ojpm Open Journal of Preventive Medicine 2162-2485 2162-2477 Scientific Research Publishing 10.4236/ojpm.2026.161001 ojpm-148971 Article Medicine Healthcare Improving Childhood Immunization Completion in Rural Bayelsa State, Nigeria: A Pragmatic Cluster Randomized Trial of Mobile Phone Reminders and Home Visits Promise Vivian Ibienebakabobo 1 Alabere Ibidabo 2 Abdulraheem Ibraheem 3 Raimi Morufu Olalekan 4 Department of Public Health, Faculty of Health Sciences, Bayelsa Medical University, Yenagoa, Nigeria Department of Community Medicine, School of Public Health, University of Port Harcourt, Port Harcourt, Nigeria Department of Epidemiology and Community Health, Faculty of Health Sciences, University of Ilorin, Ilorin, Nigeria Niger-Delta Institute for Emerging and Re-Emerging Infectious Diseases (NDIERID), Federal University Otuoke, Nigeria

The authors declare no conflicts of interest regarding the publication of this paper.

 20 01 2026 01 2026 16 01 1 20 20 11 2025 17 01 2026 20 01 2026 © 2026 by the authors and Scientific Research Publishing Inc. 2026 This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( https://creativecommons.org/licenses/by/4.0/ ). https://doi.org/10.4236/ojpm.2026.161001

Background: Immunization is a critical public health intervention for preventing vaccine-preventable diseases (VPDs) and achieving herd immunity. However, suboptimal vaccination coverage remains a challenge, particularly in rural and underserved areas. Missed appointments due to forgetfulness and logistical barriers contribute significantly to low immunization rates. This study evaluates the impact of mobile phone (MP) reminders and home visits (HV) on childhood immunization completion rates in Bayelsa State, Nigeria. Aim: The study aimed to assess the effectiveness of MP reminders and HV outreach in improving vaccination coverage among children under two years of age. Methods: A pragmatic cluster randomized controlled trial was conducted in rural communities of Bayelsa State, Nigeria. A total of 384 participants were randomly assigned to three study arms: control (no intervention), MP reminders, and HV outreach (128 per arm). A multi-stage sampling technique was employed, and data were collected using a semi-structured WHO SAGE survey tool. Statistical analyses were performed using SPSS v25, with chi-square (χ2) tests used to compare categorical variables. Statistical significance was set at p ≤ 0.05, with effect sizes reported. Results: The study revealed significant differences in immunization completion rates across study groups: control (46.1%, 59/128), MP reminders (59.4%, 76/128), and HV outreach (63.3%, 81/128). Both interventions were effective in improving vaccination uptake, with a statistically significant difference (p = 0.015) and a moderate effect size (0.257). However, HV outreach demonstrated the highest completion rate, suggesting its greater effectiveness in overcoming access and engagement barriers. Conclusion: Integrating MP reminders and HV outreach into routine immunization programs can significantly improve childhood vaccination coverage. HV, in particular, addresses accessibility challenges and enhances community trust, making it a preferred strategy for increasing immunization rates. To optimize immunization coverage, policymakers should implement a hybrid approach, combining MP reminders with HV outreach, particularly in rural and underserved areas. Strengthening community-based health worker engagement and leveraging digital health innovations will further enhance vaccination efforts. Improved immunization coverage through these interventions reduces the risk of VPD outbreaks, enhances herd immunity, and contributes to achieving global vaccination targets. By addressing barriers to vaccine access and adherence, these strategies offer scalable, cost-effective solutions for improving child health outcomes. This trial provides robust evidence on the effectiveness of digital and community-based interventions for improving vaccination coverage. By comparing MP reminders and HV outreach, the study offers practical insights for health policymakers and program implementers. The findings contribute to global immunization research by highlighting scalable, low-cost solutions that can be adapted in resource-limited settings to strengthen immunization programs and reduce childhood morbidity and mortality.

 Immunization Coverage Vaccine-Preventable Diseases (VPDs) Mobile Phone Reminders Home Visits Childhood Vaccination Cluster Randomized Controlled Trial Public Health Intervention Herd Immunity Rural Healthcare Vaccination Adherence 1. Introduction

Vaccines have transformed global health by reducing the burden of infectious diseases. They prevent severe illness, lower mortality rates, and extend life expectancy, making them one of the most effective public health interventions [1]-[9]. The World Health Organization (WHO) estimates that vaccines save 3 to 5 million lives annually, either through direct protection or herd immunity [2]. Despite this success, vaccination gaps persist, threatening progress toward Sustainable Development Goal (SDG) 3, which aims for universal health coverage [10]-[12]. Although the Global Vaccine Action Plan targeted 90% immunization coverage by 2020, the current global rate remains at 84%, below the pre-pandemic level of 86% [13]. Approximately 20 million children worldwide are under-immunized, with 6.5 million receiving no vaccines at all [5][6][8][10]. This gap increases outbreaks of preventable diseases, particularly in low-resource regions. Sub-Saharan Africa faces significant vaccination challenges, with frequent outbreaks of diseases like measles and polio due to low immunization rates [5][6][8][14]. In Nigeria, for example, only 39% of children receive all basic antigens, far below the global target [1][2][5]-[8][15]. This leaves vulnerable populations, especially children under five, at higher risk of preventable deaths. Nigeria’s immunization coverage has improved from 21% in 2017 to 39% in 2024, but progress remains slow [1]-[8][15][16]. Bayelsa State has one of the lowest rates, with only 36.9% of children aged 12 - 23 months fully immunized. This has prompted emergency interventions like the State Emergency Routine Immunization Coordination Centre (SERICC), yet coverage remains critically low. Reminder strategies, such as mobile alerts and home visits, have proven effective in improving vaccination rates. Studies show that text message reminders increase appointment adherence by 15% - 20% [17], while phone calls improve follow-up rates by 25% [18]. However, their impact in low-resource settings like Bayelsa State remains understudied. While reminder systems work in some contexts, their effectiveness in rural Nigeria, where internet access and literacy vary is unclear. Few studies compare different reminder methods (e.g., mobile calls vs. home visits) in similar settings. Without this data, policymakers lack evidence to allocate resources effectively. While, low vaccination rates disproportionately affect rural, low-income families in Nigeria. Outbreaks of preventable diseases strain healthcare systems, costing an estimated $1.3 billion annually in treatment and outbreak response [19]-[28]. The problem has persisted for decades, with coverage fluctuating due to logistical and cultural barriers. Thus, improving vaccination rates aligns with SDG 3’s targets for reducing child mortality and ensuring equitable healthcare [10]-[12]. This study also intersects with research on health communication, technology adoption, and community engagement, offering broader lessons for public health planning. By identifying the most effective reminder method for Bayelsa State, this study can guide policy decisions and resource allocation. The findings will help Nigeria and similar regions close immunization gaps, saving lives and reducing healthcare costs. Thus, this research evaluates mobile phone reminders and home visits in Bayelsa State to determine which method improves vaccination coverage more. By testing these approaches in a real-world setting provide actionable insights for scaling up immunization programs.

 2. Methods 2.1. Participants

This study involved two related participant groups. The first comprised children under two years of age who were assessed to establish baseline immunization coverage in rural communities of Bayelsa State, Nigeria. The second group consisted of neonates enrolled at birth and followed from their first vaccine dose through completion of the routine childhood immunization schedule in accordance with the national guidelines. Vaccines introduced into the schedule after 2023 were not included in this study. Exclusion criteria were: infants with congenital conditions; parents or caregivers planning to relocate during the study period; communities without a functional primary health center; and, for the mobile phone reminder arm (Intervention A), parents or caregivers without access to a mobile phone. Written informed consent was obtained from all participating mothers and caregivers prior to enrollment.

 2.2. Interventions

Three local government areas (LGAs) were selected using simple random sampling from the three senatorial districts. These LGAs were then randomly allocated, via balloting, in a 1:1:1 ratio to two intervention arms and one control arm. Two LGAs served as intervention arms: Intervention A (mobile phone reminders) and Intervention B (home visits by community health volunteers). The third LGA served as the control. Within each LGA, five communities were randomly selected, yielding a total of 15 communities for the study. Each LGA had a sample size of 128 participants, proportionally distributed across the selected communities.

 2.3. Objectives

The primary objective was to evaluate the impact of two reminder-based interventions on routine childhood immunization coverage in Bayelsa State, Nigeria.

 2.4. Outcomes

The primary outcome was the immunization coverage rate, assessed through mobile phone reminders and community health volunteers. The secondary outcome was a comparative analysis of the effectiveness of the two interventions in improving vaccination coverage.

 2.5. Sample Size Determination

The required sample size was calculated using the cluster-randomized trial formula:

n = Deff × ( Z 1 − α / 2 + Z 1 − β ) 2 × | P 1 ( 1 − P 1 ) + P 2 ( 1 − P 2 ) | ( P 1 − P 2 ) 2

The formula selected represents the standard equation for determining the sample size in a cluster-randomized trial. The breakdown of its components includes:

1) Deff: Design effect, accounting for intracluster correlation.

2) Z 1 − α / 2 : Critical value of the standard normal distribution at a significance level of 0.05

3) Z 1 − β : Critical value of the standard normal distribution for a power of 80%.

4) P1, P2: Expected proportions of the outcome (e.g., immunization coverage) in the intervention and control groups.

5) P1 (1 − P1) and P2 (1 − P2): Variance estimates for the two groups.

6) P1 − P2: Expected difference between the intervention and control groups.

Assumptions included:

Power: 80%Significance level (α): 0.05Intracluster correlation coefficient: 0.01Average cluster size: 25Proportion outcome in control group: 24%Expected increase in coverage: 18%Attrition rate: 20%Design effect (Deff) was calculated using Deff = 1 + (m − 1) × ICC, where m is the average cluster size and ICC is the intracluster correlation coefficient.

This yielded a required sample size of 128 per cluster, with five communities per LGA and approximately 26 participants per community.

 2.6. Sequence Generation

Bayelsa State was stratified into three districts (East, West, and Central). One LGA was randomly selected from each district using simple random sampling. The 1:1:1 allocation ratio was applied via balloting to determine the intervention and control LGAs.

 2.7. Allocation Concealment

Cluster-based random allocation was employed. Participants were eligible if they had infants born between February and June 2023. Blinding was maintained among participants and research assistants, ensuring that those in one cluster remained unaware of interventions in other clusters.

 2.8. Statistical Methods

The primary analysis was conducted at the LGA level. Descriptive statistics were used to summarize baseline characteristics. Chi-square tests were applied for inferential statistics to compare immunization coverage between intervention and control groups. An intention-to-treat (ITT) approach was adopted to analyze the outcomes, ensuring that all randomized participants were included in their originally assigned groups.

 2.9. Participant Flow

Figure 1 illustrates the participant flow for Local Government Area (LGA) selection and intervention allocation in the study. Of the eight LGAs assessed for eligibility, five were excluded after the selection process was completed, leaving three LGAs that were successfully randomized. These three LGAs were then allocated equally to Intervention A (mobile phone-based intervention), Intervention B (home visit–based intervention), and a control group, with 128 participants assigned to each arm. Participants were drawn from five communities per LGA, with approximately 3-26 (or 2-25) participants recruited per community. Follow-up was completed across all study arms with no reported loss to follow-up. Consequently, all 128 participants in each group were retained and included in the final analysis, demonstrating complete participant retention and adherence throughout the study period.

 2.10. Recruitment

Participants were enrolled over five months (February to June 2023). Follow-up commenced immediately after recruitment, with each child monitored across five visits, completing their routine immunization schedule by 15 months of age. The final cohort of neonates recruited in June 2023 completed their immunization schedule in September 2024, marking the conclusion of the study.

Figure 1. Participant flow diagram for LGA selection and intervention allocation.

 3. Results 3.1. Baseline Characteristics

Table 1. Comparison of vaccination coverage across all baselines.

Vaccination Completion Baseline Control (n = 128) Baseline Mobile Phone (n = 128) Baseline CHV Home Visits (n = 128) (p-value)
Completed 53 (41.4%) 51 (39.8%) 55 (42.9%) 0.258 (0.879)
Not Completed 75 (58.6%) 77 (60.2%) 73 (57.1%)

All 128 participants in each cluster were analyzed using the intention-to-treat approach.

Table 1 and Figure 2 present a comparison of vaccination coverage across all three study arms at baseline, showing that the proportion of children who had completed their vaccinations was 41.4% in the control group, 39.8% in the mobile phone intervention group, and 42.9% in the community health volunteer (CHV) home visit intervention group. The Chi-square test yielded a p-value of 0.879, indicating no statistically significant differences in baseline vaccination completion rates across the study arms. This confirms that randomization successfully ensured comparable groups at the start of the trial, eliminating potential selection bias. The relatively low vaccination coverage at baseline, with less than half of the children completing their immunization schedules, underscores the need for targeted interventions to improve uptake. Establishing similarity in baseline vaccination rates is crucial for accurately assessing intervention impact, ensuring that observed improvements in post-intervention coverage are due to the interventions rather than pre-existing differences. In a real-world context, these findings highlight systemic barriers such as vaccine accessibility issues, caregiver awareness gaps, and logistical challenges in distribution, reinforcing the importance of strategies like mobile phone reminders and home visits to enhance immunization coverage.

Figure 2. Baseline vaccination completion across study groups.

 3.2. Effect of Mobile Phone Reminder on Vaccination Coverage

Table 2. Comparison of vaccination coverage between control and mobile phone intervention.

Vaccination Completion Control (n = 128) Mobile Phone (n = 128) (p-value)
Completed 59 (46.1%) 76 (59.4%) 4.529 (0.033)*
Not Completed 69 (53.9%) 52 (40.6%)

*Statistically significant (p < 0.05).

Table 2 and Figure 3 compare vaccination completion rates between the control group and the mobile phone intervention group, showing that 59.4% of children in the mobile phone intervention group completed their vaccinations, compared to 46.1% in the control group. The Chi-square test yielded a p-value of 0.033, indicating a statistically significant improvement in vaccination completion due to the mobile phone intervention. This result provides strong evidence that mobile phone-based interventions can positively influence vaccination uptake, demonstrating the potential of digital health tools in addressing gaps in immunization coverage. Given the widespread availability of mobile phones, these findings suggest that SMS or voice call reminders can serve as an effective and scalable strategy to enhance immunization adherence. The statistically significant improvement underscores the need for health authorities to integrate mobile phone reminders into national immunization programs, particularly in areas with high mobile phone penetration but limited healthcare infrastructure. By leveraging this intervention, policymakers can enhance timely vaccination uptake, reduce the burden of vaccine-preventable diseases, and improve overall public health outcomes.

Figure 3. Vaccination completion.

 3.3. Effect of CHV Home Visits on Vaccination Coverage

Table 3 and Figure 4 compare vaccination completion rates between the control group and the CHV home visit intervention group, revealing that 63.3% of children in the CHV home visit group completed their vaccinations, compared to 46.1% in the control group. The Chi-square test yielded a p-value of 0.006, indicating a statistically significant improvement in vaccination completion due to the home visit intervention. This result highlights the effectiveness of direct, in-person engagement in increasing immunization adherence, as CHVs educated parents, addressed vaccine hesitancy, and provided personalized follow-ups. The findings reinforce the importance of community-based outreach strategies in public health interventions, particularly in resource-limited settings where access to healthcare facilities may be a challenge. Given this significant impact, governments and health organizations should consider expanding CHV programs as

Table 3. Comparison of vaccination coverage between control and CHV home visit intervention.

Vaccination Completion Control (n = 128) CHV Home Visits (n = 128) (p-value)
Completed 59 (46.1%) 81 (63.3%) 7.630 (0.006)*
Not Completed 69 (53.9%) 47 (36.7%)

*Statistically significant (p < 0.05).

Figure 4. Vaccination completion.

part of broader immunization strategies. By integrating home-based education, reminders, and support into routine healthcare services, CHVs can bridge healthcare access gaps, ensuring that caregivers receive the necessary guidance and motivation to complete their children’s immunization schedules.

 3.4. Comparison of Vaccination Coverage

Table 4 and Figure 5 present the overall comparison of vaccination completion rates across all three study arms, with 46.1% completion in the control group, 59.4% in the mobile phone intervention group, and 63.3% in the CHV home visit intervention group. The Chi-square test yielded a p-value of 0.015, confirming a statistically significant difference in vaccination coverage across the groups. Additionally, Cohen’s W was calculated as 0.257, indicating a small but meaningful effect of the interventions on vaccination rates. These findings confirm that both interventions significantly improved immunization completion compared to the control, with CHV home visits demonstrating the highest impact, followed by mobile phone reminders. The study highlights the effectiveness of reminder-based interventions in addressing gaps in childhood immunization coverage, particularly in resource-limited settings where caregiver awareness and access to healthcare services may be constrained. In terms of real-world application, these results provide a strong justification for adopting reminder-based strategies to improve vaccination rates. Policymakers could implement mobile-based reminders in urban and semi-urban areas where mobile phone penetration is high, while CHV-led outreach programs could be prioritized in rural areas where direct

Table 4. Comparison of vaccination coverage across control and interventions.

Vaccination Completion Control (n = 128) Mobile Phone (n = 128) CHV Home Visits (n = 128) (p-value)
Completed 59 (46.1%) 76 (59.4%) 81 (63.3%) 8.444 (0.015) *
Not Completed 69 (53.9%) 52 (40.6%) 47 (36.7%)

*Statistically significant (p < 0.05).

Figure 5. Vaccination completion rates by intervention group.

engagement is necessary to address vaccine hesitancy and accessibility challenges. Additionally, a hybrid approach that combines digital tools with in-person outreach may offer a comprehensive strategy to maximize immunization coverage.

 3.5. Effect Size Analysis: Cohen’s W

Cohen’s W, a measure of effect size for categorical data, was calculated as:

W = 8.444 128 = 0.257

A Cohen’s W of 0.257 suggests a small but meaningful impact of the interventions on vaccination coverage.

Thus, this study contributes valuable evidence on the role of low-cost, scalable interventions in improving childhood immunization coverage. The findings support the integration of digital health tools and community-based outreach into routine immunization programs. These interventions could be particularly beneficial in settings where immunization coverage remains suboptimal due to systemic barriers.

 4. Discussion

This study demonstrated that both mobile phone reminders and community health volunteer (CHV) home visits significantly improved childhood immunization completion compared with the control group. The baseline equivalence observed across study arms (p = 0.879) confirms that randomization was successful and supports the validity of post-intervention comparisons. Similar emphasis on baseline comparability has been reported in previous immunization studies, where researchers highlighted that parity in pre-intervention characteristics strengthens causal inference and minimizes confounding [29]-[31]. Studies conducted in Bayelsa and other Nigerian settings also underscored the importance of baseline uniformity when assessing vaccination interventions [3][4]. The improvement in vaccination completion observed in the mobile phone intervention arm aligns with existing evidence showing that digital reminders enhance immunization uptake. SMS and call-based interventions have consistently demonstrated positive effects on appointment adherence and timely vaccination in various settings [1][2][17][32][33]. These findings are further supported by research indicating high caregiver receptivity to mobile health (mHealth) reminders in Nigeria and other low-resource contexts [33]. The present study reinforces this body of evidence by demonstrating a statistically significant improvement (59.4% vs. 46.1%) attributable to digital reminders. However, consistent with prior work, this study also acknowledges that the effectiveness of mobile-based interventions is shaped by broader contextual factors such as network reliability, digital literacy, and persistent vaccine hesitancy [4][6][8][21][25][30]. These challenges suggest that digital reminders alone may not fully overcome structural and behavioral barriers to vaccination. The CHV home visit intervention produced the highest completion rate (63.3%), highlighting the added value of direct community engagement strategies. This result is consistent with evidence from multiple studies showing that personalized, in-person visits enhance caregiver understanding, address hesitancy, and provide opportunities to overcome logistical constraints [14][20][21][25][34][35]. The role of CHVs has been widely documented as critical in improving vaccine uptake in underserved populations, with several studies demonstrating that community workers effectively bridge gaps in access, information, and trust [3][36]-[49]. The present findings reinforce these observations, underscoring that interpersonal communication remains a powerful mechanism for increasing adherence, particularly in settings where structural barriers limit routine health facility attendance. The results also align with broader literature that highlights the complementary strengths of mobile reminders and community-based strategies. Previous studies in African and Asian contexts have shown that integrating mHealth solutions with community outreach enhances vaccination timeliness and completion [50]-[58]. While digital reminders are scalable and cost-effective, they may be limited by socioeconomic disparities and infrastructural challenges, as noted in studies from Togo and other low-income settings [22][44]-[66]. Conversely, CHV-led approaches provide deeper engagement but require consistent training, supervision, and incentive structures to remain sustainable. Thus, evidence from this trial supports a multifaceted strategy that combines digital and community-based interventions to maximize immunization outcomes. Overall, the study’s findings demonstrate that both mobile phone reminders and CHV home visits are effective strategies for improving childhood immunization completion in rural Nigeria, with home visits offering the greatest impact. This aligns with a growing body of evidence emphasizing that improving vaccination outcomes in resource-limited settings requires integrated approaches that address behavioral, structural, and access-related barriers simultaneously. By contributing new empirical evidence from Bayelsa State, this study adds to the global discourse on scalable, low-cost interventions that can strengthen immunization programs and accelerate progress toward national and global vaccination targets.

 5. Conclusion

This study demonstrates that reminder-based interventions, specifically mobile phone reminders and community health volunteer (CHV) home visits, significantly improve childhood vaccination coverage in Bayelsa State, Nigeria. The findings revealed that while the control group had the lowest vaccination completion rate (46.1%), the mobile phone intervention group exhibited a significantly higher rate (59.4%), and the CHV home visit intervention yielded the highest completion rate (63.3%). These statistically significant differences indicate that both interventions effectively enhance immunization adherence, with CHV home visits showing the greatest impact. The results confirm that targeted interventions addressing vaccine uptake barriers can substantially improve immunization rates in communities with historically low coverage. Mobile phone reminders leverage digital accessibility to enhance compliance, while CHV home visits provide direct engagement, education, and personalized follow-ups to caregivers. The calculation of Cohen’s W effect size further validates the meaningful impact of these interventions, reinforcing their potential for broader implementation in public health strategies. By highlighting the effectiveness of these approaches, this study provides critical insights for policymakers, healthcare providers, and global health organizations seeking to improve immunization rates. The findings underscore the need for sustainable, community-driven programs that integrate both digital and human resource-based strategies to strengthen immunization systems and protect children from vaccine-preventable diseases.

 6. Policy Implication and Public Health Significance

The findings of this study underscore the critical need for policymakers to integrate reminder-based interventions into routine immunization programs at national and subnational levels. The demonstrated effectiveness of mobile phone reminders and community health volunteer (CHV) home visits highlights their value as low-cost, scalable strategies for improving childhood vaccination completion. Incorporating mobile health (mHealth) tools such as automated SMS and voice call reminders into immunization schedules can reduce missed appointments, particularly in urban and peri-urban areas with high mobile phone penetration. Sustaining these interventions will require strong public–private partnerships, where telecommunications companies, donor organizations, and government agencies collaborate to support and subsidize digital reminder systems. Strengthening community-based health workforce capacity is equally important. CHV-led home visits address vaccine hesitancy, close knowledge gaps, and improve accessibility in rural and hard-to-reach communities. Policy frameworks should prioritize the recruitment, training, supervision, and motivation of CHVs as part of broader primary healthcare system strengthening. Institutionalizing community-driven outreach within immunization programs can significantly enhance vaccine uptake and help reduce preventable child morbidity and mortality. The public health significance of these findings extends beyond Bayelsa State. The combined use of mHealth interventions and CHV engagement offers a replicable model for improving immunization coverage in other low-resource settings. By addressing both behavioral and structural barriers to vaccination, these strategies contribute meaningfully to global goals for herd immunity, reduced disease outbreaks, and progress toward WHO and UNICEF immunization targets. Investing in digital tools alongside community-based platforms represents a practical, people-centered approach to ensuring that no child is left unvaccinated due to logistical constraints or lack of awareness. Thus, graphically it is represented (Figure 6 below) as:

Figure 6. Enhancing immunization coverage.

 7. Recommendations

1) Scale-Up of Mobile Phone Reminders: Given the positive impact of mobile phone reminders on vaccination completion, health authorities should integrate SMS and voice call reminders into national immunization schedules. Future interventions could explore personalized messaging that includes culturally appropriate content to further improve caregiver compliance.

2) Expansion of CHV Home Visit Programs: Governments and health organizations should prioritize the recruitment and training of CHVs to provide door-to-door vaccination education, follow-ups, and support. This approach is particularly beneficial in rural and underserved communities where healthcare access is limited. Incentivizing CHVs through stipends or non-monetary rewards can enhance program sustainability.

3) Hybrid Intervention Strategies: Combining mobile reminders with CHV-led follow-ups may yield even greater improvements in vaccination rates. Future studies should evaluate the effectiveness of integrated approaches to determine the most efficient and cost-effective immunization reminder model.

4) Strengthening Community Engagement: Health campaigns should involve community leaders, religious groups, and parent associations in promoting immunization. Social mobilization strategies that incorporate storytelling, peer education, and advocacy can address vaccine hesitancy and misinformation.

5) Policy Integration and Sustainability Planning: Governments should institutionalize reminder-based interventions within immunization policies, ensuring long-term funding through domestic health budgets or external grants. Research into cost-effectiveness and scalability will further support policy adoption and implementation.

 Acknowledgements

The authors would like to express their appreciation to all anonymous reviewers, for feedback and discussions that helped to substantially improve this manuscript. Also, authors are thankful to Bayelsa Medical University and University of Port Harcourt, for providing all necessary administrative supports.

 Funding

The authors gratefully acknowledge the financial support provided by the Tertiary Education Trust Fund (Tetfund) for the successful execution of this research project. This study was sponsored under the research project number BMU/TETFUND/URE/IBR/56/016. The funding from Tetfund was instrumental in facilitating the various stages of the research, including data collection, analysis, and dissemination of findings. The authors affirm that this support played a critical role in enabling the achievement of the study’s objectives.

 Authors Contribution

All authors contributed equally to conceptualization, validation, writing review and editing.

 References Kakwi, J.D., Yakasai, K.M., Raimi, M.O. and Kakwi, J.D. (2024) Understanding the Dynamics of COVID-19 Vaccine Uptake in Plateau State, Nigeria: Analyzing Socioeconomic, Cultural, and Communication Influences. https://preprints.jmir.org/ojs/index.php/preprints/preprint/70702 Kakwi, J.D. Yakasai, K.M. Raimi, M.O. Kakwi, J.D. State, N Socioeconomic, C 2024 Understanding the Dynamics of COVID-19 Vaccine Uptake in Plateau State, Nigeria: Analyzing Socioeconomic, Cultural, and Communication Influences Kakwi, J.D., Yakasai, K.M., Kakwi, J.D. and Raimi, M.O. (2024) Campaigning against Vaccine Hesitancy: Evaluating the Effectiveness of Health Communication on COVID-19 Vaccination Uptake in Plateau State, Nigeria. https://preprints.jmir.org/preprint/66755 Kakwi, J.D. Yakasai, K.M. Kakwi, J.D. Raimi, M.O. State, N 2024 Campaigning against Vaccine Hesitancy: Evaluating the Effectiveness of Health Communication on COVID-19 Vaccination Uptake in Plateau State, Nigeria Promise, V.I., Macauley, T., Alabere, I., Abdulraheem, I. and Raimi, M.O. (2024) Closing the Gap: Assessment of Vaccination Coverage among under Two Children in Bayelsa State, Nigeria. https://preprints.jmir.org/preprint/70671 Promise, V.I. Macauley, T. Alabere, I. Abdulraheem, I. Raimi, M.O. State, N 2024 Closing the Gap: Assessment of Vaccination Coverage among under Two Children in Bayelsa State, Nigeria Okechukwu, C.O., Ainu, M., Adias, T.C., Elemuwa, C.O., Rotifa, S.U., Ogbointuwei, C., et al. (2024) Evaluating the Impact of Rotavirus Vaccination on Childhood Diarrhea Incidence in Bayelsa State, Nigeria: Achievements, Challenges, and Future Directions. https://preprints.jmir.org/preprint/64822 Okechukwu, C.O. Ainu, M. Adias, T.C. Elemuwa, C.O. Rotifa, S.U. Ogbointuwei, C. State, N Achievements, C 2024 Evaluating the Impact of Rotavirus Vaccination on Childhood Diarrhea Incidence in Bayelsa State, Nigeria: Achievements, Challenges, and Future Directions Uchenna, G.E., Enato, E., Christopher, O.E., Tochukwu, D.E. and Morufu, O.R. (2024) Pentavalent Vaccine: How Safe Is It among Infants Accessing Immunization in Nigerian Health Facilities. Uchenna, G.E. Enato, E. Christopher, O.E. Tochukwu, D.E. Morufu, O.R. 2024 Pentavalent Vaccine: How Safe Is It among Infants Accessing Immunization in Nigerian Health Facilities Raimi, M.O., Emeka, C.L., Ebikapaye, O., Angalabiri, C., Christopher, O. and Atoyebi, B. (2021) COVID-19 Decision Impacts: Vaccine Hesitancy, Its Barriers and Impact Studies: Taking Bayelsa State as an Example. Raimi, M.O. Emeka, C.L. Ebikapaye, O. Angalabiri, C. Christopher, O. Atoyebi, B. Hesitancy, I 2021 COVID-19 Decision Impacts: Vaccine Hesitancy, Its Barriers and Impact Studies: Taking Bayelsa State as an Example Raimi, M.O., Omidiji, A.O., Ebikapaye, O., Moses, T., Adeolu, T.A. and Makanjuola Bosede, C. (2019) Situational Analysis of National Immunization Programme in Nigeria. Journal of Immunology and Inflammation Diseases Therapy, 1, 1-6. Raimi, M.O. Omidiji, A.O. Ebikapaye, O. Moses, T. Adeolu, T.A. Bosede, C. 2019 Situational Analysis of National Immunization Programme in Nigeria Journal of Immunology and Inflammation Diseases Therapy 1 Raimi, O.M., Lucky, E.C., Okoyen, E., Clement, A., Ogbointuwei, C., et al. (2021) Making Better Informed, More Confident COVID-19 Decisions: Vaccine Hesitancy, Its Barriers and Impact Studies: Taking Bayelsa State as an Example. The International Journal of Vaccines and Immunization, 6, 126. https://sciforschenonline.org/journals/vaccines/IJVI126.php Raimi, O.M. Lucky, E.C. Okoyen, E. Clement, A. Ogbointuwei, C. Informed, M Hesitancy, I 2021 Making Better Informed, More Confident COVID-19 Decisions: Vaccine Hesitancy, Its Barriers and Impact Studies: Taking Bayelsa State as an Example The International Journal of Vaccines and Immunization 6 Centers for Disease Control and Prevention (2011) Ten Great Public Health Achievements: United States, 2001-2010. Morbidity and Mortality Weekly Report, 60, 619-623. 2011 Ten Great Public Health Achievements: United States, 2001-2010 Morbidity and Mortality Weekly Report 60 World Health Organization (2021) Immunization Agenda 2030: A Global Strategy to Leave No One Behind. https://www.who.int 2021 Immunization Agenda 2030: A Global Strategy to Leave No One Behind Oweibia, M., Elemuwa, U.G., Akpan, E., et al. (2024) Analyzing Nigeria’s Journey towards Sustainable Development Goals: A Comprehensive Review from Inception to Present. F1000 Research, 13, Article No. 984. Oweibia, M. Elemuwa, U.G. Akpan, E. 2024 Analyzing Nigeria’s Journey towards Sustainable Development Goals: A Comprehensive Review from Inception to Present F1000Research 13 No Mordecai, O., et al. (2024) Analyzing Nigeria’s Journey towards Sustainable Development Goals: A Comprehensive Review from Inception to Present. Qeios, 1-34. Mordecai, O. 2024 Analyzing Nigeria’s Journey towards Sustainable Development Goals: A Comprehensive Review from Inception to Present Qeios 1 World Health Organization (2024) DNA Vaccines. https://www.who.int 2024 DNA Vaccines Andersson, N., Cockcroft, A., Ansari, N.M., Omer, K., Baloch, M., Ho Foster, A., et al. (2009) Evidence-Based Discussion Increases Childhood Vaccination Uptake: A Randomised Cluster Controlled Trial of Knowledge Translation in Pakistan. BMC International Health and Human Rights, 9, S8. https://doi.org/10.1186/1472-698x-9-s1-s8 10.1186/1472-698x-9-s1-s819828066https://doi.org/10.1186/1472-698x-9-s1-s8 Andersson, N. Cockcroft, A. Ansari, N.M. Omer, K. Baloch, M. Foster, A. 2009 Evidence-Based Discussion Increases Childhood Vaccination Uptake: A Randomised Cluster Controlled Trial of Knowledge Translation in Pakistan BMC International Health and Human Rights 9 10.1186/1472-698x-9-s1-s8 19828066 Nigeria Demographic Health Survey (2018) Demographic Health Survey. https://www.dhsprogram.com 2018 Demographic Health Survey Multiple Indicator Cluster Survey (2018) 2016-2017 Survey Findings Report. https://www.unicef.org/nigeria/media/10591/file/State-of-Nigerias-Children_Summary-of-the-2024-Updated-SitAn.pdf 2018 2016-2017 Survey Findings Report Haji, A., Lowther, S., Ngan’ga, Z., Gura, Z., Tabu, C., Sandhu, H., et al. (2016) Reducing Routine Vaccination Dropout Rates: Evaluating Two Interventions in Three Kenyan Districts, 2014. BMC Public Health, 16, Article No. 152. https://doi.org/10.1186/s12889-016-2823-5 10.1186/s12889-016-2823-526880141https://doi.org/10.1186/s12889-016-2823-5 Haji, A. Lowther, S. Gura, Z. Tabu, C. Sandhu, H. 2016 Reducing Routine Vaccination Dropout Rates: Evaluating Two Interventions in Three Kenyan Districts, 2014 BMC Public Health 16 No 10.1186/s12889-016-2823-5 26880141 Kagucia, E.W., Ochieng, B., Were, J., Hayford, K., Obor, D., O’Brien, K.L., et al. (2021) Impact of Mobile Phone Delivered Reminders and Unconditional Incentives on Measles-Containing Vaccine Timeliness and Coverage: A Randomised Controlled Trial in Western Kenya. BMJ Global Health, 6, e003357. https://doi.org/10.1136/bmjgh-2020-003357 10.1136/bmjgh-2020-00335733509838https://doi.org/10.1136/bmjgh-2020-003357 Kagucia, E.W. Ochieng, B. Were, J. Hayford, K. Obor, D. Brien, K.L. 2021 Impact of Mobile Phone Delivered Reminders and Unconditional Incentives on Measles-Containing Vaccine Timeliness and Coverage: A Randomised Controlled Trial in Western Kenya BMJ Global Health 6 10.1136/bmjgh-2020-003357 33509838 World Health Organization/United Nation Children Emergency Fund (2023) Progress and Challenges with Achieving Universal Immunization Coverage: 2018 WHO/UNICEF Estimates of National Immunization Coverage, Geneva. https://www.who.int/teams/immunization-vaccines-and-biologicals/immunization-analysis-and-insights/global-monitoring/immunization-coverage/who-unicef-estimates-of-national-immunization-coverage Coverage, G 2023 Progress and Challenges with Achieving Universal Immunization Coverage: 2018 WHO/UNICEF Estimates of National Immunization Coverage, Geneva 2018 Ibrahim, M.L., Sawyerr, H.O., Opasola, O.A., Adiama, Y.B. and Raimi, M.O. (2025) Bridging Knowledge and Practice Gaps in Lassa Fever Prevention: Awareness, Attitudes, and Infection Control Measures Among Healthcare Workers and Residents in Edo, Ondo, and Kwara States. https://preprints.jmir.org/preprint/75233 Ibrahim, M.L. Sawyerr, H.O. Opasola, O.A. Adiama, Y.B. Raimi, M.O. Awareness, A Edo, O 2025 Bridging Knowledge and Practice Gaps in Lassa Fever Prevention: Awareness, Attitudes, and Infection Control Measures Among Healthcare Workers and Residents in Edo, Ondo, and Kwara States Elemuwa, C.O., Raimi, M.O., Ainu, M., Adias, T.C., Ufuoma, R.S., Elemuwa, U.G., et al. (2024) Conquering Mpox: A Comprehensive Public Health Strategy for Addressing Mpox and Poxvirus Infections in Nigeria-Understanding Global Trends, Transmission Dynamics, and Effective Prevention and Control Measures in Nigeria. https://preprints.jmir.org/preprint/67534 Elemuwa, C.O. Raimi, M.O. Ainu, M. Adias, T.C. Ufuoma, R.S. Elemuwa, U.G. Trends, T 2024 Conquering Mpox: A Comprehensive Public Health Strategy for Addressing Mpox and Poxvirus Infections in Nigeria-Understanding Global Trends, Transmission Dynamics, and Effective Prevention and Control Measures in Nigeria Abaya, S.T., Ogoina, D., Stow, J., Abaye, B.B., Emeka, C. and Raimi, M.O. (2024) Beyond the Epidemic: Effective Public Health Strategies in Response to Nigeria’s First Lassa Fever Outbreak in a Non-Endemic Region. https://preprints.jmir.org/preprint/65539 Abaya, S.T. Ogoina, D. Stow, J. Abaye, B.B. Emeka, C. Raimi, M.O. 2024 Beyond the Epidemic: Effective Public Health Strategies in Response to Nigeria’s First Lassa Fever Outbreak in a Non-Endemic Region Elemuwa, C.O., Ainu, M., Adias, T.C., et al. (2024) Transforming Primary Healthcare in Nigeria: Enhancing Universal Health Coverage through Strong and Sustainable Primary Healthcare Laboratories. Qeios. Elemuwa, C.O. Ainu, M. Adias, T.C. 2024 Transforming Primary Healthcare in Nigeria: Enhancing Universal Health Coverage through Strong and Sustainable Primary Healthcare Laboratories Morufu, O.R., Aziba-anyam, G.R. and Teddy, C.A. (2021) Evidence-Based Environmental and Public Health Practices to Respond to the COVID-19 Crisis, 07 May 2021. https://europepmc.org/article/PPRID/PPR335534 Morufu, O.R. Aziba-anyam, G.R. Teddy, C.A. 2021 Evidence-Based Environmental and Public Health Practices to Respond to the COVID-19 Crisis, 07 May 2021 Elemuwa, C.O., Ainu, M., Adias, T.C., Abisoye Sunday, O., Stella Ufuoma, R., Elemuwa, U.G., et al. (2024) Boosting Community Engagement: Leveraging the Ward Health System Approach for Enhanced HPV Vaccination Acceptance in Nigeria. F1000 Research, 13, Article No. 1392. https://doi.org/10.12688/f1000research.153919.1 10.12688/f1000research.153919.1https://doi.org/10.12688/f1000research.153919.1 Elemuwa, C.O. Ainu, M. Adias, T.C. Sunday, O. Ufuoma, R. Elemuwa, U.G. 2024 Boosting Community Engagement: Leveraging the Ward Health System Approach for Enhanced HPV Vaccination Acceptance in Nigeria F1000Research 13 No 10.12688/f1000research.153919.1 Raimi, M.O. and Raimi, A.G. (2020) The Toughest Triage in Decision Impacts: Re-thinking Scientific Evidence for Environmental and Human Health Action in the Times of Concomitant Global Crises. CPQ Medicine, 11, 1-5. Raimi, M.O. Raimi, A.G. 2020 The Toughest Triage in Decision Impacts: Re-thinking Scientific Evidence for Environmental and Human Health Action in the Times of Concomitant Global Crises CPQ Medicine 11 Raimi, M.O., Moses, T., Okoyen, E., Sawyerr, H.O., Joseph, B.O. and Oyinlola, B.O. (2020) A Beacon for Dark Times: Rethinking Scientific Evidence for Environmental and Public Health Action in the Coronavirus Diseases 2019 Era. Medical and Research Microbiology, 1. Raimi, M.O. Moses, T. Okoyen, E. Sawyerr, H.O. Joseph, B.O. Oyinlola, B.O. 2020 A Beacon for Dark Times: Rethinking Scientific Evidence for Environmental and Public Health Action in the Coronavirus Diseases 2019 Era Medical and Research Microbiology 1 Samson, T.K., Ogunlaran, O.M. and Raimi, O.M. (2020) A Predictive Model for Confirmed Cases of COVID-19 in Nigeria. European Journal of Applied Sciences, 8, 1-10. Samson, T.K. Ogunlaran, O.M. Raimi, O.M. 2020 A Predictive Model for Confirmed Cases of COVID-19 in Nigeria European Journal of Applied Sciences 8 Akwataghibe, N.N., Ogunsola, E.A., Broerse, J.E.W., Popoola, O.A., Agbo, A.I. and Dieleman, M.A. (2019) Exploring Factors Influencing Immunization Utilization in Nigeria—A Mixed Methods Study. Frontiers in Public Health, 7, Article No. 392. https://doi.org/10.3389/fpubh.2019.00392 10.3389/fpubh.2019.0039231921755https://doi.org/10.3389/fpubh.2019.00392 Akwataghibe, N.N. Ogunsola, E.A. Broerse, J.E.W. Popoola, O.A. Agbo, A.I. Dieleman, M.A. 2019 Exploring Factors Influencing Immunization Utilization in Nigeria—A Mixed Methods Study Frontiers in Public Health 7 No 10.3389/fpubh.2019.00392 31921755 Ahmad, R.A., Hayat, M.I.G., Sahalu, B.J., Muhammad, N.S., Halima, M.A., Au-walu, M. and Abdulmaleek, M.A. (2020) Perception of Health Workers on Use of Immunization Mobile Application at Primary Health Care Facilities in Kano State, Nigeria. Journal of Medicine and Biomedical Research, 19, 43-49. Ahmad, R.A. Hayat, M.I.G. Sahalu, B.J. Muhammad, N.S. Halima, M.A. Au-walu, M. Abdulmaleek, M.A. State, N 2020 Perception of Health Workers on Use of Immunization Mobile Application at Primary Health Care Facilities in Kano State, Nigeria Journal of Medicine and Biomedical Research 19 Sarker, A.R., Akram, R., Ali, N., Chowdhury, Z.I. and Sultana, M. (2019) Coverage and Determinants of Full Immunization: Vaccination Coverage among Senegalese Children. Medicina, 55, Article No. 480. https://doi.org/10.3390/medicina55080480 10.3390/medicina5508048031416213https://doi.org/10.3390/medicina55080480 Sarker, A.R. Akram, R. Ali, N. Chowdhury, Z.I. Sultana, M. 2019 Coverage and Determinants of Full Immunization: Vaccination Coverage among Senegalese Children Medicina 55 No 10.3390/medicina55080480 31416213 Bangure, D., Chirundu, D., Gombe, N., Marufu, T., Mandozana, G., Tshimanga, M., et al. (2015) Effectiveness of Short Message Services Reminder on Childhood Immunization Programme in Kadoma, Zimbabwe—A Randomized Controlled Trial, 2013. BMC Public Health, 15, Article No. 137. https://doi.org/10.1186/s12889-015-1470-6 10.1186/s12889-015-1470-625885862https://doi.org/10.1186/s12889-015-1470-6 Bangure, D. Chirundu, D. Gombe, N. Marufu, T. Mandozana, G. Tshimanga, M. Kadoma, Z 2015 Effectiveness of Short Message Services Reminder on Childhood Immunization Programme in Kadoma, Zimbabwe—A Randomized Controlled Trial, 2013 BMC Public Health 15 No 10.1186/s12889-015-1470-6 25885862 Akinrinade, O.T., Ajayi, I.O., Fatiregun, A.A., Isere, E.E. and Yusuf, B.O. (2018) Ownership of Mobile Phones and Willingness to Receive Childhood Immunization Reminder Messages among Caregivers of Infants in Ondo State, South-Western Nigeria. South African Journal of Child Health, 12, 111-116. Akinrinade, O.T. Ajayi, I.O. Fatiregun, A.A. Isere, E.E. Yusuf, B.O. State, S 2018 Ownership of Mobile Phones and Willingness to Receive Childhood Immunization Reminder Messages among Caregivers of Infants in Ondo State, South-Western Nigeria South African Journal of Child Health 12 Siddiqi, D.A., Ali, R.F., Munir, M., Shah, M.T., Khan, A.J. and Chandir, S. (2020) Effect of Vaccine Reminder and Tracker Bracelets on Routine Childhood Immunization Coverage and Timeliness in Urban Pakistan (2017-18): A Randomized Controlled Trial. BMC Public Health, 20, Article No. 1086. https://doi.org/10.1186/s12889-020-09088-4 10.1186/s12889-020-09088-432652969https://doi.org/10.1186/s12889-020-09088-4 Siddiqi, D.A. Ali, R.F. Munir, M. Shah, M.T. Khan, A.J. Chandir, S. 2020 Effect of Vaccine Reminder and Tracker Bracelets on Routine Childhood Immunization Coverage and Timeliness in Urban Pakistan (2017-18): A Randomized Controlled Trial BMC Public Health 20 No 10.1186/s12889-020-09088-4 32652969 Ekhaguere, O.A., Oluwafemi, R.O., Badejoko, B., Oyeneyin, L.O., Butali, A., Lowenthal, E.D., et al. (2019) Automated Phone Call and Text Reminders for Childhood Immunisations (PRIMM): A Randomised Controlled Trial in Nigeria. BMJ Global Health, 4, e001232. https://doi.org/10.1136/bmjgh-2018-001232 10.1136/bmjgh-2018-00123231139442https://doi.org/10.1136/bmjgh-2018-001232 Ekhaguere, O.A. Oluwafemi, R.O. Badejoko, B. Oyeneyin, L.O. Butali, A. Lowenthal, E.D. 2019 Automated Phone Call and Text Reminders for Childhood Immunisations (PRIMM): A Randomised Controlled Trial in Nigeria BMJ Global Health 4 10.1136/bmjgh-2018-001232 31139442 Domek, G.J., Contreras-Roldan, I.L., O’Leary, S.T., Bull, S., Furniss, A., Kempe, A., et al. (2016) SMS Text Message Reminders to Improve Infant Vaccination Coverage in Guatemala: A Pilot Randomized Controlled Trial. Vaccine, 34, 2437-2443. https://doi.org/10.1016/j.vaccine.2016.03.065 10.1016/j.vaccine.2016.03.06527026145https://doi.org/10.1016/j.vaccine.2016.03.065 Domek, G.J. Contreras-Roldan, I.L. Leary, S.T. Bull, S. Furniss, A. Kempe, A. 2016 SMS Text Message Reminders to Improve Infant Vaccination Coverage in Guatemala: A Pilot Randomized Controlled Trial Vaccine 34 10.1016/j.vaccine.2016.03.065 27026145 Domek, G.J., Contreras-Roldan, I.L., Bull, S., O’Leary, S.T., Bolaños Ventura, G.A., Bronsert, M., et al. (2019) Text Message Reminders to Improve Infant Immunization in Guatemala: A Randomized Clinical Trial. Vaccine, 37, 6192-6200. https://doi.org/10.1016/j.vaccine.2019.08.046 10.1016/j.vaccine.2019.08.04631492475https://doi.org/10.1016/j.vaccine.2019.08.046 Domek, G.J. Contreras-Roldan, I.L. Bull, S. Leary, S.T. Ventura, G.A. Bronsert, M. 2019 Text Message Reminders to Improve Infant Immunization in Guatemala: A Randomized Clinical Trial Vaccine 37 10.1016/j.vaccine.2019.08.046 31492475 Jacobson Vann, J.C., Jacobson, R.M., Coyne-Beasley, T., Asafu-Adjei, J.K. and Szilagyi, P.G. (2018) Patient Reminder and Recall Interventions to Improve Immunization Rates. Cochrane Database of Systematic Reviews, 2018, CD003941. https://doi.org/10.1002/14651858.cd003941.pub3 10.1002/14651858.cd003941.pub329342498https://doi.org/10.1002/14651858.cd003941.pub3 Vann, J.C. Jacobson, R.M. Coyne-Beasley, T. Asafu-Adjei, J.K. Szilagyi, P.G. 2018 Patient Reminder and Recall Interventions to Improve Immunization Rates Cochrane Database of Systematic Reviews 2018 10.1002/14651858.cd003941.pub3 29342498 Isaac, M.R., Chartier, M., Brownell, M., Chateau, D., Nickel, N.C., Martens, P., et al. (2015) Can Opportunities Be Enhanced for Vaccinating Children in Home Visiting Programs? A Population-Based Cohort Study. BMC Public Health, 15, Article No. 620. https://doi.org/10.1186/s12889-015-1926-8 10.1186/s12889-015-1926-826149681https://doi.org/10.1186/s12889-015-1926-8 Isaac, M.R. Chartier, M. Brownell, M. Chateau, D. Nickel, N.C. Martens, P. 2015 Can Opportunities Be Enhanced for Vaccinating Children in Home Visiting Programs? 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Conference, K University, M 2025 Echoes of Outbreaks Past: Rethinking Public Health Preparedness in Sub-Saharan Africa in the Age of Emerging Pandemics The 3rd Ku8+ International Conference 6 Opasola, O.A. and Raimi, M.O. (2025) From Crisis to Catalyst: Lever-Aging Public Health Emergencies to Redesign Urban Health Policy in Nigerian Megacities. The3 rd Ku8+ International Conference, Kwara State University, Malete with the Theme“ Innovation and Sustainability of Higher Education in a Changing World”, Otuoke, 6-8 August 2025, 28. Opasola, O.A. Raimi, M.O. Conference, K University, M 2025 From Crisis to Catalyst: Lever-Aging Public Health Emergencies to Redesign Urban Health Policy in Nigerian Megacities The 3rd Ku8+ International Conference 6 Hofstetter, A.M., DuRivage, N., Vargas, C.Y., Camargo, S., Vawdrey, D.K., Fisher, A., et al. (2015) Text Message Reminders for Timely Routine MMR Vaccination: A Randomized Controlled Trial. Vaccine, 33, 5741-5746. https://doi.org/10.1016/j.vaccine.2015.09.042 10.1016/j.vaccine.2015.09.04226424607https://doi.org/10.1016/j.vaccine.2015.09.042 Hofstetter, A.M. DuRivage, N. Vargas, C.Y. Camargo, S. Vawdrey, D.K. Fisher, A. 2015 Text Message Reminders for Timely Routine MMR Vaccination: A Randomized Controlled Trial Vaccine 33 10.1016/j.vaccine.2015.09.042 26424607 Gibson, D.G., Ochieng, B., Kagucia, E.W., Were, J., Hayford, K., Moulton, L.H., et al. (2017) Mobile Phone-Delivered Reminders and Incentives to Improve Childhood Immunisation Coverage and Timeliness in Kenya (M-SIMU): A Cluster Randomised Controlled Trial. The Lancet Global Health, 5, e428-e438. https://doi.org/10.1016/s2214-109x(17)30072-4 10.1016/s2214-109x(17)30072-428288747https://doi.org/10.1016/s2214-109x(17)30072-4 Gibson, D.G. Ochieng, B. Kagucia, E.W. Were, J. Hayford, K. Moulton, L.H. 2017 Mobile Phone-Delivered Reminders and Incentives to Improve Childhood Immunisation Coverage and Timeliness in Kenya (M-SIMU): A Cluster Randomised Controlled Trial The Lancet Global Health 5 10.1016/s2214-109x(17)30072-4 28288747 Kazi, A.M., Ali, M., Zubair, K., Kalimuddin, H., Kazi, A.N., Iqbal, S.P., et al. (2018) Effect of Mobile Phone Text Message Reminders on Routine Immunization Uptake in Pakistan: Randomized Controlled Trial. JMIR Public Health and Surveillance, 4, e20. https://doi.org/10.2196/publichealth.7026 10.2196/publichealth.702629514773https://doi.org/10.2196/publichealth.7026 Kazi, A.M. Ali, M. Zubair, K. Kalimuddin, H. Kazi, A.N. Iqbal, S.P. 2018 Effect of Mobile Phone Text Message Reminders on Routine Immunization Uptake in Pakistan: Randomized Controlled Trial JMIR Public Health and Surveillance 4 10.2196/publichealth.7026 29514773 Raimi, M.O. (2025) Peer Review Report For: Zero-Dose Childhood Immunization in Conflict-Affected Productive Safety Net Program Districts of Ethiopia: A Comparative Cross-Sectional Study. Raimi, M.O. 2025 Peer Review Report For: Zero-Dose Childhood Immunization in Conflict-Affected Productive Safety Net Program Districts of Ethiopia: A Comparative Cross-Sectional Study Raimi, M.O. (2025) Peer Review Report For: Zero-Dose Childhood Immunization in Conflict-Affected PSNP Districts of Ethiopia: A Comparative Cross-Sectional Study. Raimi, M.O. 2025 Peer Review Report For: Zero-Dose Childhood Immunization in Conflict-Affected PSNP Districts of Ethiopia: A Comparative Cross-Sectional Study Raimi, M.O. (2025) Peer Review Report for: Mapping Community Vulnerability to Reduced Vaccine Impact in Uganda and Kenya: A Spatial Data-Driven Approach. NIHR Open Research, 5, Article No. 24. Raimi, M.O. 2025 Peer Review Report for: Mapping Community Vulnerability to Reduced Vaccine Impact in Uganda and Kenya: A Spatial Data-Driven Approach NIHR Open Research 5 No Raimi, M.O. (2025) Peer Review Report For: Mapping Community Vulnerability to Reduced Vaccine Impact in Uganda and Kenya: A Spatial Data-Driven Approach. NIHR Open Research, 2025, 5:24. Raimi, M.O. 2025 Peer Review Report For: Mapping Community Vulnerability to Reduced Vaccine Impact in Uganda and Kenya: A Spatial Data-Driven Approach NIHR Open Research 2025 24 Raimi, M.O. (2025) Peer Review Report for: Development of a Health Impact Assessment Implementation Model: Enhancing Intersectoral Approaches in Tackling Health Inequalities—A Mixed Methods Study Protocol. HRB Open Research, 7, 14. https://hrbopenresearch.org/articles/7-14/v3#referee-response-45418 Raimi, M.O. 2025 Peer Review Report for: Development of a Health Impact Assessment Implementation Model: Enhancing Intersectoral Approaches in Tackling Health Inequalities—A Mixed Methods Study Protocol HRB Open Research 7 Oginifolunnia, O.C., Elemuwa, C.O., Adias, T.C., Raimi, M.O. and Angalabiri, C. (2025) Bridging the Gaps: Unveiling Weaknesses in Disease Surveillance during Mass Immunization Campaigns in Nigeria. https://preprints.jmir.org/preprint/80148 Oginifolunnia, O.C. Elemuwa, C.O. Adias, T.C. Raimi, M.O. Angalabiri, C. 2025 Bridging the Gaps: Unveiling Weaknesses in Disease Surveillance during Mass Immunization Campaigns in Nigeria Landoh, D.E., Ouro-kavalah, F., Yaya, I., Kahn, A., Wasswa, P., Lacle, A., et al. (2016) Predictors of Incomplete Immunization Coverage among One to Five Years Old Children in Togo. BMC Public Health, 16, Article No. 968. https://doi.org/10.1186/s12889-016-3625-5 10.1186/s12889-016-3625-527618851https://doi.org/10.1186/s12889-016-3625-5 Landoh, D.E. Ouro-kavalah, F. Yaya, I. Kahn, A. Wasswa, P. Lacle, A. 2016 Predictors of Incomplete Immunization Coverage among One to Five Years Old Children in Togo BMC Public Health 16 No 10.1186/s12889-016-3625-5 27618851 Raimi, O.M., Sunday, O.A., Mcfubara, K.G., Adias, T.C., Raimi, G.A., Daniel, A.A., Izah, S.C., Okoyen, E., Ogbointuwei, C., Clement, A., Godspower, A. and Funmilayo, A.A. (2022) Perspective Chapter: Applying Innovative Research as a Tool to Advance Immunization Coverage in Bayelsa State, Nigeria. In: Raimi, M.O., Sunday, O.A., Sawyerr, H.O. and Adias, T.C., Eds., Emerging Issues in Environmental Epidemiology and Its Reflection [ Working Title], IntechOpen, 1-31. Raimi, O.M. Sunday, O.A. Mcfubara, K.G. Adias, T.C. Raimi, G.A. Daniel, A.A. Izah, S.C. Okoyen, E. Ogbointuwei, C. Clement, A. Godspower, A. Funmilayo, A.A. State, N Raimi, M.O. Sunday, O.A. Sawyerr, H.O. Adias, T.C. 2022 Perspective Chapter: Applying Innovative Research as a Tool to Advance Immunization Coverage in Bayelsa State, Nigeria In: Raimi 1 Morufu, O.R., Aziba-anyam, G.R. and Teddy, C.A. (2021) “Silent Pandemic”: Evidence-Based Environmental and Public Health Practices to Respond to the Covid-19 Crisis. IntechOpen. https://www.intechopen.com/online-first/silent-pandemic-evidence-based-environmental-and-public-health-practices-to-respond-to-the-covid-19-Published Morufu, O.R. Aziba-anyam, G.R. Teddy, C.A. 2021 “Silent Pandemic”: Evidence-Based Environmental and Public Health Practices to Respond to the Covid-19 Crisis Abdulraheem, A.F., Ononokpono, D.N. and Raimi, M.O. (2025) Breaking Barriers to Safe Motherhood: How Social, Cultural, and Geographic Inequalities Shape Skilled Birth Attendance in Nigeria. Sociology International Journal, 9, 188-200. Abdulraheem, A.F. Ononokpono, D.N. Raimi, M.O. Social, C 2025 Breaking Barriers to Safe Motherhood: How Social, Cultural, and Geographic Inequalities Shape Skilled Birth Attendance in Nigeria Sociology International Journal 9 Abdulraheem, A.F., Ononokpono, D.N. and Raimi, M.O. (2025) Breaking Barriers: How Socio-Demographic, Cultural, and Geographic Factors Shape Skilled Birth Attendance in Nigeria—A Call for Equity and Empowerment. https://preprints.jmir.org/preprint/78050 Abdulraheem, A.F. Ononokpono, D.N. Raimi, M.O. Socio-Demographic, C 2025 Breaking Barriers: How Socio-Demographic, Cultural, and Geographic Factors Shape Skilled Birth Attendance in Nigeria—A Call for Equity and Empowerment Abdulraheem, A.F., Raimi, M.O. and Ononokpono, D.N. (2025) Who Delivers Safely? The Hidden Role of Transport and Education in Nigeria’s Maternal Health Crisis. https://preprints.jmir.org/preprint/79460 Abdulraheem, A.F. Raimi, M.O. Ononokpono, D.N. 2025 Who Delivers Safely? The Hidden Role of Transport and Education in Nigeria’s Maternal Health Crisis Sawyerr, H.O. and Raimi, M.O. (2025) Surveillance in the Shadows: Reinventing Community-Based Disease Monitoring Systems in Rural Nigeria. The3 rd Ku8+ International Conference, Kwara State University, Malete with the Theme“ Innovation and Sustainability of Higher Education in a Changing World”, Malete, 6-8 August 2025, 33. Sawyerr, H.O. Raimi, M.O. Conference, K University, M 2025 Surveillance in the Shadows: Reinventing Community-Based Disease Monitoring Systems in Rural Nigeria The 3rd Ku8+ International Conference 6 Teddy, C.A., Christopher, O.E. and Morufu, O.R. (2025) Community Engagement and Social Innovation for Environmental Justice in Sub-Saharan Africa. The1 st International Conference of the Faculty of Science, Federal University Otuoke, Bayelsa State on the Theme: Revolutionizing a Sustainable Tomorrow: Harnessing Science, Innovation and Community Power to Drive Circular Economy Solutions, Climate Resilience, and a Thriving Green Economy, Otuoke, 4-7 March 2025, 75. Teddy, C.A. Christopher, O.E. Morufu, O.R. Science, F Otuoke, B Science, I Solutions, C Economy, O 2025 Community Engagement and Social Innovation for Environmental Justice in Sub-Saharan Africa The 1st International Conference of the Faculty of Science 4