Abstract

BackgroundThe rapid growth in mobile phone penetration and use of Short Message Service (SMS) has been seen as a potential solution to improve medical and public health practice in Africa. Several studies have shown effectiveness of SMS interventions to improve health workers’ practices, patients’ adherence to medications and availability of health facility commodities. To inform policy makers about the feasibility of facility-based SMS interventions, the coverage data on mobile phone ownership and SMS use among health workers and patients are needed.MethodsIn 2012, a national, cross-sectional, cluster sample survey was undertaken at 172 public health facilities in Kenya. Outpatient health workers and caregivers of sick children and adult patients were interviewed. The main outcomes were personal ownership of mobile phones and use of SMS among phone owners. The predictors analysis examined factors influencing phone ownership and SMS use.ResultsThe analysis included 219 health workers and 1,177 patients’ respondents (767 caregivers and 410 adult patients). All health workers possessed personal mobile phones and 98.6% used SMS. Among patients’ respondents, 61.2% owned phones and 71.4% of phone owners used SMS. The phone ownership and SMS use was similar between caregivers of sick children and adult patients. The respondents who were male, more educated, literate and living in urban area were significantly more likely to own the phone and use SMS. The youngest respondents were less likely to own phones, however when the phones were owned, younger age groups were more likely to use SMS. Respondents living in wealthier areas were more likely to own phones; however when phones are owned no significant association between the poverty and SMS use was observed.ConclusionsMobile phone ownership and SMS use is ubiquitous among Kenyan health workers in the public sector. Among patients they serve the coverage in phone ownership and SMS use is lower and disparities exist with respect to gender, age, education, literacy, urbanization and poverty. Some of the disparities on SMS use can be addressed through the modalities of mHealth interventions and enhanced implementation processes while further growth in mobile phone penetration is needed to reduce the ownership gap.

Highlights

  • The rapid growth in mobile phone penetration and use of Short Message Service (SMS) has been seen as a potential solution to improve medical and public health practice in Africa

  • Mobile health or mHealth is broadly defined as the use of mobile devices such as phones, to support medical and public health practice [1]. mHealth has gained momentum in Africa where rapid growth in mobile phone penetration has been seen as a potential solution to lever human, economic and infrastructure weaknesses of the health system [2,3]

  • Sample description The survey included 1,291 febrile patients seen by 222 health workers at 172 health facilities

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Summary

Introduction

The rapid growth in mobile phone penetration and use of Short Message Service (SMS) has been seen as a potential solution to improve medical and public health practice in Africa. Several studies have shown effectiveness of SMS interventions to improve health workers’ practices, patients’ adherence to medications and availability of health facility commodities. Despite a paucity of evaluations to demonstrate the effectiveness and cost-effectiveness of SMS interventions, those interventions targeting patients’ adherence to medications, health workers’ adherence to guidelines and post-treatment attendance have shown significant outcome improvements during recent randomized trials [5,6,7,8,9] and further studies are either underway or planned [10,11]. An important aspect for policy makers planning to adopt SMS interventions is a measure of mobile phone ownership and use among target populations of health workers and their patients at health facilities [14,15]. We report here recent national data on mobile phone ownership and use among health workers’ and patients’ in Kenya and examine factors influencing ownership and SMS use to help guide the policy implications of mHealth

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