Using innovative transportation options to increase vaccination rates

Mothers in Kampala, Uganda, will receive vouchers to pay for rides to clinics.Mothers in Kampala, Uganda, will receive vouchers to pay for rides to clinics. Photo: Shutterstock Vaccines are the most powerful and cost-effective means of protecting infants from many life-threatening diseases. But in order for vaccines to work, many have to be given at the right time in a baby’s first year of life. For parents in low-income countries, getting their infants vaccinated on time can be difficult-to-impossible due to many issues—including a lack of transportation to clinics.

To increase vaccination timeliness for infants, a U of M team is testing a new strategy in Uganda that may offer residents living in high-density urban areas cheap, reliable transportation to clinics through transportation network companies (TNCs) such as Uber and Safeboda.

The U of M team includes study leader Diana Negoescu, assistant professor in the Department of Industrial & Systems Engineering (ISyE); Saif Benjaafar, Distinguished McKnight University Professor, ISyE professor, and director of the U’s Initiative on the Sharing Economy; and Nicole Basta, assistant professor in the School of Public Health. Dr. Cecily Banura from Makerere University in Uganda is also a member of the team. The project was recently funded by the Bill & Melinda Gates Foundation Grand Challenges Explorations Program. 

“We are thrilled that the Gates Foundation is supporting our highly interdisciplinary team as we work to increase access to measles vaccinations among vulnerable populations in low-income urban areas,” says Basta.

Basta, who studies the impact of vaccines among vulnerable populations, said that in many parts of the world access to vaccination remains a significant challenge. “We aim to improve access by harnessing the power of network transportation providers to integrate with health systems and provide the means for families to reach vaccination clinics,” she says.

Project team members Saif Benjaafar, Diana Negoescu, and Nicole BastaProject team members Saif Benjaafar, Diana Negoescu, and Nicole Basta The team will combine mathematical modeling and analysis efforts led by Negoescu and Benjaafar with epidemiologic field studies led by Basta and Banura to design and evaluate an intervention that provides new mothers with vouchers to access services such as Uber to pay for rides to clinics when their infants are due for vaccinations. The system would also send mothers text-message reminders of when it’s time to vaccinate their babies.

The project grew out of a collaboration between Benjaafar and Negoescu on research funded by the Minnesota Council on Transportation Access (MCOTA) that examined opportunities for public-private partnerships involving TNCs.

“We are excited that research funded by MCOTA inspired work that caught the attention of the Gates Foundation and may have an impact on a global level,” Benjaafar says.

During this pilot project, the researchers will model the expense and benefits of increasing vaccination timeliness and rates in urban areas of Kampala, Uganda. They’ll also work with a group of residents to learn more about the most effective ways to overcome barriers to vaccination and to assess their access to cell phones, which they’ll need in order to receive text messages and use shared transportation services.

If the pilot project is successful, the team will scale up the concept to conduct a large, randomized trial to see if the voucher program consistently increases infant first-year vaccination timeliness across Kampala. If the trial shows that the approach could improve access to vaccinations, the system could be used to protect infants when they need it most in similar settings around the globe.

(Adapted from an article written by Charlie Plain and reprinted courtesy of the UMN School of Public Health.)