In April 2024, Uganda became the nineteenth country in Africa to introduce a vaccine against malaria, launching one of the largest malaria vaccine programs to date. The country’s Ministry of Health initially aimed to distribute 3.5 million doses in 105 high- and moderate-transmission districts, part of an overall strategy that includes ongoing use of mosquito nets and other malaria prevention measures.
Malaria vaccines reduce severe illness and death due to malaria among children younger than 5 years of age. Now, an innovative call center program is helping ensure that fewer children miss out on this lifesaving intervention—and that parents and caregivers can access the information they need.
Supporting the four-dose schedule
In Uganda, children receive the malaria vaccine at 6 months, 7 months, 8 months, and 18 months of age. But ensuring that children complete the entire four-dose schedule presents challenges, especially for caregivers who live far from the nearest health center, are juggling responsibilities at work and at home, or lack adequate information about where and when to get their children vaccinated.
To address gaps in information and similar challenges, PATH is partnering with Communication for Development Foundation Uganda (CDFU) on a call center program that provides information to parents and other caregivers about malaria vaccination, reminders about the schedule, and referrals to vaccinating centers to ensure that children stay up to date on all four doses.
For more than a decade, CDFU’s call center has provided information, counseling, and referrals on a variety of health services in Uganda, handling hundreds of calls a day. The center has introduced an innovative “call-back” service that is used to check if callers accessed the services they were referred to and whether they were satisfied with their quality.
Building on this program, PATH is now providing training and resources to equip call center agents with information on malaria vaccines. The CDFU call center actively partners with health facility staff, community health workers, and members of Village Health Teams (VHTs) to collect phone numbers from consenting parents and caregivers. Agents then make outbound calls to issue reminders of children’s next malaria vaccine visits. Additionally, the call center provides a toll-free line for caregivers seeking information or expressing concerns about the malaria vaccine program.
“The call center intervention is meant to play a vital role in supporting caregivers to complete the malaria immunization schedule,” said CDFU Executive Director Nankunda Babihuga. “We see it as an important innovation that gently nudges families to return for all required doses. Through these calls, we hope to understand how parents are preparing to bring their children back as well as identify those who may not intend to return and the reasons behind such a decision. This will allow us to offer timely support before they default.”
Proactive outreach to caregivers
The program is already making an impact, according to parents and caregivers who have received reminders.
“This is a good way of reminding us to take back our children for vaccination,” said Namugerwa, a mother who lives in Kalungu District, Uganda. “I forgot to take [my son] on his return date on 6th November 2025, and when you called me, I promised to take him on the 13th but forgot again. I later took him on 19th November” to receive the third dose of the malaria vaccine.
After receiving a reminder call from CDFU, Katushabe Agnes and her husband took their 8-month-old to receive his second dose of the malaria vaccine at St. Francis Mbirizi Health Center III in Lwengo District.
“This kind of follow up is very much appreciated, especially involving us men,” said Agnes’s husband. “Your efforts and time to reach out to us just to remind us to take back our children for immunization is good.”
Ssekinkuse Julius, CDFU’s call center coordinator, responds to a call. Photo: PATH/Joseph Waninda.
Increasing malaria vaccine uptake
Call center agents work closely with PATH and the VHTs to follow up on children who have been referred to vaccinating centers. In addition to phone call reminders, VHTs conduct individual outreach to caregivers of children who have missed malaria vaccine doses. Throughout the process, call center agents and VHTs record caregiver feedback to track the most common reasons for missed doses. Understanding these reasons helps inform potential solutions.
PATH and CDFU are piloting the malaria vaccine call center program at 60 health facilities across four districts in Uganda’s South-Central region. The collaboration builds on PATH’s ongoing work in the region to improve malaria vaccine uptake. This work includes support for community dialogues, health worker job aids, and communication materials to promote awareness of the vaccine.
“We are optimistic that this approach will not only boost uptake of the malaria vaccine but also help caregivers catch up on any missed doses,” Nankunda said. “Already, many mothers have expressed appreciation for the calls. Knowing that someone is checking on their child’s health makes them feel valued, and the follow-up by health workers is motivating them to continue returning for subsequent doses.”
PATH and CDFU are working closely to address early challenges and refine processes at the call center to ensure families stay engaged and on schedule. With more countries implementing malaria vaccines, this approach could become a valuable model for tracking children with missed appointments and reducing barriers to uptake.
