Improving Immunization Coverage in
Nigeria
through SMS Reminders  

Challenge

A 2016/2017 survey revealed very low immunization coverage in Nigeria. While national coverage of 3rd dose of pentavalent vaccine was 33%, as at least 40% of children had never received any vaccine from the routine immunization program, and only 23% were fully vaccinated by 23 months of age. Coverage was highly variable across the country, ranging from 3% in Sokoto to 80% in Lagos state. The northwest and northeast zones had the worst performance. 

Prior investments by the government and partners in the last five years have largely addressed supply side problems, but demand for vaccines remains poor, largely due to lack of information and knowledge about the vaccination program. 

Approach

The Immunization Reminder and Information SMS System (IRISS) is a demand creation intervention that will be implemented by IVAC in Nigeria in collaboration with the Direct Consulting and Logistics (DCL) Limited. The project aims to improve immunization coverage and equity by reducing the proportion of children who are left out (non-vaccinated) or who drop out (under-vaccinated) of the routine immunization program. IRISS will accomplish this by delivering immunization messages in two ways: 1) geographically targeted SMS broadcast of vaccination program information and schedules specific to health facility catchments areas; and 2) as individualized SMS messages to parents who voluntarily register on an e-registry for reminders. 

Results

We expect to accomplish the following: 

  1. Establish a basis for an electronic immunization registry that can be linked to the existing district health information system (DHIS) data platform 
  1. Increase the proportion of parents of newborns receiving vaccine information including benefits, reminders, schedules, and service availability in their locality 
  1. Increase the proportion of parents of vaccine-age children receiving follow-up up SMS reminders on child’s vaccine schedule and vaccination service information 
  1. Demonstrate evidence on the affordability, viability, and feasibility of replicating an SMS/IVR (interactive voice response)-based immunization.