Challenges of implementing mobile phone text messages in reminding parents to get their children immunized in Nigeria: A narrative inquiry of mothers’ experience

Evidence suggests that mobile phone reminders improve the uptake, completeness and timeliness of routine childhood immunization. However, the implementation of the reminder system in resource limited settings is affected by challenges. Some of the challenges of the reminder interventions in Low- and Middle-Income Countries (LMICs) include: the non-ownership of mobile phones and language barrier. There is however a paucity of evidence on the challenges that may affect such intervention in Nigeria. This study explored the challenges experienced by mothers who were reminded about the immunization of their children in Nigeria. Using a qualitative narrative inquiry, in-depth interviews were conducted with eligible participants. The participants were purposively selected from mothers who earlier received mobile phone text message reminders on the immunization of their children in Kano State, Nigeria. The recorded interviews were transcribed, translated to English and analysed using thematic analysis. A total of thirteen in-depth interviews were conducted. The themes that emerged are: benefits of the mobile phone reminders, mobile phone ownership, network issues, parental ability to read, and spousal support. While the reminder system was found to be helpful, not owning a mobile phone and the inability to read messages were among the challenges experienced. The active involvement of male spouses/fathers in the reminder system, use of local languages, and phone call reminders are hereby recommended. Deliberate actions towards improving the level of literacy, mobile phone network and infrastructure by policy makers is also recommended to facilitate future implementation of mobile phone reminder interventions.