Evaluation of an mHealth Intervention Designed to Increase Child Vaccination Coverage in Mozambique

Last registered on April 18, 2016
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Pre-Trial

Trial Information

General Information

Title
Evaluation of an mHealth Intervention Designed to Increase Child Vaccination Coverage in Mozambique
RCT ID
AEARCTR-0001184
Initial registration date
April 18, 2016

Initial registration date is when the trial was registered.

It corresponds to when the registration was submitted to the Registry to be reviewed for publication.

First published
April 18, 2016, 10:35 AM EDT

First published corresponds to when the trial was first made public on the Registry after being reviewed.

Locations

Country
Mozambique
Region
Nampula Province

Primary Investigator

Name
Lucas Crowley
Affiliation
Innovations for Poverty Action
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Other Primary Investigator(s)

PI Name
Gunther Fink
PI Affiliation
Harvard School of Public Health
Contact Investigator
PI Name
Dean Karlan
PI Affiliation
Yale University
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Additional Trial Information

Status
On going
Start date
2015-02-01
End date
2019-03-01
Keywords
Health
Additional Keywords
vaccines, mobile phones, reminders, supply chain
JEL code(s)
Secondary IDs
Abstract
Mozambique has a high child mortality rate, with a substantial portion of these deaths stemming from vaccine-preventable diseases. A key issue is the drop-off between the first and subsequent doses of a vaccine. This evaluation tests a mobile phone-based application introduced to health facility technicians in the Ministry of Health's national Extended Program of Immunization (EPI). The application is intended to (a) improve the EPI's management of vaccine stock and (b) automatically remind caregivers of upcoming vaccination appointments. The evaluation examines the impact of the intervention on child vaccination rates and management of the vaccine supply chain.
External Link(s)

Registration Citation

Citation
Crowley, Lucas, Gunther Fink and Dean Karlan. 2016. "Evaluation of an mHealth Intervention Designed to Increase Child Vaccination Coverage in Mozambique." AEA RCT Registry. April 18. https://doi.org/10.1257/rct.1184-1.0
Former Citation
Crowley, Lucas, Gunther Fink and Dean Karlan. 2016. "Evaluation of an mHealth Intervention Designed to Increase Child Vaccination Coverage in Mozambique." AEA RCT Registry. April 18. https://www.socialscienceregistry.org/trials/1184/history/7719
Sponsors & Partners

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Experimental Details

Interventions

Intervention(s)
The mVacciNation application was developed by Mezzanine, a Vodafone subsidiary, and runs on entry-level Android smartphones. As part of this intervention, one technician in the Extended Program of Immunization (EPI) of each treatment health facility will be given a smartphone equipped with the mVacciNation application. The technician will use the mVacciNation application to register caregivers and their children on a Ministry of Health database. The application will send SMS reminders of upcoming vaccination appointments to caregivers. It will also allow the EPI team to view and record vaccination events for each child. Finally, the application will prompt the EPI team to regularly report on vaccine stock levels in an effort to improve supply chain management of vaccines.
Intervention Start Date
2015-06-01
Intervention End Date
2018-02-01

Primary Outcomes

Primary Outcomes (end points)
The primary outcome of interest is complete coverage of the combination vaccine for diphtheria, pertussis, and tetanus ("DPT"). Other outcomes of interest include complete coverage of the Bacillus Calmette–Guérin vaccine ("BCG"), the polio vaccine, the pneumococcal conjugate vaccine ("PCV"), and the measles vaccine. The evaluation will also test the impact of the intervention on the length of intervals between vaccine doses and vaccine stock levels at the health facility level.
Primary Outcomes (explanation)

Secondary Outcomes

Secondary Outcomes (end points)
Secondary Outcomes (explanation)

Experimental Design

Experimental Design
Eligible health facilities in Nampula Province, Mozambique, are randomly assigned to either the treatment group or the control group with equal probability. Eligibility is defined as public health facilities (a) with a GSM cellular network signal (b) that were administering child vaccines immediately prior to baseline.
Experimental Design Details
Randomization Method
Stata do.file.
Randomization Unit
The unit of randomization is the health facility/health facility population catchment area. A health facility's catchment area is defined as the collection of census enumeration areas (EAs) for which that particular health facility is the nearest health facility, measured as the distance between the health facility and the centroid of the EA. (The shape file data set of census EAs was shared by the Institute of Statistics of Mozambique.)
Was the treatment clustered?
Yes

Experiment Characteristics

Sample size: planned number of clusters
This evaluation consists of 151 experimental health facilities for health facility-level outcome measures (e.g., vaccine stock levels) in the non-clustered portion of the study. There is a sub-set of 80 experimental health facility catchment areas for caregiver- and child-level outcome measures (e.g., complete vaccination coverage rates) in the clustered portion of the study.
Sample size: planned number of observations
The clustered portion of the study consists of approximately 2,400 children aged 12 to 23 months-old.
Sample size (or number of clusters) by treatment arms
The sample for the non-clustered portion of the study consists of 76 treatment and 75 control health facilities. The sample for the clustered portion of the study consists of a sub-set of 40 treatment and 40 control health facility catchment areas with approximately 1,200 children apiece.
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
Supporting Documents and Materials
IRB

Institutional Review Boards (IRBs)

IRB Name
University of Cape Town's Faculty of Commerce Ethics in Research Committee
IRB Approval Date
2013-12-06
IRB Approval Number
UCT/COM/299/2013
IRB Name
National Bioethics Committee for Health of Mozambique
IRB Approval Date
2014-07-18
IRB Approval Number
IRB00002657
Analysis Plan

Post-Trial

Post Trial Information

Study Withdrawal

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Intervention

Is the intervention completed?
No
Data Collection Complete
Data Publication

Data Publication

Is public data available?
No

Program Files

Program Files
Reports, Papers & Other Materials

Relevant Paper(s)

Reports & Other Materials