Identifying Tech-Based Pathways To Scale The Boosting Immunization Demand Program

As of 2022, approximately 100 million children in India remain under-immunized. National data shows that over 90% of children are partially immunized in both rural and urban areas, suggesting no strong opposition to immunizations. However, significant drop-offs occur at later stages in the full immunization series (NFHS-5), suggesting that demand-side challenges—such as procrastination, the opportunity cost time, lack of information on immunization schedules—may contribute to low uptake. Over decades of research, J-PAL South Asia has identified and tested cost-effective interventions to improve immunization coverage by building parental demand through targeted SMS reminders, local ambassadors, and incentives (aka BID). A subsequent government-led pilot in Haryana highlighted the need to identify cost-effective and tech-based implementation pathways for scaling BID. To address this, J-PAL SA is conducting an RCT in Maharashtra to test a phone-based approach for ambassador nomination and recruitment, implemented by NGO Suvita.