Child Health Care and Immunization Reminder: Design and Implementation of a Web-Based Immunization Reminder and Child Health Record System for Low-Resource Settings

Abstract Routine childhood immunization is one of the most cost-effective public health interventions available, and Bangladesh’s Expanded Programme on Immunization (EPI) is widely regarded as a success story, maintaining third-dose pentavalent coverage of approximately 98% in recent years. Nevertheless, national aggregates conceal important pockets of zero-dose and under-immunized children, and dose timeliness remains imperfect: recent survey evidence finds 1.9% zero-dose and 11.6% under-immunized children nationally, with markedly higher rates in wetland (haor) areas, coastal belts, and urban slums. Caregiver-level barriers—forgotten appointments, competing demands, and paper-based child health cards that are easily lost—are frequently cited contributors to missed doses. A substantial body of evidence shows that patient reminder and recall interventions measurably increase vaccination uptake, with systematic reviews of low- and middle-income countries (LMICs) reporting relative increases of 9–16% for text-message reminders. This paper presents the design, implementation, and functional evaluation of the Child Health Care and Immunization Reminder (CHCIR) system, a web-based platform that maintains digitized child immunization records, computes per-child vaccination due dates from the national EPI schedule, and dispatches automated short-message service (SMS) and e-mail reminders to guardians. The system follows a three-tier architecture built on the Microsoft .NET technology stack with a relational back end normalized to third normal form, and it supports three stakeholder roles—administrator, field employee, and guardian—through role-based access control. Security measures include salted password hashing, parameterized database access, anti-CSRF tokens, and output encoding against cross-site scripting. The system was verified through unit, integration, and system testing with all functional test cases passing. The CHCIR system demonstrates that an individually targeted, schedule-aware reminder capability can be engineered at low cost atop infrastructure that already reaches more than 190 million mobile subscriptions in Bangladesh, making it a plausible complement to national defaulter-tracing efforts. Field evaluation of vaccination-coverage impact remains an important next step.