Mobile Phone Features as a Strategy to Promote Malaria Vaccine Uptake
Introduction
Advancements in technology allow us to lower the cost of living and even improve the standard of living by reducing human suffering from common medical problems. It is well known that malaria is a threat to achieving global health security as well as being a public health challenge in developing countries. In 2021, over 610, 000 mortality cases were reported globally, with 96% of these occurring in Sub-Saharan Africa. Furthermore, with the significant increase in the number of cases reported every year, there could be a re-emergence of malaria in Africa, especially in areas with low or no preventive strategies. This continues to pose a serious threat to attaining global health equity and will undoubtedly have an impact on the UN’s SDG Goal 3 targets.
Leveraging technological innovation and promoting equity to lessen the impact of malaria infection is of the utmost importance. This challenge calls for fresh approaches to preventive strategies to control malaria in Africa. This can be achieved by using caller tunes on mobile phones to raise awareness of malaria vaccine uptake.
Numerous strategies and intensive campaigns have already been implemented to eradicate malaria in Africa, notably, the Roll Back Malaria (RBM) initiative. The impact of the RBM has effectively reduced the burden of malaria since its inception. Tremendous efforts have also been made to combat the disease, notably, long-lasting insecticide nets (LLINs), in-door residual spray and intermittent preventive treatment (IPT) of malaria in infants, children and pregnant women. However, more innovative strategies are needed to leverage these efforts.
We live in a technologically advanced society where artificial intelligence and software surround us, influencing our daily lives and communication with one another. The application of such technologies in medical practice is known as e-health, m-health or telemedicine. In health research, especially clinical trials, phone-based interventions can play an important role in addressing health issues around the world.
Impact of m-Health on Medical Practice
Mobile technologies have been deployed, tested and deemed effective in healthcare delivery. Thus, SMS reminders can help health workers manage malaria home treatment for patients. Moreover, mobile technology played a vital role in medical services during the COVID-19 pandemic. mHealth tools significantly helped African healthcare workers provide clinical services in remote places and hard-to-reach communities, outside the clinical setting. This innovative approach, made possible through technology, makes healthcare services accessible to patients and also reduces travel expenses. Furthermore, mobile devices have successfully supported malaria community case management by improving communication and the monitoring of primary healthcare centres in different communities in Kenya. These mobile technologies were used as reminders and alerts for patients to take malaria medication. Moreover, mobile devices have been used to monitor and improve diagnostic services provided by community health workers in remote communities.
Innovation and Vaccine Development
Technology and innovative clinical investigation have resulted in the development of a malaria vaccine (RTS, S), which is a potential low-cost intervention to combat the disease. The RTS, S is the first malaria vaccine approved as an added preventive measure for malaria control, supporting existing malaria interventions. The vaccine has now been trialled and implemented in Malawi, Ghana and Kenya.
However, for the RTS, S to be integrated into national immunisation programs in Africa, much work is still needed regarding perceptions, acceptability and beliefs. To raise awareness on a massive scale, new communication strategies are needed, particularly in this era of pandemics and technological revolution.
Technological Innovation for Early Vaccine Uptake Awareness
Mobile phone technology features have been extensively tested and deployed to provide health services through alerts and SMS interventions, particularly to address medication adherence. Caller tunes or ring back tones are mobile phone features that have not yet been effectively used for vaccine uptake awareness. A caller tune is a mobile phone feature that plays music, voicemails or any other sound effects for callers as they wait for the recipient to answer.
Caller tune services are popular and widely used in Asia and Africa. These services promote popular music or religious gospel music, serving as an effective medium for communication. In 2013 in India, a local celebrity’s voice was used as a caller tune to improve awareness and communication about cervical cancer, obesity, stress, cardiovascular diseases and breast cancer. Thus, caller tunes could also be used to create large-scale awareness of RTS, S vaccine uptake in Africa. This could be trialled in Nigeria, which is expected to receive the vaccine in 2024.
Lesson Learned from Previous Outbreaks
From experience, regarding COVID-19 vaccine acceptability, Africans accepted the vaccine as a result of the disease’s virulence. However, Sub-Saharan Africans do not believe that malaria is a dangerous disease. People delay or even refuse vaccines for themselves or their children due to culture, perceptions or beliefs. As a result, the burden of malaria and vaccine hesitancy are an increasing public health and immunisation program challenge in low-income countries. This, in turn, creates a threat to global health equity. Poor vaccine uptake rates have resulted in the emergence and re-emergence of infectious outbreaks in Africa, further straining the already weak health systems in Africa. Strategic and effective communication is needed to address vaccine hesitancy and enhance health equity.
Recommendations
To successfully use caller tunes as an approach to raising malaria vaccine uptake in Africa, several factors need to be considered.
First, a pilot study should be conducted to inform policymakers about community perceptions and beliefs regarding the newly approved malaria vaccine. These use of caller tunes to raise awareness has been successfully used in certain parts of Africa; however, a second pilot study is need is those parts of Africa where this strategy has not been trialled. This baseline data will guide national health officials on how to structure strategic information to reduce fear and encourage vaccine uptake as soon as the vaccine becomes available. Second, it is necessary to establish collaboration with other sectors, such as telecommunication companies, which would be providing the caller tunes service. This will ensure that the campaigns to raise malaria vaccine uptake are effective.
Conclusion
Using caller tunes as a mobile phone technology feature, together with collaboration with the telecommunications sector in Africa, can enhance vaccine uptake awareness. This medium can also be used to convey the advantages of malaria vaccination, especially in areas where the disease is endemic. This innovative use of technology will be of great importance in raising awareness of malaria vaccines to avoid vaccine hesitancy and support existing malaria interventions.
Authors
Stanley Eneh1, Onukansi Francisca2
1. The Nigerian Institute of Medical Research (NIMR)
2. Department of Public Health, Federal University of Sciences and Technology, Owerri, Nigeria
Disclaimer
The views expressed in this World EBHC Day Blog, as well as any errors or omissions, are the sole responsibility of the author and do not represent the views of the World EBHC Day Steering Committee, Official Partners or Sponsors; nor does it imply endorsement by the aforementioned parties.
