A field trial to assess the effectiveness of a reminder sticker in reducing immunization dropout rates was conducted in two districts of Addis Ababa between 14 October 1991 and 31 January 1992. A total of 703 children were entered into the study. The study population was randomly divided into intervention and control groups. The intervention group received a reminder sticker and the control group did not. All other services were identical. A baseline interview documented the socio-demographic and maternal characteristics potentially related to immunization services utilization and revealed no statistically significant differences between the two groups. The dropout rates were 7.3 and 13.3% in the intervention and control groups respectively. This difference is clinically and statistically (P < 0.01) significant. Therefore, it is concluded that the reminder sticker is effective in reducing immunization dropout rates. Further investigations under operational conditions are recommended prior to the routine introduction of stickers into the immunization services.
PIP: Between October 1991 and February 1992 in Ethiopia, community health providers followed 703 6-week-old to 23-month-old children who came to 4 vaccination centers in the Lideta and Nefas-Silk districts in Addis Ababa to determine whether reminder stickers applied to the inside of their home front door would reduce immunization dropout rates. The health workers gave a circular sticker with a picture of a child receiving a vaccination and an appointment date to the mothers of 343 children after they received their first diphtheria-pertussis-tetanus (DPT1) vaccination. The health workers did not give a sticker to the mothers of the 360 remaining children. They visited the homes of 35% of the children in the intervention group to determine compliance with applying the sticker. No statistically significant sociodemographic and maternal differences between the 2 groups existed. The immunization dropout rate of children whose mothers received a reminder sticker was 55% lower than that of the control group (7.3% vs. 13.3%; p .01). The researchers compared the immunization dropout rate of the study control group with that of a historical control group who received their DPT1 in July 1991. They found that the study control group was less likely to drop out than the historical control group (relative risk = 0.68; p 0.01). The mothers of just 4.7% of the intervention children who had a home visit did not apply the sticker. The dropout rate for the intervention subjects whose mothers did not apply the sticker was very high (30%), but it was not statistically significant. The leading reasons for dropouts not applying the sticker were child illness and unawareness of the need for another dose. These findings showed that stickers effectively reminded mothers to bring their children to the vaccination centers for another vaccination, thereby reducing the immunization dropout rate.