Frequently Asked Questions
We did extensive research and found that increasing immunization rates is one of the best and most cost-effective ways to improve human lives. By protecting children from dangerous diseases, immunizations both save lives and improve quality of life in a population. In addition, increasing immunization rates accelerates the process of achieving “herd immunity” in a population: when a significant proportion of a population is inoculated against a disease, the pathogens causing the disease cannot find suitable hosts and have difficulty surviving in the population. This means that increasing immunization rates can help protect even those who are not immunized, so a program that effectively increases immunization rates enjoys a “multiplier effect” by benefiting even people that the program does not reach directly.
Why SmS reminders?
People’s lives are hectic, especially people who live in resource-constrained settings. For families with infants it is often difficult to remember a visit to a health clinic scheduled months ago, what with everything else going on in their lives. Research in behavioral science suggests that people often intend to do things but have difficulty following through—even on things they consider important. In these cases, a “nudge” in the form of a timely reminder or encouragement can often help people follow through. Research suggests that text message reminders are a cheap and effective way to provide this sort of nudge.
India has both problematically low vaccination rates and high rates of mobile phone ownership. The high mobile penetration means that SMS reminders for vaccinations can potentially reach a large percentage of the population, and the low vaccination rates suggest that there is significant room for interventions to improve the situation.
What makes you think your program will improve lives?
There are four randomized controlled trials, considered the gold standard of scientific studies, on SMS reminders in the developing world, all showing that they increase vaccination rates. There are even more studies in the developed world showing similar results. Finally, we will be doing extensive testing of different strategies for outreach and message delivery, and refining our approach based on what works. As a result, our effectiveness will only increase over time.
How do people enrol in your program?
We do a variety of outreach strategies. We partner with hospitals to conduct outreach and offer enrollment to pregnant women and families with young children. We go door-to-door in resource-constrained neighborhoods and ask if new parents would like to receive reminders. Additionally, we work with front line health workers to inform people of our services. Participants may also sign up via text message, according to the instructions here.
Who manages and sends the sms messages?
Charity Science manages the process of designing and sending the SMS messages. We have built the necessary infrastructure to deliver a large number of text messages at low cost.
DO participants have to pay to receive sms messages?
No. Our services are completely free for participants. Incoming text messages are always free on mobile phones in India, so participants never have to worry about being charged for participating in our program.
Can people receive messages if they are registered for the Do not Disturb (DnD) list?
Yes. The DnD list applies only to unsolicited promotional messages. By agreeing to sign up for our SMS services, participants consent to receive messages from us and our messages will be permitted under the DnD.
Where will participants’ information be stored? How will you guarantee participants’ privacy?
In compliance with Indian federal laws regarding personal information, all participant data will be stored exclusively on secure servers within India. We are committed to participants’ privacy and will never disclose their information to anyone without the participant’s express written consent.
What areas of India do you work in?
Anyone in India can sign up to receive reminder messages (instructions here). We currently have partnerships with hospitals in Maharashtra and Gujarat, and we do door-to-door in Delhi, Uttar Pradesh, Madhya Pradesh, West Bengal, and Rajasthan.
What languages are supported?
At the moment we are able to send messages in Hindi, Bengali, Gujarati, and English. We are committed to always delivering messages in local languages and will expand our supported languages as we begin operating in more areas of the country.
When do people receive these SMS reminders?
Participants receive two reminders for every scheduled vaccination, one sent one week before the vaccination is scheduled, and one sent the day before.
Which vaccines do people receive reminders for?
Our reminders cover all of the vaccines recommended under India’s Universal Immunization Plan. This includes BCG (Bacillus Calmette Guerin), OPV (Oral Polio Vaccine), measles, TT (Tetanus Toxoid), and the pentavalent vaccine, which is five vaccines in one: Diphtheria, Pertussis, Tetanus (DPT), hepatitis B, and haemophilus influenzae. In addition, as the rotavirus vaccine is rolled out, our reminders will also cover this. People living in districts where the Japanese encephalitis vaccine is recommended will receive reminders for this vaccine as well.
Do you provide any other kinds of SMS messages beyond vaccination reminders?
We are beginning with vaccination reminders because, according to our research, they have the strongest evidence for impact. However, we plan to explore adding other kinds of SMS health-related messages to our program, including reminders for other types of medical appointments, breastfeeding reminders, and general health information and advice.
What about people who don’t have cell phones or who are not literate?
Admittedly there are some people whom our intervention will be unable to reach, and this includes people without mobile phones and those with low literacy. There are programs that address these issues by, for example, using interactive voice response (IVR) messages (such as the Kilkari program). Thus far, our analysis suggests that the significantly higher costs of voice messaging make these approaches less cost-effective than SMS reminders, meaning that if we incorporated them, we would help less people. However, we are constantly exploring ways to expand the reach of our program, and this may include voice-based messages in the future.
How are you evaluating the impact of your activities? How will you use the results to improve your program?
Once our program has a track record of sending reminder messages, we plan to conduct a randomized controlled trial (RCT) to determine whether people who receive our reminders are more likely to have their children vaccinated than similar people who aren’t enrolled in our program. We will also conduct extensive testing of different strategies for outreach and different ways of framing our reminder messages. We will collect data to track how effective each strategy is at increasing vaccination rates, and refine our approach accordingly.
Questions about Our Hospital Partnerships
What does Charity Science gain from working with hospitals?
We are a non-profit organization, so we do not seek to benefit financially from partnering with hospitals. Our only interest is in improving patients’ health. Working with hospitals allows us to do a better job at fulfilling our mission of increasing vaccination rates.
What resources do hospitals have to commit in order to partner with you?
For all our partner hospitals, we offer the opportunity to register patients in our SMS reminder program, free of charge. For large but resource-constrained hospitals serving particularly vulnerable populations, we also provide funding to place a dedicated staff member on site to approach potential participants and inform them about the program. Thus, these hospitals can partner with us without committing significant financial or staff resources to recruitment for our program. We ask only for hospitals’ cooperation and permission to talk to their patients about our program.
What benefits do hospitals get from working with Charity Science?
Our program lets hospitals improve patient care by helping patients take advantage of one of the most important services that hospitals provide to families with young children: immunizing children against deadly diseases. In addition, we will gather data on the impact of our program and share our findings with our partners, alerting them to trends in vaccination coverage among their patients.
When you work with a hospital that has multiple sites/branches, do you enrol participants at all the branches or just the primary site?
We would like to work with as many branches as possible in order to maximize the reach of our program and the number of people we sign up. However, we are happy to begin with a pilot initiative at a single branch to let partners become familiar with us and our process before expanding to other sites.
Questions About Our NGO Partnerships
How do you partner with NGOs based in India?
Our NGO partners help us to enroll new participants in our program. We rely on our partner's’ experience and connections in local communities to inform potential beneficiaries about our services and help them enroll in our program.
What benefits do NGOs get from working with Charity Science?
We provide funding to NGOs that employ low-cost strategies for enrolling new participants in our program. If you are an NGO and think you might like to work with us, you can find out more about what we look for in our partners by viewing our recent request for proposals. Please direct any questions to Katherine Savoie, Executive Director, at firstname.lastname@example.org
Questions About Our Funding
Who funds your operations?
Charity Science Health has been provided with incubation funding from GiveWell.
are you looking for donations?