P6.032 Design of a Complex Intervention: Community-Based Mobile Phone Text Messaging For Sexual and Reproductive Health Referral in Tanzania

Abstract

<h3>Introduction</h3> In many countries there are private stores known as drug shops that sell medicines for treatment of various illnesses. These shops are licenced to sell non-prescription, pre-packaged medicines only. In Tanzania, evidence shows they sell ‘prescription-only’ drugs including antibiotics and antimalarials. An intervention with objective to increase uptake of reproductive health (RH) services in formal health facilities was designed to facilitate patients’ and drug shops’ access to prescriptions from formal health facilities. <h3>Methods</h3> Nested in a cluster-randomised trial, the intervention is implemented in 9 intervention communities against 9 comparison communities in Mwanza region Tanzania. Using a web-based mobile phone application, an electronic referral platform was designed to host a text messaging referral system. The platform was configured with the telephone numbers of drug shop attendants, dispensary and health centre clinical officers and a toll-free number. Drug shop attendants and clinical officers were trained and given a texting guideline cue card. <h3>Results</h3> Forty-four drug shop attendants, 14 dispensaries, and 3 health centres have enrolled onto the intervention. These facilities use the technology to treat patients with RH needs ranging from family planning to STI and HIV treatment. On average 14 patients pass through the system per week. We expect data on at least 700 patients by the end of a 12-month implementation period. This data will be analysed to report on family planning and contraception, pregnancy and antenatal care, STI and HIV/AIDS outcomes. <h3>Conclusions</h3> The system has proved to work effectively. Participation of stakeholders in the design was optimal. Given the automatic data collection facility of this system, data for research, monitoring and reporting is readily accessible to researchers, district health authorities and the ministry of health through authorised logins. The contribution of this system to RH service uptake and health system strengthening will be verified after an impact evaluation.