AudiencScapes

As healthcare projects deploying text messaging multiply in Africa, researchers are beginning to evaluate their effectiveness. Dinfin Mulupi reports on some of the emerging results.

By Dinfin Mulupi

A relatively new technology is making headway in fighting some of the African continent’s most pernicious epidemics. With adoption of mobile phones increasing rapidly in Africa, the use of health tools involving text messaging is also spreading. Text messaging is being deployed to fight malaria, encourage child immunizations and help people living with HIV/AIDS, among other uses.

While many of these projects are in the early stages, some initial evaluations of SMS-text-messaging projects suggest they are effective in helping people get treatment, understand how to protect themselves and their families or get tested early. After a study was conducted showing favorable outcomes of the use of SMS to connect HIV-positive Kenyans with medical practitioners, plans were made to expand the project significantly. According to sources, plans are underway to unveil a five-year nationwide SMS initiative that would connect Kenya’s more than 2 million HIV-positive patients with medical practitioners.

Kenya Connects Patients With Providers

The study prompting this expansion was conducted by WelTel Kenya, an organization started by scientists, which released its results in November 2010. The “WelTel Kenya1” study, written by Dr. Richard Lester and colleagues, assessed the effectiveness of SMS-text messaging in improving patients’ adherence to antiretroviral therapy (ART). The SMS model being studied was designed in 2007 by Dr. Lester, of the British Columbia Centre for Disease Control in Vancouver, along with Kenyan clinicians and scientists working in HIV/AIDS care.

The study’s results showed that sending reminders via SMS to patients to take their medication achieved a significant increase in patients’ adherence. The researchers found adherence to ART was reported in 168 of 273 (62 percent) patients receiving the SMS intervention, compared with 132 of 265 (50 percent) in the control group. The patients receiving SMS communication were also more likely than the control group to achieve HIV viral suppression below detectable levels.

“This study shows that mobile health innovations can improve HIV treatment outcomes,” wrote Dr. Lester in the report published in the Lancet. “Patients who received the SMS support were more likely to report adherence to ART and were more likely to have their viral load suppressed below detection levels than patients who received the standard care alone.”

The study concluded that mobile phones might be effective tools to improve patient outcome in settings with limited resources.

According to Boniface Beti of WelTel, with more than 17 million mobile phone users, mobile phones are easily accessible to most HIV patients in Kenya.  The advantage of using the SMS model is that it is unrestricted to any location and offers patients privacy. Kenya’s physical infrastructure is a stark contrast to the country’s mobile phone infrastructure.  In marginalized areas, for example, patients have to travel for up to 50 kilometers to access healthcare facilities but even then, the shortage of health practitioners still poses a challenge. 

Studying Ugandan’s HIV Awareness

Kenya is not the only African country turning to SMS in the fight against HIV. Zambia is using SMS to encourage early testing of infants for HIV. In Uganda for instance, a study conducted by Text to Change indicates that SMS can be used to increase HIV awareness and double the number of people who go for HIV testing. (See study here: “Using SMS for HIV/AIDS Education”). Text to Change is an organization that uses mobile phone technology to collect health information and deliver health information.

During the study, conducted in Lira (northern Uganda), participants received seven questions on HIV/AIDS issues and three on family planning. One of the questions asked was: “Would you think of getting an HIV test? YES or NO. “

To improve participants’ knowledge, an SMS confirming whether their responses were correct was sent. Participants, who replied incorrectly, received additional information on HIV. A record 96 percent of participants in the survey stated that the survey helped them gain new knowledge on HIV and related issues.  

The applications for SMS messaging in the service of health education or health care delivery are growing as pilot projects get expanded and improved upon. According to WelTel’s Beti: “The availability of mobile phone infrastructure will not be a major hindrance to widespread use of this technology. In many African countries, service coverage is nearly ubiquitous, and almost everyone has a mobile phone or access to a shared one.”

Dinfin Mulupi is a business journalist based in Nairobi, Kenya. She is currently the East Africa corresp for an online business paper based in Cape Town in South Africa.

Related Links
An SMS a Day Keeps the Doctor Away

Picture Courtesy: Geoff Coupe on Flickr