“Notify Health Vaccination Reminders - Our first year, pilot results and the path ahead” by Samuel Harvey, DanielHa

Jun 9, 2025

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TL;DR

This post introduces Notify Health, an AIM-incubated charity that reduces vaccine-preventable child deaths in Nigeria via SMS and voice vaccination reminders.

Nigeria has the highest number of children missing vaccines globally by count. Over 50% of missed vaccines are caused in part by caregivers forgetting or misunderstanding the schedule. SMS and call vaccination reminders are a scalable solution that has strong evidence of effectiveness. A meta-analysis in LMICs shows sizable effects, and there are programs that prove this intervention can work at scale by serving millions of children already. Implementation remains neglected in many contexts, including Nigeria.

Founded one year ago, Notify Health piloted reminders with ~2,200 caregiver-child pairs from 44 clinics in Kogi state, Nigeria. The program works by digitising widespread health facility paper records to enrol caregivers. During the pilot, we sent 42,000+ reminders and saw timely vaccination increase by 12–24 percentage points in our analysis [...]

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Outline:

(00:21) TL;DR

(02:37) The problem - Millions miss vaccination due to simple knowledge barriers

(05:35) The solution - Make it easy with proven, low-cost, and scalable reminders

(05:41) Intervention: Vaccination Reminders

(07:48) Our implementation

(09:39) Progress - Notify Health piloted reminders in Nigeria with ~2,200 caregivers

(11:00) Operational metrics - Feasibility & Reach

(13:06) Caregiver Feedback

(15:10) Changes in immunization rates

(19:05) Discussion and limitations

(19:46) Timeliness vs coverage

(21:02) Limitations of our analysis

(24:28) Cost-Effectiveness - Not Yet 10x, but a clear path there

(29:30) Up Next - Iterating on the model for greater impact and cost-effectiveness

(29:53) Pilot in another Nigerian State

(30:23) Find a way to enrol a wider range of children from the general population

(31:04) Iterate on the program design to reduce cost and improve impact

(32:12) Continue to build our monitoring and evaluation muscle

(32:55) Looking further ahead

(34:01) How you can get involved

(35:15) Acknowledgements - Who we're grateful for

The original text contained 7 footnotes which were omitted from this narration.

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First published:
June 4th, 2025

Source:
https://forum.effectivealtruism.org/posts/22323TMBfYzkosrhy/notify-health-vaccination-reminders-our-first-year-pilot

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Narrated by TYPE III AUDIO.

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Images from the article:

Anonymised dashboard displaying key metrics from some facilities

Call pick-up rates. Light purple is the pick up rate and dark purple is listening >10 seconds. Pick-up rates improved over time as we introduced call re-tries. The dip is an outage of the virtual phone number provider.

Sensitivity analysis results across different parameters. “Low Gap” means 5% vaccination gap, which might for example result from an enrollment focus on high-coverage urban areas.

Bar graph showing vaccination rates for Penta 1 and Penta 2 during pilot period.

Flow diagram showing three-step vaccination process: Enrol, Remind, and Vaccinate. Each step shows implementation actions and monitoring/evaluation metrics below.

An infographic showing newborn vaccination schedule from birth to 15 months.

The image displays a winding path marking important vaccination milestones starting at birth with BCG, OPV-0, and Hep B vaccines. It continues through various stages at 6 weeks, 10 weeks, 14 weeks, and then monthly intervals showing different vaccines including Penta/DTP series, PCV series, Rotavirus vaccines, Malaria vaccines, and Vitamin A supplements.

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