We conducted a multicountry study at 6 immunization centers, 3 each in Pakistan and Bangladesh. Both countries vary in terms of full immunization coverage rate (Pakistan 66%; Bangladesh 84%) and infant mortality rates (81/1000 live births in Pakistan; 43/1000 live births in Bangladesh) [21 ,22 ]. Immunization centers were selected based on the influx of children, availability of vaccines and vaccinators, and absence of any kind of decision support system at these sites. The selected study sites had high penetration of mobile phones (>90%) and the presence of cellular networks (data connectivity) among the population [23 ,24 ].
Two of the selected immunization centers in Pakistan were located in Gilgit district in Gilgit Baltistan territory, which had a full immunization coverage rate of 57% among children aged 12 to 23 months in 2018 [21 ]. The third selected immunization center in Pakistan was a private center located in the Rahim Yar Khan district in Punjab province, with a full immunization coverage rate of 65% in 2019 [23 ].
In Bangladesh, all 3 immunization centers were located in Dhaka city in Dhaka district. The district had a full immunization coverage rate of 85% among children aged 12 to 23 months as of 2019 [25 (link)].
Two of the selected immunization centers in Pakistan were located in Gilgit district in Gilgit Baltistan territory, which had a full immunization coverage rate of 57% among children aged 12 to 23 months in 2018 [21 ]. The third selected immunization center in Pakistan was a private center located in the Rahim Yar Khan district in Punjab province, with a full immunization coverage rate of 65% in 2019 [23 ].
In Bangladesh, all 3 immunization centers were located in Dhaka city in Dhaka district. The district had a full immunization coverage rate of 85% among children aged 12 to 23 months as of 2019 [25 (link)].
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