RT Journal Article
SR Electronic
T1 Effectiveness of SMS Technology on Timely Community Health Worker Follow-Up for Childhood Malnutrition: A Retrospective Cohort Study in sub-Saharan Africa
JF Global Health: Science and Practice
JO GLOB HEALTH SCI PRACT
FD Johns Hopkins University- Global Health. Bloomberg School of Public Health, Center for Communication Programs
SP 345
OP 355
DO 10.9745/GHSP-D-16-00290
VO 6
IS 2
A1 Shohinee Sarma
A1 Bennett Nemser
A1 Heather Cole-Lewis
A1 Nadi Kaonga
A1 Joel Negin
A1 Patricia Namakula
A1 Seth Ohemeng-Dapaah
A1 Andrew S. Kanter
YR 2018
UL http://www.ghspjournal.org/content/6/2/345.abstract
AB In Ghana, Rwanda, Senegal, and Uganda, we found positive association between community health workers (CHWs) using SMS data entry with reminder alerts and timely follow-up for childhood malnutrition screening visits compared with paper forms. This association was strongest when CHWs used SMS data entry consecutively over multiple visits than when they switched between SMS and paper forms.Background: The Millennium Villages Project facilitated technology-based health interventions in rural under-resourced areas of sub-Saharan Africa. Our study examined whether data entry using SMS compared with paper forms by community health workers (CHWs) led to higher proportion of timely follow-up visits for malnutrition screening in under-5 children in Ghana, Rwanda, Senegal, and Uganda.Methods: Children under 5 years were screened for malnutrition every 90 days by CHWs using mid-upper arm circumference (MUAC) readings. CHWs used either SMS texts or paper forms to enter MUAC data. Reminder texts were sent at 15 days before follow-up was needed. Chi-square tests assessed proportion of timely follow-up visits within 90 days between SMS and paper groups. Logistic regression analysis was conducted in a step-wise multivariate model. Post-hoc power calculations were conducted to verify strength of associations.Results: SMS data entry was associated with a higher proportion of timely malnutrition follow-up visits compared with paper forms across all sites. The association was strongest with consistent SMS use over consecutive visits. SMS use at the first of 2 consecutive visits was most effective, highlighting the importance of SMS reminder alerts.Conclusions: SMS technology with reminders increased timely CHW malnutrition screening visits for under-5 children in Ghana, Rwanda, Senegal, and Uganda, highlighting the importance of such technology for improving health worker behavior in low-resource settings.