Using a mobile application (“PrimaKu”) to promote childhood immunization in Indonesia: A cross-sectional study


mobile application

How to Cite

Nurhaeni, N., Chodidjah, S., Adawiyah, R., & Astuti, A. (2021). Using a mobile application (“PrimaKu”) to promote childhood immunization in Indonesia: A cross-sectional study. Belitung Nursing Journal, 7(4), 329–335.
Share |


Background: Universal immunization coverage among children in Indonesia is low compared to the global target. Many children in Indonesia are not fully immunized as recommended by the government, which results in a high mortality rate. The government has developed a mobile application (PrimaKu) to provide information on vaccinations and reminder features. However, the successful use of the immunization features of the app has not been widely studied.

Objective: This study aimed to evaluate the use of PrimaKu on maternal attitudes toward immunization and complete basic immunizations status among Indonesian children aged 12 to 24 months.

Methods: A cross-sectional research was conducted at a public health center in West Java Province, Indonesia, from August to December 2020. Convenience sampling was used to select the respondents. Data were collected using validated questionnaires and analyzed using binomial logistic regression.

Results: A total of 119 mothers were included. About 44.5% of children had a complete basic immunization status. Mothers who had a supportive attitude toward immunization were 3.58 times (95% CI 1.49-8.57, p 0.003) more likely to complete the basic immunization, and those who used the mobile app were 3.23 times (95% CI 1.18-8.87, p 0.034) more likely to complete the immunization. 

Conclusion: Using the PrimaKu mobile application could increase maternal attitudes toward immunization and complete basic immunization status. Therefore, public health nurses should provide comprehensive education and improve mothers’ literacy to use the application.

Supporting Agencies

Universitas Indonesia, Indonesia


Copyright (c) 2021 Nani Nurhaeni, Siti Chodidjah, Robiyatul Adawiyah, Astuti Astuti

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Article Metrics

Abstract views: 536 | PDF views: 405


Download data is not yet available.

PlumX Metrics


Abahussin, A. A., & Albarrak, A. I. (2016). Vaccination adherence: Review and proposed model. Journal of Infection and Public Health, 9(6), 781-789.

Atkinson, K. M., Wilson, K., Murphy, M. S. Q., El-Halabi, S., Kahale, L. A., Laflamme, L. L., & El-Khatib, Z. (2019). Effectiveness of digital technologies at improving vaccine uptake and series completion–A systematic review and meta-analysis of randomized controlled trials. Vaccine, 37(23), 3050-3060.

Bangure, D., Chirundu, D., Gombe, N., Marufu, T., Mandozana, G., Tshimanga, M., & Takundwa, L. (2015). Effectiveness of short message services reminder on childhood immunization programme in Kadoma, Zimbabwe-a randomized controlled trial, 2013. BMC Public Health, 15(1), 1-8.

Bartfay, W., & Bartfay, E. (2016). Program planning and evaluation in public health. In W. J. Bartfay & E. Bartfay (Eds.), Public Health in Canada 2.0 (1st ed., pp. 469-510). Dubuque, Iowa, U.S: Kendall Hunt Publishing.

Burgess, K., Atkinson, K. M., Westeinde, J., Crowcroft, N., Deeks, S. L., & Wilson, K. (2017). Barriers and facilitators to the use of an immunization application: A qualitative study supplemented with Google Analytics data. Journal of Public Health, 39(3), e118-e126.

Chiabi, A., Nguefack, F. D., Njapndounke, F., Kobela, M., Kenfack, K., Nguefack, S., . . . Angwafo, F. (2017). Vaccination of infants aged 0 to 11 months at the Yaounde Gynaeco-obstetric and pediatric hospital in Cameroon: How complete and how timely? BMC Pediatrics, 17(1), 1-7.

Damnjanovic, K., Graeber, J., Ilić, S., Lam, W. Y., Lep, Ž., Morales, S., . . . Vingerhoets, L. (2018). Parental decision-making on childhood vaccination. Frontiers in Psychology, 9, 735.

Domek, G. J., Contreras-Roldan, I. L., O’Leary, S. T., Bull, S., Furniss, A., Kempe, A., & Asturias, E. J. (2016). SMS text message reminders to improve infant vaccination coverage in Guatemala: A pilot randomized controlled trial. Vaccine, 34(21), 2437-2443.

Fadda, M., Galimberti, E., Fiordelli, M., Romanò, L., Zanetti, A., & Schulz, P. J. (2017). Effectiveness of a smartphone app to increase parents’ knowledge and empowerment in the MMR vaccination decision: A randomized controlled trial. Human Vaccines & Immunotherapeutics, 13(11), 2512-2521.

Faul, F., Erdfelder, E., Lang, A.-G., & Buchner, A. (2007). G* Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods, 39(2), 175-191.

Febriastuti, N., Arief, Y., & Kusumaningrum, T. (2014). Kepatuhan orang tua dalam pemberian kelengkapan imunisasi dasar pada bayi 4—11 bulan [Parental compliance in providing complete basic immunization for infants 4-11 months]. Pediomaternal Nursing Journal, 2(2), 11793.

Hailu, S., Astatkie, A., Johansson, K. A., & Lindtjørn, B. (2019). Low immunization coverage in Wonago district, southern Ethiopia: A community-based cross-sectional study. PloS one, 14(7), e0220144.

Haji, A., Lowther, S., Ngan’Ga, Z., Gura, Z., Tabu, C., Sandhu, H., & Arvelo, W. (2016). Reducing routine vaccination dropout rates: Evaluating two interventions in three Kenyan districts, 2014. BMC Public Health, 16(1), 1-8.

Harmasdiyani, R. (2015). Pengaruh karakteristik ibu terhadap ketidakpatuhan pemberian imunisasi dasar lengkap pada anak bawah dua tahun [The effect of maternal characteristics on non-compliance with complete basic immunization in children under two years]. Jurnal Berkala Epidemiologi, 3(3), 304-314.

Hasibuan, E. A., & Sinambela, M. (2020). Analisis faktor yang berhubungan dengan penerimaan ibu terhadap imunisasi MR pada murid sekolah dasar [Analysis of factors related to maternal acceptance of MR immunization in elementary school students]. Jurnal Penelitian Kebidanan & Kespro, 2(2), 45-52.

Kazi, A. M., Ali, M., Zubair, K., Kalimuddin, H., Kazi, A. N., Iqbal, S. P., . . . Ali, S. A. (2018). Effect of mobile phone text message reminders on routine immunization uptake in Pakistan: Randomized controlled trial. JMIR Public Health and Surveillance, 4(1), e7026.

Larson, H. J. (2018). The biggest pandemic risk? Viral misinformation. Nature, 562(7726), 309-310.

Larson, H. J., Jarrett, C., Eckersberger, E., Smith, D. M. D., & Paterson, P. (2014). Understanding vaccine hesitancy around vaccines and vaccination from a global perspective: A systematic review of published literature, 2007–2012. Vaccine, 32(19), 2150-2159.

Legesse, E., & Dechasa, W. (2015). An assessment of child immunization coverage and its determinants in Sinana District, Southeast Ethiopia. BMC Pediatrics, 15(1), 1-14.

Mbengue, M. A. S., Sarr, M., Faye, A., Badiane, O., Camara, F. B. N., Mboup, S., & Dieye, T. N. (2017). Determinants of complete immunization among senegalese children aged 12–23 months: Evidence from the demographic and health survey. BMC Public Health, 17(1), 1-9.

Ministry of Health of Indonesia. (2018). Measles and rubella situation in Indonesia. Retrieved from

Mohamud, A. N., Feleke, A., Worku, W., Kifle, M., & Sharma, H. R. (2014). Immunization coverage of 12–23 months old children and associated factors in Jigjiga District, Somali National Regional State, Ethiopia. BMC Public Health, 14(1), 1-9.

Nyhan, B., Reifler, J., Richey, S., & Freed, G. L. (2014). Effective messages in vaccine promotion: A randomized trial. Pediatrics, 133(4), e835-e842.

Omer, S. B., Enger, K. S., Moulton, L. H., Halsey, N. A., Stokley, S., & Salmon, D. A. (2008). Geographic clustering of nonmedical exemptions to school immunization requirements and associations with geographic clustering of pertussis. American Journal of Epidemiology, 168(12), 1389-1396.

Phadke, V. K., Bednarczyk, R. A., Salmon, D. A., & Omer, S. B. (2016). Association between vaccine refusal and vaccine-preventable diseases in the United States: A review of measles and pertussis. JAMA, 315(11), 1149-1158.

PrimaKu. (2018). Children’s health app for the first 1000 days of life. Retrieved from

Salathé, M., & Bonhoeffer, S. (2008). The effect of opinion clustering on disease outbreaks. Journal of The Royal Society Interface, 5(29), 1505-1508.

Schlumberger, M., Bamoko, A., Yaméogo, T. M., Rouvet, F., Ouedraogo, R., Traoré, B., . . . Bazié, B. B. (2015). Positive impact on the expanded program on immunization when sending call-back SMS through a computerized immunization register, Bobo Dioulasso (Burkina Faso). Bulletin de la Societe de Pathologie Exotique (1990), 108(5), 349-354.

Seeber, L., Conrad, T., Hoppe, C., Obermeier, P., Chen, X., Karsch, K., . . . Diedrich, S. (2017). Educating parents about the vaccination status of their children: A user-centered mobile application. Preventive Medicine Reports, 5, 241-250.

Smith, L. E., Amlôt, R., Weinman, J., Yiend, J., & Rubin, G. J. (2017). A systematic review of factors affecting vaccine uptake in young children. Vaccine, 35(45), 6059-6069.

Stansfield, S. K., Walsh, J., Prata, N., & Evans, T. (2006). Information to improve decision making for health. In D. T. Jamison, J. G. Breman, A. R. Measham, G. Alleyne, M. Claeson, D. B. Evans, P. Jha, A. Mills, & P. Musgrove (Eds.), Disease control priorities in developing countries (2nd ed.). Washington (DC), New York: The International Bank for Reconstruction and Development / The World Bank Oxford University Press.

Uddin, M. J., Shamsuzzaman, M., Horng, L., Labrique, A., Vasudevan, L., Zeller, K., . . . Alam, N. (2016). Use of mobile phones for improving vaccination coverage among children living in rural hard-to-reach areas and urban streets of Bangladesh. Vaccine, 34(2), 276-283.

UNICEF. (2019). The state of the world’s children 2019. Retrieved from

USAID. (2003). Immunization essentials: A practical field guide. Retrieved from

WHO. (2016). Process of translation and adaptation of instruments. Retrieved from

WHO. (2019). Immunization coverage estimates for 2019. Geneva: World Health Organization.

WHO, UNICEF, & World Bank. (2009). State of the world’s vaccines and immunization. Geneva: World Health Organization.

Wilson, K., Atkinson, K. M., Deeks, S. L., & Crowcroft, N. S. (2016). Improving vaccine registries through mobile technologies: A vision for mobile enhanced Immunization information systems. Journal of the American Medical Informatics Association, 23(1), 207-211.

Wilson, M., Bakkabulindi, F., & Ssempebwa, J. (2016). Validity and reliability of Allen and Meyer’s (1990) measure of employee commitment in the context of academic staff in Universities in Uganda. Journal of Sociology and Education in Africa, 14(1), 1-9.

World Health Organization [WHO]. (2020). 2019-nCoV outbreak is an emergency of international concern. Retrieved from