Original Article

Improving the timeliness and completeness of childhood vaccination through color-coded bracelets: a pilot study among Fulani tribe populations in Nigeria

Inuwa B. Yau, Mahmud Zubair Mustapha, Eric Nwaze, Ouédraogo Nobila, Aliyu Maigoro, Adamu Abdullah, Adamu Gamawa, Peter Meissner, Jahn Albrecht, Olaf Müller
Journal of Public Health in Africa | Vol 14, No 5 | a194 | DOI: https://doi.org/10.4081/jphia.2023.2079 | © 2024 Inuwa B. Yau, Mahmud Zubair Mustapha, Eric Nwaze, Ouédraogo Nobila, Aliyu Maigoro, Adamu Abdullah, Adamu Gamawa, Peter Meissner, Jahn Albrecht, Olaf Müller | This work is licensed under CC Attribution 4.0
Submitted: 06 April 2024 | Published: 31 May 2023

About the author(s)

Inuwa B. Yau, National Primary Health Care Development Agency, Abuja, Nigeria
Mahmud Zubair Mustapha, National Primary Health Care Development Agency, Abuja, Nigeria
Eric Nwaze, National Primary Health Care Development Agency, Abuja, Nigeria
Ouédraogo Nobila, German Cancer Research Center, Heidelberg, Germany
Aliyu Maigoro, Federal Medical Center, Azare, Nigeria
Adamu Abdullah, Bauchi State Primary Health Care Development Agency, Bauchi, Nigeria
Adamu Gamawa, Bauchi State Primary Health Care Development Agency, Bauchi, Nigeria
Peter Meissner, Department of Pediatrics and Adolescent Medicine, Ulm University, Germany
Jahn Albrecht, Institute of Global Health, Medical School, Ruprecht-Karls-University, Heidelberg, Germany
Olaf Müller, Institute of Global Health, Medical School, Ruprecht-Karls-University, Heidelberg, Germany

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Abstract

Background: Childhood immunization remains one of the most cost-effective public health interventions. Globally, millions of children are not being reached with safe and effective vaccines and Nigeria has the highest number of unprotected children.

Objective: The effects of locally adapted interventions on vaccination timeliness and completeness were studied amongst Fulani populations across 6 health facilities in 2 districts of Bauchi State, Nigeria.

Methods: The intervention group consisted of newborns who received 5-color-coded bracelets representing different immunization contacts, while the control group had no bracelets. Vaccination rates across contacts were followed for 11 months. In addition, mothers of children in the intervention group were voluntarily recruited as peer-to-peer mobilizers (PPM).

Results: In this study, 435 children were studied. Vaccination completeness was higher in the intervention group compared to the control group at all contacts during follow-up. The difference was most noticeable at the fifth contact, with 158/256 (62%) children in the intervention group completing, compared to 73/179 (41%) in the control group (P<0.0001). Vaccination timeliness was better in the intervention group compared to the control one, which reached statistical significance at the second and third vaccination contacts (P<0.05). 68% of women volunteered as PPM and recruited 82 additional children for vaccination.

Conclusion: This study demonstrated the feasibility of a composite intervention (bracelets and PPM) to increase the completeness and timeliness of childhood immunization and provided preliminary evidence for its efficacy among Fulani populations in Nigeria. Findings from this pilot study should be confirmed through a larger cluster randomized controlled trial.


Keywords

childhood vaccinations; vaccination timeliness; vaccination completeness; vaccination reminders

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