JMIR Publications

ABSTRACT

Child immunization is a key component of the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF)’s child survival intervention package. Yet, internationally, there are up to 19.4 million children who are still unvaccinated, and face unnecessary deaths, especially among refugees. Growing access to smartphones, among refugees, was a leading factor to use this technology to improve vaccination rate. This study aims to determine whether a smartphone application (app) can improve the vaccination uptake among refugees and determine the app effectiveness in improving the documentation of vaccination records among parents. We developed and planned to test an app through a randomized trial that will be carried out at the Zaatari refugees camp in Jordan. The study will be open to all parents that carry Android smartphone phones, have at least one child and agree to participate in the study. The parents will be recruited to the study by trained volunteers at the seven local clinics, providing vaccinations, around the Zaatari camp. Inclusion criteria will be: having at least one child age 0-5 years of age, being a local resident of the camp and having an Android smartphone that can allow CImA app installation. The intervention includes an app that will allow storing Jordanian vaccination records, per child, on the parents’ smartphones in Arabic and in English languages (in an interchangeable fashion). Every record will have a set of automated reminders prior the appointment of each child. The app will summarize immunization records in form of “due”, “taken” or “overdue” appointments, labeled in orange, green and red respectively. Baseline will include the collection of our primary and secondary outcomes that are needed for the pre- and post-data measurements. This includes social demographic data, any prior vaccine history and eHealth literacy. Participants, in both study arms, will be monitored for their follow-up visits to the clinic for the vaccination doses. For the study outcome measures, we will measure any differences in the uptake of vaccinations. The secondary outcome is to analyze the effect of the CImA app on visits for the follow-up doses. Due to the limited evidence of effective interventions for childhood vaccination among refugees, research in this area is in great need. The project will have a significant impact on the health of refugees and the public health system. In Jordan, and the Middle East, the vaccination level is low. Given the influx of refugees from the area it is crucial to ensure a high vaccination level for the refugees, especially for children, to avoid VPDs.