MobileActive.org

M-PESA an agent-assisted, mobile phone-based, person-to-person payment and money transfer system, was launched in Kenya on March 6, 2007. This study is the first of its kind to explore the economic effects of M-PESA in Kenya at the community level.

The findings from the first stage of the study indicate that M-PESA affects the economic outcomes of community members, both users and non-users of M-PESA, through direct and externality effects, and identify 11 economic effects within the broad categories of local economic expansion, security, capital accumulation and business environment after 2.5 years of M-PESA’s use in these communities. The research also shows that effects were not visible in all the study communities and among all the population segments within the communities; they tended to be influenced by gender and geographic location of the communities.

Also, the effects were not always perceived as mutually exclusive, but as interwoven with each other to produce overall community effects.

Background: The objectives are to compare the effectiveness of cell phone-supported SMS messaging to standard care on adherence, quality of life, retention, and mortality in a population receiving antiretroviral therapy (ART) in Nairobi, Kenya.

Methods and Design: A multi-site randomized controlled open-label trial. A central randomization centre provided opaque envelopes to allocate treatments. Patients initiating ART at three comprehensive care clinics in Kenya will be randomized to receive either a structured weekly SMS (’short message system’ or text message) slogan (the intervention) or current standard of care support mechanisms alone (the control). Our hypothesis is that using a structured mobile phone protocol to keep in touch with patients will improve adherence to ART and other patient outcomes. Participants are evaluated at baseline, and then at six and twelve months after initiating ART. The care providers keep a weekly study log of all phone based communications with study participants. Primary outcomes are self-reported adherence to ART and suppression of HIV viral load at twelve months scheduled follow-up. Secondary outcomes are improvements in health, quality of life, social and economic factors, and retention on ART. Primary analysis is by ‘intention-to-treat’. Sensitivity analysis will be used to assess per-protocol effects. Analysis of covariates will be undertaken to determine factors that contribute or deter from expected and determined outcomes.

Discussion: This study protocol tests whether a novel structured mobile phone intervention can positively contribute to ART management in a resource-limited setting.

[Adapted from Abstract]

This paper presents a year long study protocol for a trial, to evaluate the influence of mobile phone reminders on adherence to first-line antiretroviral treatment in South India (Chennai and Bangalore).

Researchers plan to enroll 600 treatment naïve patients for first-line treatment as per the national antiretroviral treatment guidelines at two clinics in South India. Patients will be randomized into control and intervention arms. The control arm will receive the standard of care; the intervention arm will receive the standard of care plus mobile phone reminders.

Each reminder will take the form of an automated call and a picture message. Reminders will be delivered once a week, at a time chosen by the patient. Patients will be followed up for 24 months or till the primary outcome i.e. virological failure, is reached, whichever is earlier.
Self-reported adherence is a secondary outcome. Analysis is by intention-to-treat. A cost-effectiveness study of the intervention will also be carried out.

A step-by-step outline of designing a 24-month long trial to determine effectiveness of phone reminders for anti-retroviral adherence.

Two challenges to successful antiretroviral therapy (ART) scale-up in resource-limited settings (RLS) are human resource and healthcare infrastructure limitations. 

We read with interest the modeling study by Bärnighausen et al. which describes the complexities of ensuring adequate human resources to treat HIV/AIDS (HRHA). The authors suggest that factors needed to achieve universal ART coverage include “changes in the nature or organization of care,” training health workers with skills specific to the developing world to reduce emigration, and developing systems that decrease the number of traditional HRHA required to treat a fixed number of patients.

The Rakai Health Sciences Program (RHSP) PEPFAR-funded ART program has been actively pursuing innovative HIV care strategies that directly address these important points. In 2006, we piloted a novel program utilizing peer health workers (PHW) and mobile phones to monitor patients in a rural ART program in Rakai, Uganda.

This guide provides an inexpensive way to create an SMS communications network to enable healthcare field workers as they serve communities and their patients. The steps are purposefully simple – the system is easy to set up, use and maintain.

Answers to Frequently Asked Questions:

1. Who might benefit from a text-based communications network?
2. What are the benefits for my hospital, clinic or organization and the people it serves?
3. What technology do I need?
4. Do I need an internet connection?
5. How expensive is an SMS network?
6. How do I distribute communication credit?
7. How much staff training is required?
8. How much time does it take, per day, to manage the SMS network?
9. How do I conduct SMS training?
10. What is the best power source for the cell phones?
11. Do the CHWs communicate with each other?
12. Where can I find more information on FrontlineSMS?

The  usage  of  mobile  phones  is  abundant  in  our  daily  lives  in  various  aspects from making phone calls or sending text messages to checking e-mails or news updates to planning our activities or managing our budget. This project aims at making use of this wide spread usage of mobiles to help in the  data  collection  process.  It  designs  and  develops  a  web  based  system  called “MobiCollect”  that  is  used  for  creating  forms  or  questionnaires  to  be  later accessed  by  the  data  collectors  using  their  mobile  phone  web  browser  in  order fill in the form with the appropriate data. 
 
Once  the  system  design  and  implementation  is  completed  it  will be  tested  and evaluated to ensure the satisfaction of at least the minimum requirements of the proposed system.