Text messaging effective support in treatment of HIV and TB
Mobile phone text messaging is a powerful tool for improving quality of care, as shown by José António Nhavoto in his doctoral thesis in informatics at Örebro University. He has developed and tested a method in Mozambique, helping patients with severe diseases to follow through with their treatments.
"Patients who received text messages felt that their doctor
cared and the method proved to be significant in getting people
to show up for their appointments," says José
António Nhavoto.
Combining care and
communication in his thesis project, José António
Nhavoto has examined how text messages can be used in several
different ways to improve care for patients linked to 16
healthcare centres in the Maputo region in his native
Mozambique. The actual technology was already in place, but it
was given a new scope and new content.
"The patients
were undergoing treatment for HIV/AIDS or tuberculosis, diseases
with among the highest mortality rate in the country. In
addition, these diseases are stigmatising.
Significantly fewer no-shows
A very
tangible result of the project was that the number of missed
doctor's appointments reduced radically – from one in four
to near enough none at all. This based on a patient group of
50,000.
The patients had four different types of text
messages linked to their treatments. Two of them were reminders
– of doctor's appointments and of picking up
prescriptions. A third type was aiming at encouraging and
motivating the patients to follow their treatments.
"The
fourth message category focused on information, for example on
how to avoid having others catching the disease and the
possibility to test for HIV for free," says José
António Nhavoto.
All text messages were
anonymous but personal in as much as they were based on the
medical records for each patient, which were held at the
healthcare centres.
Inexpensive and easy to adapt
Using
text messages for the improvement of care turned out to work
very well in this project, both for patients and for healthcare
staff. But the benefits do not stop there.
"The
technology used is cheap and easy to scale up. It can be used
for other diseases and in other countries. In India, mobile
phones are widely used. Even in affluent countries such as
Sweden, where many people own much more advanced phones, voice
messaging or even video may well be a development of what we
have done here," says José António Nhavoto.
He
is now returning to Mozambique and is hoping to present his
finding to the Ministry of Health and to various aid
organisations. One advantage with the text messaging technology
in a poor country is that it is cheap and that mobile phones are
relatively common. But there are obstacles to be overcome:
"Women
in rural areas in Mozambique are not allowed mobile phones so
they are relying on their husbands. Neither do healthcare
centres in certain areas have any computers, since there is no
electricity. What people do have, however, is the possibility to
charge their phones.
Using text messaging within
healthcare in Mozambique is consequently not only a question of
technology and healthcare as such, but it is also dependent on
cultural and social conditions. And language. There are 43
different local languages, in addition to the official
Portuguese used in this particular project.
Source:
Örebro Universitet
