Unstructured Supplementary Service Data Research Articles

Complexities of competition regulation in Zimbabwe’s mobile money sector

This study explores the complexities of competition regulation in Zimbabwe’s mobile money sector—through an analysis of EcoCash’s market position and practices, and the regulatory steps taken in response. The study is grounded in the competition complaint made in 2014 by Zimbabwean banks against EcoCash to the Competition and Tariff Commission (CTC), wherein EcoCash was alleged to have initially refused to share its unstructured supplementary service data (USSD) infrastructure with banks; and then later to have granted access only on discriminatory terms. The research assessed the market structure and market power in the Zimbabwe mobile money sector; the regulatory challenges that these market features pose; the market power and conduct of EcoCash; and the effectiveness of the measures taken by regulators to address the competition concerns raised in relation to EcoCash. The findings indicated that, in spite of regulatory attempts to dilute its power in the market, EcoCash was, at the time of the core data collection in 2021–22, still in a dominant position in Zimbabwe’s mobile money market.

Digitalisation in the WFP fresh food voucher programme: a pilot study from rural Amhara region, Ethiopia.

Malnutrition continues to pose a major challenge to human well-being around the world. In Ethiopia, 39% of children <5 years are stunted, with peaks in northern regions of the country such as Amhara (54.8%). Very few (2%) children in the region achieve the minimum dietary diversity and only a minority (27%) belong to households that can afford a nutritious diet. To tackle the high stunting rate, diets high in fruits and vegetables are widely recommended to improve dietary diversity. Programmes leveraging fresh food vouchers can be used to support vulnerable groups with malnutrition and limited affordability. Cash-based transfer (CBT) programmes have repeatedly been shown to improve child growth and increase household food security and dietary diversity. This study is part of the World Food Programme (WFP) intervention regarding a stunting reduction rural programme of restricted CBT for improving dietary diversity in households with children under 2 years of age and pregnant and lactating women. A community- based pilot study to assess the itemised foods purchased by beneficiaries was conducted in the four most accessible woredas of the Amhara region of Ethiopia. A total of 556 beneficiaries and 12 active retailers were selected randomly from 10 rural markets in the targeted woredas. A point of sale (POS) system was used to collect the itemised food prices and amounts of food procured by the beneficiaries. Approximately 51, 35, and 15% of the beneficiaries purchased vegetables, fruits, and eggs, respectively. Prices, taste preferences of children, and shelf life determine the purchase of certain food items. The average food expenditure was 49 Ethiopian Birr (ETB; US$ 0.94), representing the 63 and 37% daily and monthly requirements, respectively, for affordability. The higher increase in prices of some food items might be due to their seasonality. Almost half of the Fresh Food Voucher (FFV) beneficiaries were purchasing and consuming vegetables. The finding indicates that the WFP fresh food voucher programme contributes 63% (49 ETB, US$ 0.94) and 37% (837 ETB, US$ 16.1) of the daily and monthly needs of affordability, respectively, for a diversified nutritious diet. The use of Unstructured Supplementary Service Data (USSD) technology in the WFP digital voucher under the Fresh Food Voucher (FFV) project was effective at collecting itemised prices of foods purchased by the beneficiaries. The point of sale (POS) system can be scaled up under the Fresh Food Voucher (FFV) programme so that the digital voucher can contain the itemised food prices. Timely data from the point of sale could be used for timely Social Behaviour Change Communication (SBCC) development to improve dietary diversity.

An Unstructured Supplementary Service Data System to Verify HIV Self-Testing Among Nigerian Youths: Mixed Methods Analysis of Usability and Feasibility.

Mobile health (mHealth) interventions among adolescents and young adults (AYAs) are increasingly available in African low- and middle-income countries (LMICs). For example, the unstructured supplementary service data (USSD) could be used to verify HIV self-testing (HIVST) among AYAs with poor bandwidth. The aim of this study is to describe the creation of an USSD platform and determine its feasibility and usability to promote the verification of HIVST results among AYAs in Nigeria. We developed and evaluated a USSD platform to verify HIVST results using a user-centered approach. The USSD platform guided AYAs in performing HIVST, interpreting the result, and providing linkage to care after the test. Following the usability assessment, the USSD platform was piloted. We used a mixed methods study to assess the platform's usability through a process of quantitative heuristic assessment, a qualitative think-aloud method, and an exit interview. Descriptive statistics of quantitative data and inductive thematic analysis of qualitative variables were organized. A total of 19 AYAs participated in the usability test, with a median age of 19 (IQR 16-23) years. There were 11 females, 8 males, and 0 nonbinary individuals. All individuals were out-of-school AYAs. Seven of the 10 Nielsen usability heuristics assessed yielded positive results. The participants found the USSD platform easy to use, preferred the simplicity of the system, felt no need for a major improvement in the design of the platform, and were happy the system provided linkage to care following the interpretation of the HIVST results. The pilot field test of the platform enrolled 164 out-of-school AYAs, mostly young girls and women (101, 61.6%). The mean age was 17.5 (SD 3.18) years, and 92.1% (151/164) of the participants reported that they were heterosexual, while 7.9% (13/164) reported that they were gay. All the participants in the pilot study were able to conduct HIVST, interpret their results, and use the linkage to care feature of the USSD platform without any challenge. A total of 7.9% (13/164) of the AYAs had positive HIV results (reactive to the OraQuick kit). This study demonstrated the usability and feasibility of using a USSD system as an alternative to mobile phone apps to verify HIVST results among Nigerian youth without smartphone access. Therefore, the use of a USSD platform has implications for the verification of HIVST in areas with low internet bandwidth. Further pragmatic trials are needed to scale up this approach.

Examining the evolutionary trends of mobile banking platforms in Nigeria

This paper takes a critical review of the evolutionary trend of mobile banking platforms deployed by commercial banks in Nigeria, with the aim to recommend a more secure and robust one. It identifies the strengths and weaknesses of each and highlights the factors that led to the invention of the next succeeding one. The mobile banking platforms reviewed includes Short Messaging Service (SMS), Interactive Voice Response (IVR), Unstructured Supplementary Service Data (USSD), Wireless Application Protocol (WAP), SIM Application Toolkit (SAT), and Application (APP) based platforms. Many of these mobile banking platforms are still utilized by most commercial banks in Nigeria today. However, it is obvious that, although most commercial banks combine two or more of the mobile banking platforms in order to get better result, there are inherent security problems and other challenges in them, which need to be addressed. Having a mobile banking platform (APPbased) with inbuilt ability to confirm a user’s authenticity before his transaction is completed, would bring a better security check and thereby bring enhancement to mobile banking transactions. The Application is made more flexible for users by allowing more than one user to use the application to transact once installed in a phone. It is as well equipped with more functionalities like including means for users to: enable/disable their SMS alerts, Change their SMS phone number, Edit their residential address, and Update their next of kin information, as their needs may arise.

Usability Evaluation of Mobile USSD-SMS Interactive Result Checking System for Resource-Constrained Settings (MIRCS) using System Usability Score (SUS).

Mobile phones, especially smartphones have impacted the way we access information related to education. For instance, students are now able to view their results using a smartphone on a browser. However, these result systems that make it possible for students to view their exam results through web browsers or emails on their mobile devices need an internet connection for the process to work as expected. Also, given the indigent nature of most students in developing countries, this creates a digital divide for students that do not own smartphones. With many students coming from rural and often low economic status homes, not many can afford smartphones. Hence, leveraging on the potentials of Unstructured Supplementary Service Data (USSD) and Short Message Service (SMS), a Mobile USSD-SMS Interactive Result Checking System for Resource-Constrained Settings (MIRCS) was developed to provide a device agnostic accessible Result Checking System. This study evaluated MIRCS using System Usability Scale (SUS) to verify the effectiveness from a usability point of view. The result of the evaluation shows that the MIRCS is usable which received grade C (66.21), although it does not meet the acceptable level specified by SUS. Further analysis of the interaction with respondents suggests some areas of improvement to include cost of service, high availability and accuracy.

Tracking adaptation strategies of an HIV prevention intervention among youth in Nigeria: a theoretically informed case study analysis of the 4 Youth by Youth Project

BackgroundAlthough many behavioral interventions are adapted, little is known about the reasons for adaptations and the process and outcomes influencing adaptations. To address this gap, we explored the adaptations made to promote HIV prevention services, including HIV self-testing (HIVST), among Nigerian youth.MethodsThe main objective of this qualitative case study design was to document the adaptations made over time using the Framework for Reporting Adaptations and Modifications – Expanded (FRAME). Between 2018 and 2020, we organized four participatory activities as part of the 4 Youth by Youth project to increase the uptake of HIVST services in Nigeria—an open call, a designathon, a capacity-building bootcamp and a pilot feasibility trial. We also began the process of implementing a final intervention using a pragmatic randomized control trial (RCT). The open call solicited creative strategies to promote HIVST among Nigerian youth and then had experts evaluate them. The designathon brought together youth teams to further develop their HIVST service strategies into implementation protocols. Teams determined to be exceptional were invited to a four-week capacity-building bootcamp. The five teams that emerged from the bootcamp were supported to pilot their HIVST service strategies over a 6-month period. The adapted intervention is currently being evaluated in a pragmatic RCT. We transcribed meeting reports and conducted document reviews of study protocols and training manuals.ResultsSixteen adaptations were identified and categorized into three domains: (1) modifications to the content of the intervention (i.e. photo verification system and/or Unstructured Supplementary Service Data (USSD) system to verify HIVST); (2) modifications to the delivery the intervention (i.e. implement participatory learning community sessions to provide supportive supervision and technical support); (3) modifications to the evaluation processes (i.e. economic evaluation to estimate the cost of implementing intervention on a larger scale). Frequent reasons for adaptation included increasing intervention reach, modifying interventions to enhance their appropriateness and fit with the recipient, and increasing the intervention’s feasibility and acceptability. Most adaptations were planned and reactive, and the need for modifications was determined by the youths, 4YBY program staff, and advisory group.ConclusionsFindings suggest that the nature of adaptations made throughout the implementation process reflects the necessity of evaluating services in context while adjusting to specific challenges as they are identified. Further research is needed to understand the effect of these adaptations on the overall intervention effect as well as the quality of youth engagement.

Dynamic Linkage(s) between Financial Innovation and Efficiency of Deposit Money Banks in Nigeria

The emergence of new technologies, changing customer expectations, and regulatory imperatives, among others, have driven the financial industry into an era where "digital innovations" thrive, culminating in the emergence and growth of innovative products such as agency banking, mobile/internet banking, mobile money, unstructured supplementary service data (USSD), just to name a few. There is increased customers' reliance on e-channels. This has further established the need for banks to engage in financial innovation for relevance, competitiveness, efficiency and growth. This study, therefore, examines the dynamic linkage(s) between financial innovation and the efficiency of deposit money banks (DMBs) in Nigeria. The population of the study comprises the 13 listed DMBs in Nigeria as of 31 December 2021, and these serve as the sample size. The period covered is 48 months -2016 and 2019. Data were collected from the bank's annual reports and Apex bank's statistical bulletin. Descriptive statistics, correlation and autoregressive distributed lag (ARDL) cointegration techniques were used for data analyses. The efficiency of DMBs was estimated using data envelopment analysis (DEA). Findings reveal that financial innovation has forward and backwards dynamic linkages with the efficiency of DMBs in Nigeria.

Integration of Unstructured Supplementary Service Data (USSD) Into A University's Portal

Integration of Unstructured Supplementary Service Data (USSD) Into A University's Portal

The use of various appointment systems among patients visiting academic outpatient centers in Kerman and the evaluation of patients’ perspective and satisfaction

BackgroundTo optimize appointment systems, it is necessary to assess their users’ perspectives. This study aims to determine the use of various appointment systems among patients in academic outpatient centers and to investigate their perspectives and satisfaction.MethodsThis survey study was conducted on 332 patients or those accompanying patients in academic outpatient centers. A five-part questionnaire consisting of (1) demographic information, (2) willingness to use systems, (3) problems when using these systems, (4) problems after reserving the appointment, (5) recommendations and critics was used. The relationship between the system of interest and the available tools was examined by the Chi-square test, and the relationship between demographic characteristics and satisfaction was assessed using multiple regression.ResultsThe participants’ overall satisfaction towards appointment systems, regardless of the type of system, was 49.12 ± 16.04 (out of 100). Satisfaction with the appointment system using Unstructured Supplementary Service Data (USSD) was significantly higher than the other two systems (p = 0.03). Web-based application and Interactive Voice Response (IVR) were the most frequently used systems with 61% and 48%, respectively. More than half of those who had access to a telephone (56%) preferred the IVR appointment system, and most of those who had Internet access (71%) preferred the web-based application (p < 0.05). Among 137 participants who had access to both the Internet and telephone, 49% (n = 67) stated that they would rather arrange their appointment through the web-based application.ConclusionThe web-based application and IVR are the most frequently used and favorable appointment system among the patients or those accompanying patients. Despite the availability of the infrastructure, the participant had moderate satisfaction with these systems due to their failures. Therefore, to have more efficient systems and increase patients or those accompanying patients satisfaction with these systems, healthcare authorities should have a plan to solve the problems of these systemes and use the capacity of information resources to inform the community regarding these systems.

Feasibility of e-commerce pharmacy provision and acceptability of levonorgestrel 1.5 mg for pericoital use in urban and peri-urban settings in Kenya: a prospective cohort study

IntroductionAn ‘on-demand’ contraceptive pill may suit women having infrequent sex. We assessed the feasibility of e-commerce pharmacy provision and acceptability of levonorgestrel (LNG) 1.5 mg for pericoital use in Kenya.MethodsA...

Mobile Phone-based Intervention to promote un-interrupted HIV treatment during the COVID-19 pandemic.

Keeping HIV-infected adults away from the health care system during the COVID-19 travel restrictions, presents a challenge to HIV treatment adherence. This study focused on the initial two phases where Phase 1 designed a Makerere College of Health Sciences (MakCHS) Unstructured Supplementary Service Data (USSD)-based application; and Phase 2 piloted patient enrolment onto the application and determined the feasibility of remote follow-up of patients receiving long-term antiretroviral therapy (ART). A off/online user application, MakCHS Health app, was developed. Overall, 112 patients [(66(59%) female] receiving ART at Mulago ISS clinic, Kampala, were enrolled onto the MakCHS Health app. Up to 89 (80%) utilized the app to access medical help. Patients' medical queries included needs for drug refills, missed taking HIV medication, medical illnesses, access to COVID-19 vaccination and other personal needs that required clinicians' attention. Piloting a MakCHS Health application for patient follow-up was feasible and well-received by HIV treatment providers and patients receiving ART. We recommend scale up of the application to enroll all patients receiving long-term treatment for HIV/AIDS, and subsequently expand to. other HIV treatment programs in similar settings.

Developing an Unstructured Supplementary Service Data-based mobile phone app to provide adolescents with sexual reproductive health information: a human-centered design approach

BackgroundAdolescent pregnancies and sexually-transmitted infections continue to impact 15 – 19-year-olds across the globe. The lack of sexual reproductive health information (SRH) in resource-limited settings due to cultural and societal attitudes towards adolescent SRH could be contributing to the negative outcomes. Innovative approaches, including mobile phone technologies, are needed to address the need for reliable adolescent SRH information.ObjectiveThe study aimed to co-design a Unstructured Supplementary Service Data (USSD) based mobile app prototype to provide confidential adolescent SRH information on-demand and evaluate the mobile app’s usability and user experience.MethodsA human-centered design methodology was applied. This practice framework allowed the perspectives and feedback of adolescent users to be included in the iterative design process. To participate, an adolescent must have been 15 to 19 years old, resided in Kibra and would be able to access a mobile phone. Adolescents were enrolled for the alpha and field testing of the app prototype at different time-points. The Mobile Application Rating Scale (MARS) a multidimensional mobile phone evaluation tool was used to access the functionality, engagement, aesthetics and quality of information in the app. Responses from the MARS were reported as mean scores for each category and a mean of the aggregate scores making the app’s quality score. The MARS data was also evaluated as categorical data, A Chi square test of independence was carried out to show significance of any observed differences using cumulative and inverse cumulative distribution functions.ResultsDuring the usability test, 62/109 (54.9%) of the adolescents that were followed-up had used the app at least once, 30/62 (48.4%) of these were male participants and 32/62 (51.6%) female. On engagement, the app had a mean score of 4.3/5 (SD 0.44), 4.6/5 (SD 0.38) on functionality, 4.3/5 (SD 0.57) on aesthetics and 4.4/5 (SD 0.60) on the quality of information. The overall app quality mean score was 4.4/5 (SD 0.31). The app was described as ‘very interesting’ to use by 44/62 (70.9%) of the participants, 20/44 males and 24/44 females. The content was deemed to be either ‘perfectly’ or ‘well targeted’ on sexual reproductive health by 60/62 (96.7%) adolescents, and the app was rated ‘best app’ by 45/62 (72.6%) adolescents, 27/45 females and 18/45 males, with a p-value = 0.011.ConclusionsAdolescents need on-demand, accurate and trusted SRH information. A mobile phone app is a feasible and acceptable way to deliver adolescent SRH information in resource-limited settings. The USSD mobile phone technology shows promise in the delivery of much needed adolescent SRH information on-demand..

User Acceptability of Electronic Vaccine Registry Created using Simple Mobile Phone Technology in Nyandarua County, Kenya

Vaccination is one of the most important and effective public health interventions against vaccine-preventable diseases. Developed countries have successfully reduced mortality and morbidity due to vaccine-preventable diseases through improving vaccine coverage. This is not the case among low-income countries as vaccine coverages continue to soar below the global target of 90% coverage. Among the reasons reported for the low coverage are poor documentation and poor target setting, which could be attributed to the limited use of electronic vaccine registries. An electronic vaccine registry was created using Unstructured Supplementary Service Data (USSD) technology and registered births, vaccines administered, and sent short message reminders to mothers about their clinic dates. The registry was deployed in Nyandarua County, Kenya, between June 2018 to March 2019. We conducted a study to establish the acceptability and usability of the system to receive user feedback and explore possibilities of large-scale roll-out. All those interviewed (59) were able to log into the system during their first attempt. The majority (94.8%) reported that it was easy to manoeuvre the menu and move from one menu to the other System downtime was a rare phenomenon, and more than half (63%) reported that if it occurred, it happened at most once or twice per week. The majority of the respondents, 55 (98%), reported that the system was able to record the vaccines administered as envisioned. The cost to run the platform was quite manageable and slightly lower than internet-based systems. The system was user-friendly and can be replicated elsewhere.

Towards an Integrated Mobile Technology on Animal Disease Surveillance Framework in Tanzania: A Systematic Review

Tanzanian Government, through its national audit office in March 2020, reported the prevalence decline of two animal diseases, namely; Foot and Mouth Disease (FMD) and Contagious Bovine Pleuropneumonia (CBPP). Similarly, an increase in three animal diseases, which are African Swine Fever (ASV), Contagious Caprine Pleuropneumonia (CCPP), and Lumpy Skin Disease (LSD). The national audit office mentioned inadequate animal disease surveillance system in the country was among the challenges that hinder diseases control. Therefore, this study reviews the existing animal diseases surveillance systems global and suggests measures to enhance animal diseases surveillance systems in Tanzania. This review focuses on the possibility of sharing surveillance data among livestock stakeholders (including livestock keepers) in Tanzania, considering available resources such as animal diseases existing prediction models and mobile-based surveillance systems. Also, the availability of mobile technologies such as Short Message Service (SMS), Unstructured Supplementary Service Data (USSD) and automatic voice calls (Robocalls). Reviews synthesize the previous studies to explore strengths, opportunities, weaknesses and challenges for better future interventions through proper and timely information sharing. This study selected 46 records from the 147 identified for review. The selected records include 24 from bibliographic databases, 14 from full-text journals and other non-bibliographic databases, and 8 from the open search on websites

An Unstructured Supplementary Service Data-Based mHealth App Providing On-Demand Sexual Reproductive Health Information for Adolescents in Kibra, Kenya: Randomized Controlled Trial.

BackgroundAdolescents transitioning from childhood to adulthood need to be equipped with sexual reproductive health (SRH) knowledge, skills, attitudes, and values that empower them. Accessible, reliable, appropriate, and friendly information can be provided through mobile phone–based health interventions.ObjectiveThis study aims to investigate the effectiveness and impact of an Unstructured Supplementary Service Data (USSD)–based app in increasing adolescents’ knowledge about contraceptives, gender-based stereotypes, sexually transmitted infections (STIs), abstinence, and perceived vulnerability, and helping adolescents make informed decisions about their SRH.MethodsA randomized controlled trial (RCT) methodology was applied to investigate the potential of a USSD-based app for providing on-demand SRH information. To be eligible, adolescents aged 15 to 19 years residing in Kibra, Kenya, had to have access to a phone and be available for the 3-month follow-up visit. Participants were randomly assigned to the intervention (n=146) and control (n=154) groups using sequentially numbered, opaque, sealed envelopes. The primary outcome was improved SRH knowledge. The secondary outcome was improved decision-making on SRH. The outcomes were measured using validated tools on adolescent SRH and user perceptions during the follow-up visit. A paired sample t test was used to compare the changes in knowledge scores in both groups. The control group did not receive any SRH information.ResultsDuring the RCT, 54.9% (62/109) of adolescents used the USSD-based app at least once. The mean age by randomization group was 17.3 (SD 1.23) years for the control group and 17.3 (SD 1.12) years for the intervention group. There was a statistically significant difference in the total knowledge scores in the intervention group (mean 10.770, SD 2.012) compared with the control group (mean 10.170, SD 2.412) conditions (t179=2.197; P=.03). There was a significant difference in abstinence (P=.01) and contraceptive use (P=.06). Of the individuals who used the app, all participants felt the information received could improve decision-making regarding SRH. Information on STIs was of particular interest, with 27% (20/62) of the adolescents seeking information in this area, of whom 55% (11/20) were female. In relation to improved decision-making, 21.6% (29/134) of responses showed the adolescents were able to identify STIs and were likely to seek treatment; 51.7% (15/29) of these were female. Ease of use was the most important feature of the app for 28.3% (54/191) of the responses.ConclusionsAdolescents require accurate and up-to-date SRH information to guide their decision-making and improve health outcomes. As adolescents already use mobile phones in their day-to-day lives, apps provide an ideal platform for this information. A USSD-based app could be an appropriate tool for increasing SRH knowledge among adolescents in low-resource settings. Adolescents in the study valued the information provided because it helped them identify SRH topics on which they needed more information.Trial RegistrationPan African Clinical Trial Registry PACTR202204774993198; https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=22623

Effects of Digital Banking on The Performance of Commercial Banks in Nigeria 2010 -2019

In this study, the effect of digital banking on the performance of Commercial Banks was examined from 2010 to 2019. The study applied the Autoregressive Distributive Lag (ARDL) framework to examine the relationship between point of sales machine (POSG), Banking Transactions made through unstructured supplementary service data (USSDG), Web banking (WEBG) and Return on Assets (ROA) of commercial banks in Nigeria. The data were obtained from the statistical bulletins of the Central Bank of Nigeria (CBN) and annual reports of Nigeria Deposit Insurance Corporation (NDIC). The result of the analysis revealed that digital banking has positive and insignificant effect on the performance of commercial banks in Nigeria. . In the light of this findings, the study recommends the need for relatively stable network: In other to reduce number of failed transactions, banks are hereby encouraged to liaise with network providers and their engineers to develop a standardized network platform exclusively for each of the digital banking channels. Also there is need for digital banking education to bank customers on the benefits of digital banking. Equally there is need for all banks to have 24 hours working cyber security department in order to ensure that the channels are not hijacked by cyber criminals.

Leveraging Digital Tools and Crowdsourcing Approaches to Generate High-Frequency Data for Diet Quality Monitoring at Population Scale in Rwanda

Diet quality is a critical determinant of human health and increasingly serves as a key indicator for food system sustainability. However, data on diets are limited, scattered, often project-dependent, and current data collection systems do not support high-frequency or consistent data flows. We piloted in Rwanda a data collection system, powered by the principles of citizen science, to acquire high frequency data on diets. The system was deployed through an unstructured supplementary service data platform, where respondents were invited to answer questions regarding their dietary intake. By combining micro-incentives with a normative nudge, 9,726 responses have been crowdsourced over 8 weeks of data collection. The cost per respondent was &amp;lt; $1 (system set-up, maintenance, and a small payment to respondents), with interactions taking &amp;lt;15 min. Exploratory analyses show that &amp;gt;70% of respondents consume tubers and starchy vegetables, leafy vegetables, fruits, legumes, and wholegrains. Women consumed better quality diets than male respondents, revealing a sex-based disparity in diet quality. Similarly, younger respondents (age ≤ 24 years) consumed the lowest quality diets, which may pose significant risks to their health and mental well-being. Middle-income Rwandans were identified to have consumed the highest quality diets. Long-term tracking of diet quality metrics could help flag populations and locations with high probabilities of nutrition insecurity, in turn guiding relevant interventions to mitigate associated health and social risks.

Mobile Technology and Dissemination of Information in the Kenyan Insurance Industry

It is estimated that only 15 percent of Kenyans have made plans for retirement, and many people fall into poverty once they retire. A 2018 survey by the Unclaimed Property Asset register found that insurance companies hold 25 percent of unclaimed funds with 10 percent belonging to pensioners. This was attributed to a lack of effective information flow between insurance companies and the customers and also between various departments in the insurance companies. Further, there were numerous cases of loss of documents and files and certain files were untraceable in the departments. This paper investigates ways in which mobile technology influences dissemination of information for processing pension claims in the insurance industry. An improvement in dissemination of information for processing of pension claims can carry out a key function in increasing percentage of Kenyans making plans for retirement. The study deployed a descriptive study design. The target population in this study was 561 pensioners in Jubilee Insurance and 8 heads of pensions business, finance, legal services, internal audit, operations, information and communication technology, actuary, business development and strategy and business development departments. The sample size of this study was obtained by use of Krejcie and Morgan formula of determining sample size. As a result of the small number of heads of departments, they were not sampled. Through systematic sampling a sample of 288 pensioners was selected from the list of pensioners in Jubilee Insurance. The findings from the study led to a conclusion that mobile application has a positive and significant association with dissemination of information for pension claims processing in Jubilee Insurance. It was further revealed that text messages have a positive and significant influence on dissemination of information. Concerning unstructured supplementary service data (USSD) it was concluded that it has a positive and significant influence on dissemination of information. The study findings also revealed that voice calls have a positive and significant influence on dissemination of information for pension claims processing in Jubilee Insurance.

A digital self-care intervention for Ugandan patients with heart failure and their clinicians: User-centred design and usability study.

BackgroundThe prevalence of heart failure (HF) is increasing in Uganda. Ugandan patients with HF report receiving limited information about their illness and associated self-care behaviours. Interventions targeted at improving HF self-care have been shown to improve patient quality of life and reduce hospitalizations in high-income countries. However, such interventions remain underutilized in resource-limited settings like Uganda. This study aimed to develop a digital health intervention that enables improved self-care amongst HF patients in Uganda.MethodsWe implemented a user-centred design (UCD) process to develop a self-care intervention entitled Medly Uganda. The ideation phase comprised a scoping review and preliminary data collection amongst HF patients and clinicians in Uganda. An iterative design process was then used to advance an initial prototype into a functional digital health intervention. The evaluation phase involved usability testing of the intervention amongst Ugandan patients with HF and their clinicians.ResultsMedly Uganda is a digital health intervention that allows patients to report daily HF symptoms, receive tailored treatment advice and connect with a clinician when showing signs of decompensation. The system harnesses Unstructured Supplementary Service Data (USSD) technology that is already widely used in Uganda for mobile phone-based financial transactions. Usability testing showed Medly Uganda to be both acceptable and feasible amongst clinicians, patients and caregivers.ConclusionsMedly Uganda is a functional digital health intervention with demonstrated acceptability and feasibility in enabling Ugandan HF patients to better care for themselves. We are hopeful that the system will improve self-care efficacy amongst HF patients in Uganda.

Use of Simple Mobile Technology to Create an Electronic Vaccination Registry in Kenya

Vaccination is one of the high-impact public health interventions against the spread of disease. Over time, developed countries have been able to reduce the burden of disease through improving access to vaccination and achieving high vaccine coverage. In low-income countries, the situation is different as most countries still report low coverages of less than 90%, which is the global target recommended by the World Health Organization. The main reasons for this low coverage include poor access to vaccination, stock-outs, and poor documentation and targeting for vaccination services. To address these problems, we developed an electronic vaccine registry using Unstructured Supplementary Service Data (USSD) technology that registered births, vaccines administered and sent short message reminders to mothers about their clinic dates. The study was conducted in Nyandarua County, Kenya, between June 2018 to March 2019. To participate in the study, mothers had to reside within the jurisdiction of the study site. Mothers who moved into the study site also had their children registered and previous vaccines updated. A total of 4,823 births and 20,515 vaccines administered were captured into the system. The system sent 12,554 short message reminders to mothers; 3 days before the due day and on the due day. Additionally, it generated a birth register, vaccination register, defaulter list, dropout rate report, vaccine coverage, and timeliness reports. The intervention improved vaccination coverage and timeliness of vaccination by up to 8.7%.