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      Innovations in communication technologies for measles supplemental immunization activities: lessons from Kenya measles vaccination campaign, November 2012

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          Abstract

          Background To achieve a measles free world, effective communication must be part of all elimination plans. The choice of communication approaches must be evidence based, locally appropriate, interactive and community owned. In this article, we document the innovative approach of using house visits supported by a web-enabled mobile phone application to create a real-time platform for adaptive management of supplemental measles immunization days in Kenya.

          Methods One thousand nine hundred and fifty-two Red Cross volunteers were recruited, trained and deployed to conduct house-to-house canvassing in 11 urban districts of Kenya. Three days before the campaigns, volunteers conducted house visits with a uniform approach and package of messages. All house visits were documented using a web-enabled mobile phone application (episurveyor®) that in real-time relayed information collected to all campaign management levels. During the campaigns, volunteers reported daily immunizations to their co-ordinators. Post-campaign house visits were also conducted within 4 days, to verify immunization of eligible children, assess information sources and detect adverse events following immunization.

          Results Fifty-six per cent of the 164 643 households visited said that they had heard about the planned 2012 measles vaccination campaign 1–3 days before start dates. Twenty-five per cent of households were likely to miss the measles supplemental dose if they had not been reassured by the house visit. Pre- and post-campaign reasons for refusal showed that targeted communication reduced misconceptions, fear of injections and trust in herbal remedies. Daily reporting of immunizations using mobile phones informed changes in service delivery plans for better immunization coverage. House visits were more remembered (70%) as sources of information compared with traditional mass awareness channels like megaphones (41%) and radio (37%).

          Conclusions In high-density settlements, house-to-house visits are easy and more penetrative compared with traditional media approaches. Using mobile phones to document campaign processes and outputs provides real time evidence for service delivery planning to improve immunization coverage.

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          Most cited references21

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          EpiCollect: Linking Smartphones to Web Applications for Epidemiology, Ecology and Community Data Collection

          Background Epidemiologists and ecologists often collect data in the field and, on returning to their laboratory, enter their data into a database for further analysis. The recent introduction of mobile phones that utilise the open source Android operating system, and which include (among other features) both GPS and Google Maps, provide new opportunities for developing mobile phone applications, which in conjunction with web applications, allow two-way communication between field workers and their project databases. Methodology Here we describe a generic framework, consisting of mobile phone software, EpiCollect, and a web application located within www.spatialepidemiology.net. Data collected by multiple field workers can be submitted by phone, together with GPS data, to a common web database and can be displayed and analysed, along with previously collected data, using Google Maps (or Google Earth). Similarly, data from the web database can be requested and displayed on the mobile phone, again using Google Maps. Data filtering options allow the display of data submitted by the individual field workers or, for example, those data within certain values of a measured variable or a time period. Conclusions Data collection frameworks utilising mobile phones with data submission to and from central databases are widely applicable and can give a field worker similar display and analysis tools on their mobile phone that they would have if viewing the data in their laboratory via the web. We demonstrate their utility for epidemiological data collection and display, and briefly discuss their application in ecological and community data collection. Furthermore, such frameworks offer great potential for recruiting ‘citizen scientists’ to contribute data easily to central databases through their mobile phone.
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            'Trusting blindly can be the biggest risk of all': organised resistance to childhood vaccination in the UK.

            Sociological interest in vaccination has recently increased, largely in response to media coverage of concerns over the safety of the MMR (measles, mumps and rubella) vaccine. The resulting body of research highlights the importance of risk and trust in understanding parental and professional engagement with vaccination. To date, only limited attention has been paid to organised parental groups that campaign against aspects of vaccination policy. This paper reports findings from a qualitative study of contemporary groups in the UK, and develops three main lines of argument. First, these actors are best analysed as 'Vaccine Critical groups' and include Radical and Reformist types. Second, Vaccine Critical groups discursively resist vaccination through a reframing that constructs risk as unknown and non-random. Third, trust as faith is negatively contrasted with the empowerment that is promised to result from taking personal responsibility for health and decision-making. Whilst representing a challenge to aspects of vaccination policy, this study confirms that the groups are involved in the articulation and promotion of other dominant discourses. These findings have implications for wider sociological debates about risk and trust in relation to health.
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              Immunisation and herd immunity.

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                Author and article information

                Journal
                Health Policy Plan
                Health Policy Plan
                heapol
                heapol
                Health Policy and Planning
                Oxford University Press
                0268-1080
                1460-2237
                June 2015
                11 June 2014
                11 June 2014
                : 30
                : 5
                : 638-644
                Affiliations
                1American Red Cross International Response and Programs, PO Box 41275-00100, Nairobi, Kenya, 2Division of Vaccines and Immunization, Ministry of Health, PO Box 30016, Nairobi, Kenya, 3Kenya Red Cross, PO Box 40712-00100, Nairobi, Kenya, 4UNICEF East and Southern African Regional Office, United Nations Complex, Gigiri, PO Box 44145-00100, Nairobi, Kenya and 5Bill and Melinda Gates Foundation, PO Box 45335-00100 Nairobi, Kenya
                Author notes
                *Corresponding author. Health/Measles Delegate, American Red Cross Programs for Africa, PO Box 41275-00100, Nairobi, Kenya. E-mail: william.mbabazi@ 123456redcross.org
                Article
                czu042
                10.1093/heapol/czu042
                4421834
                24920218
                5284e4fd-1524-4b14-8108-3097f8fdc177
                Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence ( http://creativecommons.org/licenses/by-nc-nd/3.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work properly cited. For commercial re-use, please contact journals.permissions@oup.com

                History
                : 20 April 2014
                Page count
                Pages: 7
                Categories
                Original Articles

                Social policy & Welfare
                house-to-house canvassing,measles campaigns,mobile phones,kenya
                Social policy & Welfare
                house-to-house canvassing, measles campaigns, mobile phones, kenya

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