According to the first ever study to examine the impact of usingtext messaging on health workers behavior, results have shown overa six-month period, that sending daily text-message reminders tohealth workers can improve the number of children with malaria being correctly treated by nearly 25%. First published online in The Lancet , the results of the trial in Kenya proved that implementation ischeap and would be easy to expand nationally. According to national guidelines, the prescription of antimalarialtreatment by health workers in Africa is crucial to ensure patientadherence to medication and treating them successfully.Unfortunately the research revealed, that compliance with treatmentguidelines remains low irrespective of introducing numerousinterventions to change clinical practice. The use of textmessaging is more and more used for health promotion and preventionof disease. |
As many countries in the developing world, the usage of mobilephones is expanding with 86% of Kenya's population having access tomobile network coverage and 22 million mobile phone subscribers. Dejan Zurovac and colleagues from the Kenya Medical ResearchInstitute-Wellcome Trust Research Programme in Nairobi, Kenya,assessed whether receiving daily text-message reminders to complywith national malaria treatment guidelines could improvehealth-worker performance. The study involved enrolling 119 health workers from 107 ruralhealth facilities across Kenya between March 2009 and May 2010 torandomly receive text-message reminders or not. The text messagesconsisted of two parts. One was a recommendation about pediatricmalaria-case management from Kenyan national guidelines andtraining manuals, the other a motivational quote.
The assessment included the case-management practices of 2,269children receiving malaria artemisinin combination therapies (ACTs)(1157 in the intervention group and 1112 in the control group). Immediately after the implementation of text messaging, remindersimproved correct ACT management by 23.7% and increased to 24.5% 6months later. Consequently, text messaging had a substantial effecton the proportion of patients receiving their first dose of ACT ata health facility, and on those counseled on how to take the restof their course, which was likely to have increased the number ofpatients following their treatment plan. The authors commented: "Our intervention provided large and sustained improvements in thequality of care given to children with malaria, but resulted inonly about half the children being correctly managed. Therefore, werecommend that text-message reminders should be used to complementexisting interventions." Bob Snow, head of the Nairobi group concluded: "The simplicity and low cost of text messaging means thatwidespread implementation of an intervention that uses thistechnology can be done quickly and successfully...The cost of atext message in Kenya is about US$0.01, resulting in the cost offull exposure to our intervention of $2.6 per health worker, or $39000 if scaled up to an estimated 15 000 health workers in all ruralfacilities nationwide." Bruno Moonen and Justin Cohen from the Clinton Health AccessInitiative, Nairobi, Kenya highlighted in a comment: "A combination of interventions will most likely be needed toimprove adherence to national guidelines to acceptable levels.Zurovac and colleagues provide strong evidence that text-messagereminders can be an effective, low-cost component of such apackage; rigorous assessment of how additional interventions-bothtraditional and innovative-can be combined with these efforts willbe needed to achieve maximum effect and ensure that donors areaware of the value of continued investment in such strategies." Written by Grace Rattue Copyright: Medical News Today Not to be reproduced without permission of Medical News Today Additional References Citations.
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