For health workers in Uganda, SMS reminders to parents are “the hope we needed”

With contribution from Ritah Okello in Kampala, Uganda

Mrs. Kalibala brought her twins for immunisation after receiving an SMS reminder

On a cold, misty Monday morning in Kampala, I needed to get a warm place as I waited for a taxi. Shortly after 7 am, I hopped into one, and it weaved its way towards Seeta on our way to Mukono, a town 18 km outside of Kampala. Despite the heavy morning traffic, the driver still needed to be prompted by the passengers to “slow down, we still have families to provide for!” As he reduced the speed, I saw a sign saying, “welcome to Mukono District.’’ I paid the conductor and walked towards the small gate of Mukono Health Centre IV.

As I entered, the compound was alive with mothers carrying babies, some tying them on the backs while holding bags in the other hand, some sitting on the grass under trees, others standing in groups talking. On arriving at the EPI clinic, I heard the nurse in charge of immunisation directing mothers where to sit and how many should enter the immunisation room. I was intrigued by the huge number waiting, and wondered how they knew when to come in. I stood close in order to find more on how parents were informed on dates for immunisation

Soon over the hum of voices I heard the sound of a lullaby, “sleep little babies” coming from the far end of the room, raising my curiosity to find who was behind the voice. I saw a mother holding two children, and as I introduced myself, realised that the babies were identical twins. This prompted me to ask her a little about herself, and the health of the children. She introduced herself, “I am Mrs. Kalibala Monica from Kigungwa, with three children and a small-scale business that helps sustain the family”.

As we spoke, she pulled a blanket from her bag, wrapped her babies, and said, “in previous years, it was hard recalling the dates of immunisation, due to the responsibilities at hand like farming, waiting for the trucks of charcoal to arrive as my husband was away, yet I had no help. This made me fail to keep track of my son’s immunisation dates, making me more disorganised and irresponsible.” Vaccine coverage in many countries remains below acceptable levels, placing children at unnecessary risk for preventable diseases. One of the reasons for this is that children aren’t taken for immunisation when they should be, because parents may forget the date.

She pulled out her mobile phone and showed me a text message she had received, which said “Your child with ID [number] is due for vaccination. Mukono HCIV works Mon to Fri. Previously received vaccines BCG, OPV0”. She told me that on the arrival of the twins in early January, their information was collected, and she was issued two new immunisation cards. “After about a month and some weeks, I received an SMS informing me of the date for immunisation, trust me this has brought a lot of relief to my life because I am now updated and aware of the immunisation dates.”

Example of an SMS reminder sent by Shifo to caregivers.

After chatting with me for a while, Mrs. Kalibala headed out to the nurse to get the twins immunised. Later when the session had ended for the day, I spoke with the nurse, Nantume Annet. She informed me that, “in the previous years, we used manila charts to keep track of immunisation and inform mothers on when to come back for the next visit, however this made our work hectic due to the small numbers of mothers turning up, increasing administration work hence causing difficulties in follow ups. But with the new intervention of SMS reminders by Shifo, this process has been simplified for us, follow ups of the children is made possible and it is helping us to meet our targets. It is the hope we needed at the centre,” said Nurse Nantume Annet.

Not only have the SMS reminders helped the health workers, but also given hope to mothers like Mrs. Kalibala, who now has a little extra help to make sure her children can be protected against preventable diseases.