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. 2015 Jan 14;3(1):e4.
doi: 10.2196/mhealth.3704.

Application of mobile technology for improving expanded program on immunization among highland minority and stateless populations in northern Thailand border

Jaranit Kaewkungwal  1 , Tawatchai Apidechkul, Kasemsak Jandee, Amnat Khamsiriwatchara, Saranath Lawpoolsri, Surasak Sawang, Aumnuyphan Sangvichean, Peerawat Wansatid, Sarinya Krongrungroj
Affiliations

Application of mobile technology for improving expanded program on immunization among highland minority and stateless populations in northern Thailand border

Jaranit Kaewkungwal et al. JMIR Mhealth Uhealth. .

Abstract

Background: Studies of undervaccinated children of minority/stateless populations have highlighted significant barriers at individual, community, and state levels. These include geography-related difficulties, poverty, and social norms/beliefs.

Objective: The objective of this study was to assess project outcomes regarding immunization coverage, as well as maternal attitudes and practices toward immunization.

Methods: The "StatelessVac" project was conducted in Thailand-Myanmar-Laos border areas using cell phone-based mechanisms to increase immunization coverage by incorporating phone-to-phone information sharing for both identification and prevention. With limitation of the study among vulnerable populations in low-resource settings, the pre/post assessments without comparison group were conducted. Immunization coverage was collected from routine monthly reports while behavior-change outcomes were from repeat surveys.

Results: This study revealed potential benefits of the initiative for case identification; immunization coverage showed an improved trend. Prevention strategies were successfully integrated into the routine health care workflows of immunization activities at point-of-care. A behavior-change-communication package contributes significantly in raising both concern and awareness in relation to child care.

Conclusions: The mobile technology has proven to be an effective mechanism in improving a children's immunization program among these hard-to-reach populations. Part of the intervention has now been revised for use at health centers across the country.

Keywords: EPI; behavioral change communication; expanded program on immunization; hill tribes; mobile technology; stateless.

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Conflict of interest statement

Conflicts of Interest: The StatelessVac project was awarded via Grand Challenges Explorations (Round 7-Grant Number OPP1046158) by the Bill & Melinda Gates Foundation. This project has been receiving in-kind support from the Faculty of Tropical Medicine, Mahidol University, Bangkok, and the School of Health Science, Mae Fah Luang University, Chiang Rai Province, Thailand. Faculty members of both universities have been actively involved in planning and implementing the project at the study locations.

Figures

Figure 1
Figure 1
The StatelessVac project initiatives. (a) Project locations on highland; (b) picture and pronunciation for case identification; and (c) behavior change communication at health center and during routine home visit before schedule date.
Figure 2
Figure 2
Overall immunization coverage before and after project implementation. (BCG= Bacillus Calmette-Guérin vaccine, DTP= diphtheria-tetanus-pertussis vaccine, JE= Japanese encephalitis vaccine, HepB= Hepatitis B vaccine, and OPV= oral polio vaccine).
Figure 3
Figure 3
Monthly immunization rates by children ages. (BCG= Bacillus Calmette-Guérin vaccine, DTP= diphtheria-tetanus-pertussis vaccine, JE= Japanese encephalitis vaccine, HepB= Hepatitis B vaccine, and OPV= oral polio vaccine).
See this image and copyright information in PMC

References

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