PLoS Medicine: Improving health worker performance through text messaging

6 October, 2018

Interesting new paper in PLoS Medicine.

A Malaria Consortium pilot-study explored the feasibility, acceptability and outcomes of a mobile health intervention that sought to use informative text messaging to improve community health worker performance and increase coverage of intermittent preventive treatment of malaria in pregnancy. This article summarises the findings of the study.

https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0203554

CITATION: Rassi C, Gore-Langton GR, Gidudu Walimbwa B, Strachan CE, King R, Basharat S, et al. (2018) Improving health worker performance through text messaging: A mixed-methods evaluation of a pilot intervention designed to increase coverage of intermittent preventive treatment of malaria in pregnancy in West Nile, Uganda. PLoS ONE 13(9): e0203554. https://doi.org/10.1371/journal.pone.0203554

ABSTRACT

Poor health worker performance is a well-documented obstacle to quality service provision. Due to the increasingly widespread availability of mobile devices, mobile health (mHealth) has received growing attention as a service improvement tool. This pilot study explored feasibility, acceptability and outcomes of an mHealth intervention designed to increase coverage of intermittent preventive treatment of malaria in pregnancy (IPTp) in two districts of West Nile, Uganda. In both districts, selected health workers (N = 48) received classroom training on malaria in pregnancy. All health workers in one district (N = 49) subsequently received 24 text messages reinforcing the training content. The intervention was evaluated using a mixed-methods approach, including four focus group discussions with health workers and three in-depth interviews with district health officials, health worker knowledge assessments one month (N = 90) and six months (N = 89) after the classroom training, and calculation of IPTp coverage from participating health facilities’ (N = 16) antenatal care registers covering six months pre- and post-intervention. Complementing classroom training with text messaging was found to be a feasible, acceptable and inexpensive approach to improving health worker performance. The messages served as reminders to those who had attended the classroom training and helped spread information to those who had not. Health workers in the district where text messages were sent had significantly better knowledge of IPTp, achieving an increased composite knowledge score of 6.00 points (maximum score: 40) compared with those in the district where only classroom training was provided. Average facility coverage of three doses of IPTp was also significantly higher where text messages were sent (85.8%) compared with the district where only classroom training was provided (54.1%). This intervention shows promise for the improvement of health worker performance for delivery of IPTp, and could have significant broader application.

Best weishes, Neil

Coordinator, mHIFA Project (Mobile Healthcare Information For All)

http://www.hifa.org/projects/mobile-hifa-mhifa

Coordinator, HIFA Project on Community Health Workers

http://www.hifa.org/projects/community-health-workers

Let's build a future where people are no longer dying for lack of healthcare information - Join HIFA: www.hifa.org

HIFA profile: Neil Pakenham-Walsh is coordinator of the HIFA global health campaign (Healthcare Information For All - www.hifa.org ), a global community with more than 18,000 members in 177 countries, interacting on five global forums in three languages. He also currently chairs the Dgroups Foundation (www.dgroups.info), which supports 800 communities of practice on international development, health and social justice. Twitter: @hifa_org FB: facebook.com/HIFAdotORG neil@hifa.org