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Scaling up of m-Health interventions for improving immunization coverage among children living in urban slums

I was the Principal Investigator of our pilot study and will continue same role of this scale up project.

Photo of Md. Jasim Uddin
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Describe what you intend to do and how you'll do it in one to two sentences (required 350 Characters)

We piloted a software based application for improving immunization coverage among children living in rural hard-to-reach areas and urban streets. The study demonstrated significant improvement in childhood vaccination coverage after implementation of the system. This successful pilot study will be scaled up in urban slums where the coverage is low.

Explain the innovation (2,500 characters)

In Bangladesh, over one-quarter population live in urban areas. About a third of this population live in slums. Poor nutritional status and above-average under-5 mortality are major concerns in urban slums. Immunization coverage is markedly lower in urban slums (67.5%) when compared to the national estimate (82.3%) of Bangladesh. Previous research has determined that the main reasons for low coverage in those areas are absence of an effective mechanism in tracking newborn children and reminding parents about EPI sessions. Evidence here and in other low-income countries has shown the use of mobile phones to be effective and acceptable for marginalized populations, and this new technology-based approach contributed substantially in improving vaccination coverage. Our proven innovation as mentioned below will be scaled up with the aim to successfully vaccinate all male and female child populations in highly mobile populations in order to achieve the targets of Sustainable Development Goals (SDGs). In our pilot study, a very low cost application was employed within the existing health system to register birth of every child electronically and auto remind mothers about routine vaccination dates with text messages. Android Smart phones were provided to all vaccinators and their supervisors in the study sites. The intervention package included: (i) mobile phone-based registration of pregnant women and children, (ii) birth notification by mothers/clients, (iii) system for auto reminders to clients, (iv) system for auto reminders to vaccinators, (v) mobile- and web-based monitoring of performance by supervisors. The very low cost interventions were implemented through the existing health system–the Expanded Program on Immunization (EPI)–run by Ministry of Health (MOH). The pilot study demonstrated significant improvement in childhood vaccination coverage among children living in hard-to-reach areas and urban streets after implementation of the innovative system. The intervention package is now positioned for scale up and the scale up will be done among the urban slum (highly mobile) populations in Bangladesh. Scaling up of above mentioned successful intervention package will lead to increased prevention of vaccine- preventable diseases among both male and female children living in urban slums.

Which part(s) of the world does this innovation target?

  • Southern Asia

Geographic Focus

The geographic focus is Dhaka city. Dhaka is the most populated city in Bangladesh, and it is also one of the most populated cities in the world. The city itself has a population estimated at about 8.5 million and more than one third of the population are slum dwellers.

Stage of Innovation

  • Scale

Who will work alongside your organization in the project idea? (1,000 characters)

Our pilot study was conducted in collaboration with MOH. In urban areas of Bangladesh, the Ministry of Local Government (MOLG) and NGOs are the key players in providing healthcare services. Therefore, MOH, MOLG and NGOs will be engaged with icddr,b in scaling up of the innovation.

How is your idea unique? (750 characters)

The main reasons for low vaccination coverage in urban slums are absence of an effective mechanism in tracking newborns and reminding parents about EPI sessions. Scaling up of our project will produce an effective and sustainable model of use of technology for improving vaccination coverage among this group of people. Findings from our pilot study showed that the innovation contributed in increasing vaccination coverage among disadvantaged population, improved program efficiency, and the system was affordable by and acceptable to both service recipients and service providers. All these will contribute to universal childhood vaccination coverage, leading to reduction of morbidity and mortality and, thus, save millions of lives.

What is the name of your organization

International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)

Explain your organization (250 characters)

icddr,b is an international health research institute to solve key public health problems through high quality scientific research and innovation. Reducing child mortality and improving the well-being of children is one of the goals of icddr,b.

Type of Submitter

  • We are a formal part of a University or Research Institution

Organizational Characteristics

  • International health research institute

Gender and Diversity (500 characters)

The organizational gender policy of icddr,b is based on principles of equity and equality; affirmative action; and enhanced research, interventions, service and training. icddr,b always encourages equal opportunities in the workplace and female candidates are strongly encouraged. The gender policy establishes an overall goal for icddr,b in the conduct of its research, interventions, service and training.

Organization Location (less than 250 Characters)

68, Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka-1212, Bangladesh

Size of organization (number of employees):

  • More than a 1,000 people

Website URL

http://www.icddrb.org

Scale of organizational work

  • Global (within 2 or more global regions)

Tell us more about you

Team members are the public health scientists, public health specialists, software engineer and programme manager from icddr,b, MOH, MOLGD and NGOs. The Principal Investigator of this project has been working with Bangladesh’s EPI for the last 20 years. The other members of the project have also long experience in this area and working with EPI stakeholdrs. The team members are selected considering their proof of strength in implementing such projects. The list of team members included: Md. Jasim Uddin, Ph.D, Principal Investigator; Nurul Alam, Ph.D, Scientist and Co-Investigator; Md. Shamsuzzaman, Ph.D, Public Health Specialist; Md. Golam Mostafa, Software Engineer; and Wazed Ali, Programme Manager.

Applying to Gavi INFUSE

  • OpenIDEO Website
  • Referred by a friend / colleague

4 comments

Join the conversation:

Comment
Photo of Manisha Laroia
Team

Hi Md. Jasim Uddin 
As the challenge is coming to a close, please make sure you have answered all the questions in the Public and the Privately Submitted section.

A few general pointers you should check for in your final submission:
[1] How your innovation solves the challenge problem?
[2] Working of your prototype and its pilot stage?
[3] Does the solution fit in the highly mobile urban settings and how it can prove to be low cost?
[4] How the solution caters to the gender equity by having an inclusive approach?
[5] About your team and your working relation with your partners?

The submission deadline is 5pm PST on Wednesday April 10th/ 1:00am CET on Thursday April 11th.
Feel free to make the necessary changes to your application and hit the submit button before the deadline.

All the best!
OpenIDEO Community Team

Photo of Md. Jasim Uddin
Team

In Bangladesh, over one-quarter population live in urban areas. About a third of this population live in slums. Poor nutritional status and above-average under-5 mortality are major concerns in urban slums. Immunization coverage is markedly lower in urban slums (67.5%) when compared to the national estimate (82.3%) of Bangladesh. Previous research has determined that the main reasons for low coverage in those areas are absence of an effective mechanism in tracking newborn children and reminding parents about EPI sessions.
Evidence here and in other low-income countries has shown the use of mobile phones to be effective and acceptable for marginalized populations, and this new technology-based approach contributed substantially in improving vaccination coverage. Our proven innovation as mentioned below will be scaled up with the aim to successfully vaccinate all male and female child populations in highly mobile populations in order to achieve the targets of Sustainable Development Goals (SDGs).
In our pilot study, a very low cost application was employed within the existing health system to register birth of every child electronically and auto remind mothers about routine vaccination dates with text messages. Android Smart phones were provided to all vaccinators and their supervisors in the study sites. The intervention package included: (i) mobile phone-based registration of pregnant women and children, (ii) birth notification by mothers/clients, (iii) system for auto reminders to clients, (iv) system for auto reminders to vaccinators, (v) mobile- and web-based monitoring of performance by supervisors. The very low cost interventions were implemented through the existing health system–the Expanded Program on Immunization (EPI)–run by Ministry of Health (MOH). The pilot study demonstrated significant improvement in childhood vaccination coverage among children living in hard-to-reach areas and urban streets after implementation of the innovative system. The intervention package is now positioned for scale up and the scale up will be done among the urban slum (highly mobile) populations in Bangladesh. Scaling up of above mentioned successful intervention package will lead to increased prevention of vaccine- preventable diseases among both male and female children living in urban slums.
More details about the questions are provided with my submission.

Photo of Manisha Laroia
Team

This sound great Md. Jasim Uddin 
I understand that you have done extensive work in this space. Our message was to help you note general points and update your submission before final deadline.
We are trying to support you in the final hours before the deadline so that you put forward your best application.
Please make sure you make all the necessary additions in the application you feel fit.
Let us know if we can support you in any other way.
Happy to help!

Photo of Md. Jasim Uddin
Team

Hi Manisha,
Thank you for your continuous support for my submission. I'll go through the submission again before deadline. Feel free to let me know if you have any further feed backs.