Submission ID 131335
| Issue/Objective | Cameroon continues to face low childhood vaccination coverage. Digital health interventions may support caregivers and frontline health workers, but evidence on their feasibility and implementation in routine immunization settings remains limited. We conducted a prospective pilot study to assess the feasibility and implementation performance of a dual digital intervention combining short message service (SMS)-based parental education and reminders with a digital dashboard and online vaccination training for healthcare providers. |
|---|---|
| Methodology/Approach | Following an initial proof-of-concept pilot, the intervention was implemented at a major primary healthcare facility in Northwest Cameroon. From November 2023 to February 2025, we enrolled newborns, at birth, into a 12-month prospective cohort and followed according to the national immunization schedule. Time-to-vaccination was analyzed using Kaplan-Meier (KM) methods, to explore factors associated with timely vaccination within the cohort. Given opt-in enrollment and the absence of a concurrent control group, analyses were descriptive and not intended to estimate causal effects. Findings were discussed and validated through stakeholder engagement with healthcare providers and program managers. |
| Results | Among the 1,022 newborns enrolled (51.8% girls), 81.6% resided in urban areas, and 20.7% lived >15 minutes from the clinic by motor taxi (median transport cost US$0.5). Vaccination rate for the third dose of diphtheria, tetanus, pertussis, Haemophilus influenzae type b, hepatitis B (Penta-3) and the first dose of measles-rubella (MR-1) was 95.4% and 92.1% respectively. The KM analysis showed a 25% dropout rate by week 48; In the final Cox regression model, travel time >15 minutes was a statistically significant predictor of dropout (aHR 1.48; 95%CI 1.10; 2.02, p = 0.01). The defaulter-tracking system required integration with community health workers (CHW) due to: i) the limited capacity of clinics to follow-up on missed cases; and ii) the need for structured information-sharing mechanisms between digital tools and the community-based health workforce operating under local health authorities. |
| Discussion/Conclusion | Educating and empowering parents and healthcare workers is feasible within routine immunization services in Northwest Cameroon. High vaccination completion was observed among enrolled infants, while persistent dropout underscores the need for strengthened follow-up, including integration of CHW in future controlled evaluations. |
| Presenters and Affiliations | Yayah Emerencia Ngah Regional Hospital Bamenda George Mondinde Ikomey Center for the Studies and Control of Communicable Diseases, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1 Fabrice Sewolo International Clinical Research Academy of Montreal Cornelius Chebo Essential Programme on Immunization, Regional Delegation of Public Pealth, Bamenda, North West Region Shalom Tchokfe Ndoula Expanded Programs on Immunization, Ministry of Health Charles Shey Wiysonge Vaccine Preventable Diseases, World Health Organization Regional Office for Africa Ujjwal Neogi Department of laboratory medicine, Karolinska Institutet Claudia Hanson Department of global public health, Karolinska Institutet Tobias Alfven Department of global public health, Karolinska Institutet Stefan Swartling Peterson Department of global public health, Karolinska Institutet Yousef Khader Jordan University of Science and Technology (JUST) Wadih Maalouf UNODC Eresso Aga UNICEF Ziad El-Khatib Karolinska Institutet |
