IVR) technology, developed by a Bhubaneswar-based NGO.

Similar to a credit card, the scratch card/mobile phone approach informs parents through a two-minute audio in Odiya, the basics of UIP, post a simple one-time registration process.

"Parents will scratch the card, get an eight digit PIN and text that to a designated number. This will register them to a database.

"The first steps after this is listening to an audio where information on reasons for vaccine, schedule and disease prevention (from 0 to 16 years of age) through vaccines is given," N. K. Patel, member of the Trinath Health and Educational Trust, told IANS.

In addition to vaccination alerts as prescribed by Odisha's Ministry of Health and Family Welfare and the Indian Academy of Paediatrics, cardholders will also have to provide feedback SMS to confirm if they have gone ahead with the vaccination. Quizzes will also be conducted through IVR.

"If not, then the IVR will again impress the importance of the procedure and encourage them to go for the next date," said Patel, adding the system can be modified to include new vaccination strategies.

Odisha population is 85 percent rural with 22 percent of the population being tribal and 17 percent belonging to scheduled castes. Further, nearly half of the population of the state is below poverty line, states the 2009 UNICEF AVDS Assessment report.

"Odisha is one of the good states in terms of RI coverage. The challenge for tech-based solutions would be to reach out to the remote areas in the tribal belts like Kalahandi etc.," Satish Gupta, immunisation specialist, UNICEF India, told IANS.

Rath said such solutions would contribute towards achievement of the National Rural Health Mission goal of reducing infant mortality in Odisha by 2017 and also help bolster efforts to achieve Millennium Development Goals 2015.

"This will also ensure participation of the father in staying up to date with vaccination schedules," she said.

(Sahana Ghosh can be contacted at sahana.g@ians.in)