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December, 2014
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The effect of mobile phone text-message reminders on Kenyan health workers’ adherence to malaria treatment guidelines: a cluster randomised trial

Abstract

Background
Health workers’ malaria case-management practices often differ from national guidelines. We assessed whether text-message reminders sent to health workers’ mobile phones could improve and maintain their adherence to treatment guidelines for outpatient paediatric malaria in Kenya.

Methods
From March 6, 2009, to May 31, 2010, we did a cluster-randomised controlled trial at 107 rural health facilities in 11 districts in coastal and western Kenya. With a computer-generated sequence, health facilities were randomly allocated to either the intervention group, in which all health workers received text messages on their personal mobile phones on malaria case-management for 6 months, or the control group, in which health workers did not receive any text messages. Health workers were not masked to the intervention, although patients were unaware of whether they were in an intervention or control facility. The primary outcome was correct management with artemether-lumefantrine, defined as a dichotomous composite indicator of treatment, dispensing, and counselling tasks concordant with Kenyan national guidelines. The primary analysis was by intention to treat. The trial is registered with Current Controlled Trials, ISRCTN72328636.

Findings
119 health workers received the intervention. Case-management practices were assessed for 2269 children who needed treatment (1157 in the intervention group and 1112 in the control group). Intention-to-treat analysis showed that correct artemether-lumefantrine management improved by 23·7 percentage-points (95% CI 7·6—40·0; p=0·004) immediately after intervention and by 24·5 percentage-points (8·1—41·0; p=0·003) 6 months later.

Interpretation
In resource-limited settings, malaria control programmes should consider use of text messaging to improve health workers’ case-management practices.

Zurovac D, Sudoi RK, Akhwale WS, Ndiritu M, Hamer DH, Rowe AK, et al. The effect of mobile phone text-message reminders on Kenyan health workers’ adherence to malaria treatment guidelines: a cluster randomised trial. The Lancet. 2011 Aug 27;378(9793):795–803.

8 August 2011

Bibliographic Data

Title:

The effect of mobile phone text-message reminders on Kenyan health workers’ adherence to malaria treatment guidelines: a cluster randomised trial

Author(s):

Zurovac, Dejan; Sudoi, Raymond K.; Akhwale, Willis S.; Ndiritu, Moses; Hamer, Davidson H.; Rowe, Alexander K.; Snow, Robert W.

Journal

The Lancet, 378(9793), pp. 795-803
(2011-08-04)

URL:

Full article

DOI:

10.1016/S0140-6736(11)60783-6

PMID:

21820166

Keyword(s):

Alerts and Reminders, Kenya, Malaria, mHealth, Pediatrics, SMS

Citation:
Zurovac D, Sudoi RK, Akhwale WS, Ndiritu M, Hamer DH, Rowe AK, et al. The effect of mobile phone text-message reminders on Kenyan health workers’ adherence to malaria treatment guidelines: a cluster randomised trial. The Lancet. 2011 Aug 27;378(9793):795–803.

Other Publications

In ICMCC Database

All The Lancet articles (15).

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Affiliated University Institutes

Boston University - School of Medicine - Department of Medicine - Section of Infectious Diseases, USA

Boston University - Center for Global Health and Development, USA

University of Oxford - Centre for Tropical Medicine, UK

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PubMed

Dejan Zurovac
Raymond K. Sudoi
Willis S. Akhwale
Moses Ndiritu
Davidson H. Hamer
Alexander K. Rowe
Robert W. Snow

Google Scholar

Dejan Zurovac
Raymond K. Sudoi
Willis S. Akhwale
Moses Ndiritu
Davidson H. Hamer
Alexander K. Rowe
Robert W. Snow

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