ABSTRACT
Objectives: National guidelines in Senegal indicate the first dose of Vitamin A Supplementation (VAS) should be received at six months; however children usually receive their first dose at an average age of nine months through twice-yearly VAS days. To increase provision of VAS to children at six months, the routine provision of VAS was piloted along with a set of SMS-based interventions. Methods: From September 2012 to April 2013, a pilot was conducted in three intervention districts in which a new child health card and vaccination calendar including a six-month contact point for VAS were introduced. SMS appointment reminders were sent to all caregivers in intervention districts when their child turned six months. Each intervention district was paired with a comparable control district that received regular services. Results: Coverage of VAS at six months in intervention districts was 70% with higher coverage in rural (100%) than semi-rural (69%) and urban (45%) districts (p<0.001). Coverage ranged from 5- 7% in control districts. 35% of caretakers reported receiving information on the six-month visit by SMS, with phone calls and mobilization by health workers other common sources. Average age of VAS receipt in intervention districts was 6.5 months. Conclusions: The addition of a six-month contact point into the routine immunization schedule was effective in increasing VAS coverage at six months. The six-month contact point should be integrated into the vaccination calendar in Senegal, and SMS messages may be helpful at increasing coverage at visits. Further strategies may be needed to achieve high coverage in urban and semi-urban areas.